Intravenous pressors, etc.

[Kasi]

I don't know if this is the right forum for this, but can anyone direct me to a website that describes intravenous pressors, intravenous fluid bolus and/or the Trendelenburg procedure. I have googled them without much success. Or, if anyone would like to share with me how they are used to control bleeds especially in people with blood disorders, I would appreciate it.
Thanks!

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[docB]

Those things don't specifically concern people with blood disorders. They don't control bleeding. They are things used to treat patients with hypotension or shock from various causes. Trendellenberg position simply means putting the pateint in a head down position by lowering the head of the gurney (or elevating the foot of the board in an ambulance). The assumption is that it will help increases blood flow to the brain. My understanding is that the data doesn't support it. Pressors are medications, usually given in drips, that raise blood pressure. That's a massive oversimplification but it'll do for now. Pressors have lots of bad side effects like poor peripheral blood flow, increased cardiac oxygen demand and so on. They are used on the sickest patients.

 

[BKN]

. Pressors . . . are used on the sickest patients . . .

unsuccessfully.

 

[Kasi]

Thanks for the info. Oversimplication is fine for my purposes.

This is what I read on the Trendelenburg Procedure:
The Trendelenburg procedure, introduced by Friedrich Trendelenburg in the late 1800s, was a method of vein treatment in which the saphenous vein was ligated through a midthigh incision. This procedure was later modified by Trendelenburg's student Perthes, who advocated a groin incision and a saphenofemoral ligature. Although called the Trendelenburg procedure, the midthigh ligation procedure was actually performed as early as the seventh century. Through the ages, the vast majority of patients who have been treated for varicose disease have undergone some variant of this procedure.

http://www.emedicine.com/med/topic2788.htm

Is this procedure still used? Do you think that current reference to Trendelenburg are really referring to the position and not the procedure?

Thanks!

 

[BKN]

Than

Is this procedure still used? Do you think that current reference to Trendelenburg are really referring to the position and not the procedure?

Thanks!

No. Yes. and incidentally Trendelenburg's position was originally head up. Reverse trendelenburg was head down. Somehow it turned around in the 30+ years since I started.

 

[In da know]

My input would be in theory that high enough dosages of levophed or epinephrine gtts would result in significant vasoconstriction which might reduce blood flow.....It will probably be arterial primarlily and do nasty things to every other organ system but I think if you turned it up high enough it would kill the flow.......For the sake of learning anyone ever have an accidental encounter. I've seen plenty of blue extremities from high dose pressors.