Each caregiver must combine scientific research with their own clinical experience to assess the needs of each patient individually. While some clinicians claim that Trendelenburg Position effectively delivers on its clinical promises, others believe that the scientific evidence speaks to the contrary and that the risks are substantial. 1 Is the Trendelenburg Position Actually Useful? 3, 4 Furthermore, experts advise against using TP for morbidly obese individuals. Additionally, there is concern for tidal volume and pulmonary compliance, venous pooling toward the head, cerebral edema, retinal detachment, brachial nerve paralysis, diminished lung capacity, and even aspiration. For example, risks can include sliding, shear, and pressure injuries. In addition to the lack of clinical evidence, some experts warn of serious risks that come from using Trendelenburg Position.
This produces results that are cloudy, at best. 2 Studies were also inconsistent in their administration of TP and/or mTP. More recent studies have been conducted however, a 2012 literature review proposes that sample sizes have been too small and positive effects have been minute and temporary. Out of those eleven patients, nine experienced no benefit from the Trendelenburg Position. For instance, a 1967 study by Taylor and Weil tested the effectiveness of the technique on six hypotensive patients and five normotensive control participants. Throughout history, studies on Trendelenburg Position have shown lackluster results, at best. Upon examination of the studies, it remains difficult to arrive at a clear answer. While some clinicians continue to tout the benefits, some believe that the Trendelenburg Position is an outdated technique with no use in modern medicine. 1 Objections to Using Trendelenburg Position Additionally, TP is commonly used in gynecological and genitourinary procedures. Surgeons also use TP on the operating table during lower abdominal surgeries and central venous catheter placement. Therefore, the position increases cardiac output through encouraging blood flow from the lower extremities. 2 In addition, proponents say that TP is useful for increasing venous return to the heart. Today, many still use TP as an immediate intervention to improve hypotension and hypovolemic shock. Arguments in Favor of Using Trendelenburg Position 3 Later, Cannon reversed his recommendation of TP, however, it remained popular within the medical community. As time went on, clinicians began using TP to prevent air embolism during central venous cannulation and to augment the effectiveness of spinal anesthesia. After the war, the technique became commonly used. 3ĭuring World War I, Walter Cannon, an American physiologist, was a proponent of TP as a treatment for shock. Originally, surgeons used the technique to improve the exposure and visibility of the pelvic organs. The creation of Trendelenburg Position is credited to Friedrich Trendelenburg, a 19 th century German surgeon. 2 Is Trendelenburg Position actually useful? In fact, this is a debate within the medical community.
1 The modified Trendelenburg Position (mTP) is a full recline of the body where the head and body are level, and the legs are slightly elevated. Clinicians usually administer TP at an angle of approximately 16°. Being sure to not keep resident sin these positions for too long.The Trendelenburg Position (TP) is a clinical technique where the body is tilted in the supine position so that the head is lower than the body and the legs. Then the standard Trendelenburg can help with blood flow. With the use of an over bed table, they can eat and watch telly. With anti-Trendelenburg set up on a profiling bed you can effectively maneuver the bed into seating position which allows those with restricted mobility to sit up and interact as such. Particularly when thinking about increasing posture in your residents. This position has been used to aid in breathing for bariatric individuals, this releases pressure from the head.Īlthough the likelihood of you needing to utilise this in your care home is low it is worth bearing in mind. This is the opposite of the standard Trendelenburg where the head is elevated above the feet at 30 degrees. At this angle more blood is flowing to essential organs allowing for better circulation. The main use of this bed position today is as a way to treat minor respiratory issues. This where the bed moves to a slope where the feet will be at the top and head at the bottom.įirst characterised in the late 19th century it was a means to gain greater access to certain areas during surgeries at the time. Most profiling beds in care environments will be able to assume the Trendelenburg position.