This week's game of "What's Wrong With This Picture?

[fallout]

I've never understood trendelenburg

The patient is in shock and having a hard time pushing all the blood out to the body and extremities. If we tend to shut down the peripheral circulation then if the legs were up wouldn't the heart have a harder time pushing that blood into the legs especially if the patients extrems were shut down basically.

to me it's like this, think of pushing a barrel up a hill, it's pretty hard, wouldn't it be more logical to keep the legs at the same level as the heart? It's easier to push that barrel on a flat surface than up a hill.

Just my thoughts.

The logic is is that

1.) Venous return, which is a significant component of cardic output (Starling's Law of the Heart) is increased by lower extremity elevation.

2.) Fluids tend to run where the resistance is least, so in theory, the core regions are perfused vs the limbs.

[paramedicmike]

Ridryder gives an excellent description of what's going on here:

http://www.emtcity.com/phpBB2/viewtopic.ph...32&start=15

Let's not duplicate the discussion, please.

-be safe.

[jmac]

what is wrong with you people, in 11 days most people on this site will be bowing their heads in remembrance of the most diabolical terrorist attack ever.

this guy is evacuating a Pt from the area of terrorist bombings of his country and all you can do is take the piss and try to critique the way he is dressed and what way he has his PT.

what you are posting is in bad bad taste,especially around this time, would the comments be so jovial if it was 9/11 pic under discussion, this bombing only happened last week in three separate areas, try google.

i am very surprised at some and disappointed in others, is it a case that it is not terror unless it is in the US, and i would love to see some of the posters in the same situation with the same resources they had.

[NREMT-Basic]

Point well taken. If this was a 9/11 photo there wouldnt be so many yahoos writing ill mannered responses. THanks JMac

[DwayneEMTP]

what is wrong with you people, in 11 days most people on this site will be bowing their heads in remembrance of the most diabolical terrorist attack ever.

this guy is evacuating a Pt from the area of terrorist bombings of his country and all you can do is take the piss and try to critique the way he is dressed and what way he has his PT.

what you are posting is in bad bad taste,especially around this time, would the comments be so jovial if it was 9/11 pic under discussion, this bombing only happened last week in three separate areas, try google.

i am very surprised at some and disappointed in others, is it a case that it is not terror unless it is in the US, and i would love to see some of the posters in the same situation with the same resources they had.

Wow jmac...having a bad day? Other than not taking the question very serious I don't think there is anything wrong with us.

I did a search on the pic before I posted...no mention of terrorism and I'm not sure it would change my thinking if there was.

If you had been part of previous discussions of this type you would have see disclaimers such as "you weren't there, you don't know all the facts" ad nausium. Here we don't know ANY facts, therefore this is not judgment, it is simply a mental exercise.

'Not terror unless it's the U.S.'? Perhaps review some world history and you will see what an idiotic statement this is....

I will certainly bow my head again on 9/11. I also will never use a tragedy such as that to grandstand and attempt to prove my political correctness.

Sorry you got shaken up...

Dwayne

[NREMT-Basic]

1. Trendelenburg is not a myth and is a moderately effective method for managing shock.

2. The point is to shunt blood to the core.

3. Leave it to Rid to bash techniques which have been used forever, and with good reason, often just to hear himself talk

4. Trendelenburg is sort of negated by having the head raised as well.

Rid, perhaps you could stop bashing emts. Remember, a Paramedic is also an EMT. I know thats hard for you to accept but its true.

[fallout]

Eh, this was just a discussion. No argument here. Move Along. These are not the droids you're looking for.

[paramedicmike]

1. Trendelenburg is not a myth and is a moderately effective method for managing shock.

2. The point is to shunt blood to the core.

3. Leave it to Rid to bash techniques which have been used forever, and with good reason, often just to hear himself talk

4. Trendelenburg is sort of negated by having the head raised as well.

Rid, perhaps you could stop bashing emts. Remember, a Paramedic is also an EMT. I know thats hard for you to accept but its true.

Ok. Without hijacking this too much...did you even bother to read the above posted link? Have you googled this particular topic at all? Have you read any of the studies out there?

Expand your knowledge base a bit. Read the thread to which I posted a link. Do a search on the efficacy of the Trendelenburg position. And then go back to that above referenced thread and try to argue that it's worthwhile. I don't think you'll be able to do it.

It's nothing but a myth. Myth!

[(beautiful woman peeks out from behind the billboard): "Yes?"]

Oh...and Rid's forgotten more about emergency medicine and patient care than most here could ever hope to learn. Cut him some slack. He's earned it.

[DwayneEMTP]

1. Trendelenburg is not a myth and is a moderately effective method for managing shock.

2. The point is to shunt blood to the core.

3. Leave it to Rid to bash techniques which have been used forever, and with good reason, often just to hear himself talk

4. Trendelenburg is sort of negated by having the head raised as well.

Rid, perhaps you could stop bashing emts. Remember, a Paramedic is also an EMT. I know thats hard for you to accept but its true.

Yikes...what is going on here??

Basic...do a search on this subject and you will see that your statements are far from true.

(1) Trendelenburg is far from proven as an effective method of handling shock. (Did you look at the info from the previous posts?)

(2) Very few people support new people here and Basics in general like Rid does. (If you can't separate educational critique of the position from critique of the people that do the job then you're missing the point. Unfortunately for you, your stand on Trendelenburg makes this point for him.)

Is everyone just ticked off about something today? (I guess me too since they seem to be pushing my buttons )

Have a good day all...

Dwayne

[JPINFV]

1. Trendelenburg is not a myth and is a moderately effective method for managing shock.

2. The point is to shunt blood to the core.

3. Leave it to Rid to bash techniques which have been used forever, and with good reason, often just to hear himself talk

4. Trendelenburg is sort of negated by having the head raised as well.

Rid, perhaps you could stop bashing emts. Remember, a Paramedic is also an EMT. I know thats hard for you to accept but its true.

Leave it to someone who has a quote from Mythbusters to reject science fact for science fiction. Just because it 'makes sense' or 'has been used since the dawn of time' does not make it effective or worthwild.