![]() This position is often used to help venous return to the heart and restore adequate brain perfusion in individuals with hypotension. Our Clinical Education team of Registered Nurses and other licensed health care professionals provide education on topics such as Early Mobility in the ICU, Nursing Considerations for Prone Positioning, Skin Care Guidelines, and assistance with protocol development. The purpose of this retrospective study is to repeat the investigation after adopting a recent policy change of 10-degree Reverse Trendelenburg position as the routine for surgical patients, unless deemed inappropriate by either the anesthesiology or operating room nursing staff. A trendelenburg position is when the patient is lying on their back with their hips and knees flexed at a 90-degree angle. The modified Trendelenburg position is when the individual laying flat on their back with their head level to their body and their legs are passively raised. The post-operative length of hospital stay was 2 days longer with hypoxemia, compared to no hypoxemia (p <0.0001) and this represented a total of 300 additional days for the 2 months of the study. Trendelenburg/Reverse☑6° Batterybackupsystem Underbedlighting Onepointofcontactfor bariatricwidthexpansion CPRreleasehandles Integratedscale Bedexitalarmwithnurse call Omni-wheeldrivesystem. Likewise, previous work by this group showed a 30% perioperative hypoxemia rate, which was significantly associated with horizontal positioning. There is substantial operating room, ICU, and animal investigative evidence that aspiration occurs despite the presence of a cuffed endotracheal tube. Other investigations have shown a profound relationship between horizontal positioning and intra-operative aspiration. Similar to the Trendelenburg position, patients will need restraints to keep them from sliding off the table. Here, the patient is flat but the table is moved so the head is higher than the legs. During intensive care unit (ICU) mechanical ventilation, the Institute for Healthcare Improvement recommends elevating the head of the bed to prevent pulmonary aspiration and VAP. The reverse Trendelenburg position flips what we described for the original Trendelenburg’s position. However, evidence from the literature demonstrates that the supine position in mechanically ventilated patients is a risk for aspiration and ventilator associated pneumonia (VAP). Most patients undergoing general endotracheal anesthesia are in the supine or horizontal position. However, the diagnosis is presumptive when there is intraoperative or postoperative development of a new chest x-ray infiltrate and attendant tachypnea, hypoxia, wheezing, or changes in ventilator airway pressures. The finding is certain when there is aspiration of bile or particulate matter from the tracheobronchial tree or there is endoscopic visualization. Furthermore, aspiration diagnosis can be imprecise. Relevant studies are retrospective chart reviews or results from voluntary reporting databases. In part, this ambiguity relates to the lack of prospective data. In addition, reliable estimates of aspiration rates are uncertain. Intraoperative pulmonary aspiration can cause death and lead to morbidity. ![]() Why Should I Register and Submit Results?. ![]()
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