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Use of the trendelenburg position to improve haemodynamics during hypovolaemic shock

Report by Nicolas Kettaneh, Medical student

Search checked by Jeffrey S Jones, Research director, emergency medicine

Institution: Grand Rapids Medical Education and Research/Michigan State University

Clinical scenario

A 28-year-old man with a gunshot wound to the leg presents to the emergency department in hypovolaemic shock. Among other things, you place the patient in the Trendelenburg position, with the body tilted so that the feet are higher than the head. You wonder if this position actually improves haemodynamics.

Three-part question

In [adults with hypotension] does the [Trendelenburg position] improve [haemodynamics]?

Search strategy

Medline and Embase databases searched via OvidSP interface in June 2010. [shock.mp OR hypovol$.mp OR hypotensi$.mp] AND [trendelenburg.mp OR head-down tilt.mp] LIMIT …

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