This is a steep head-down tilt so that the patient’s pelvis and legs lie above the heart. It is used to improve access, and to limit blood loss, during surgery to the pelvis. It has been used to treat shocked patients (see SHOCK), but, as the position increases pressure on the DIAPHRAGM and embarrasses breathing, raising the legs by themselves is better.
If an individual is unconscious – whether as a result of accident or illness or when in the postoperative recovery unit – but is breathing and has a pulse, he or she should be placed in the recovery position. The individual is turned on his or her side to allow the tongue to fall forwards and so reduce the likelihood of pharyngeal obstruction (see PHARYNX). Fluid in the mouth can also drain outwards instead of into the TRACHEA and LUNGS. The person can lie on either side with upper or lower leg ?exed. Sometimes the semi-prone position is used; this gives better drainage from the mouth and greater stability during transport, but makes it more di?cult to observe the face, colour or breathing. (See APPENDIX 1: BASIC FIRST AID.)... recovery position
the internationally accepted body position for anatomical descriptions, such that any part of the body can be related to any other part of it. A person in the anatomical position stands erect, the arms hanging by the sides with the palms facing frontwards and the legs and feet together with the toes pointing forwards (see illustration overleaf).... anatomical position
(BPPV) a common cause of vertigo in which the patient complains of brief episodes of rotatory vertigo precipitated by sudden head movements. It is thought to be due to microscopic debris derived from the *otoliths of the utricle and displaced into one of the semicircular canals, most commonly the posterior semicircular canal. The debris is most commonly thought to be free in the canal (canalithiasis; see canalith) but can be attached to the *cupula (cupulolithiasis; see cupulolith). Diagnosis is by performing a *Dix–Hallpike test. Treatment is with a predetermined set of head movements to move the debris from the semicircular canal (see Epley particle repositioning manoeuvre; Semont liberatory manoeuvre; Brandt-Daroff exercises). Surgery is occasionally used to occlude the relevant semicircular canal, cut the *singular nerve or vestibular nerves, or perform a *labyrinthectomy. Drugs are generally ineffective in the treatment of this condition.... benign paroxysmal positional vertigo
a special operating-table posture for patients undergoing surgery of the pelvis or for patients suffering from shock to reduce blood loss in operations on the legs. The patient is laid on his or her back with the pelvis higher than the head, inclined at an angle of about 45°. [F. Trendelenburg (1844–1924), German surgeon]... trendelenburg position
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