Hold the beanbag in place while a nurse connects suction to the bag's
valve. The suction removes air from the bag, and it wraps around your
patient as the Styrofoam beads inside conform to the shape of your
patient's shoulders and neck. You and 2 others should help mold the
bag as it deflates to ensure it fits tightly around your patient's upper
back and shoulders.
• Proper ventilation. Having a patient in Trendelenburg can disturb
the blood flow circulating from the head, resulting in facial or laryn-
geal edema during and immediately following a procedure. This is
especially true with longer surgeries, like robotic prostate surgery,
J A n U A R Y 2 0 1 8 • O U T PA T I E N TS U R G E R Y. N E T • 7 9
The risk of a patient developing deep vein thrombosis (DVT) dur-
ing or following a procedure intensifies when that patient is put in
a reverse Trendelenburg position, according to several studies,
one of which reported that the reverse Trendelenburg position
decreased femoral blood flow by 42% in patients undergoing
laparoscopic cholecystectomies.
Since there's decreased blood flow from the leg in a reverse
Trendelenburg position, patients are more likely to suffer venous
stasis — or blood pooling — which can lead to a clot in the leg.
In order to avoid this during prolonged surgeries, you can place
a compression stocking over a patient's leg, which they should
keep on their leg following the procedure, until they're fully
mobile.
Additionally, an intermittent pneumatic compression device
(IPC) over your patient's leg can help improve blood flow by put-
ting alternating amounts of pressure on the lower limb.
— Anna Merriman
BEWARE OF DVT
Reverse Trendelenburg Can Cause Clots
