the 100% directionless thread

usafmedic45 said:
Yeah, if you decompress the abdomen, you will cause the BP to bottom out. It's one of the reasons why so many patients who crash in the operating theater do so when their belly is opened initially.
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wow, i did not know about opening the abdomen. is it because of the normal pressure of everything being contains in the abdominal cavity ? Am I thinking along the right line thought?
 
is it because of the normal pressure of everything being contains in the abdominal cavity ? Am I thinking along the right line thought?
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I believe it has something to do with a vagal response but don't hold me to that.
 
But the vagal response has do with the Vagas nerve affecting heart rate. how can it affect the blood pressure drop due to opening the abdomen ?
 
What do you think happens when your heart doesn't pump as much :-)
 
Sasha said:
What do you think happens when your heart doesn't pump as much :-)
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Yea but how does that relate to opening the abdomen up? heartrate is not being affected that much ? or is it? usa sayed that the bp drops at the beginning of surgery. when they'd first open up the abdomen.
 
foxfire said:
Yea but how does that relate to opening the abdomen up? heartrate is not being affected that much ? or is it? usa sayed that the bp drops at the beginning of surgery. when they'd first open up the abdomen.
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He also said that it causes a vagal response. Vagal response drops down your heart beat, and since your heart is beating less the pressure in your vessels drop..
 
I can't remember if it is a vagal response or not but I know it has to do with the abrupt drop in intra-abdominal pressure.
 
Actually, it's more likely just a decrease in back pressure against the vessels in the abdomen which explains how you can drop someone's intracranial pressure by performing a decompressive laparotomy.
 
usafmedic45 said:
I believe it has something to do with a vagal response but don't hold me to that.
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I think it has something to do with the aldesterone / angiotension system and sodium. But Google is not helping me, at the moment...

We were explained it back in my new employee academy at my current agency, as we have / do foley's, and they explained it so that we do a quick flush of the foley line to make sure it works, but to shut it off right away and not attempt to empty the bladder.



But like you said, don't hold me to that. ;)
 
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I think it has something more to do with the aldesterone / angiotension system and sodium
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That shouldn't cause a rapid drop in the BP, etc.
 
...but renin is released based on blood flow past the juxtaglomerular apparatus, not the volume in the kidney.
 
Linuss said:
Think it had to do with a cascade effect?


11pm, so sue me.




You're the more experienced and educated person here, you should know it!
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Yeah, it would take a while to have an effect (and as JP pointed out the issue is blood flow, not back pressure) where as abruptly dropping the intraabdominal pressure in a hypotensive patient is going to drop their BP precipitously in a lot of cases, especially if the patient is hypovolemic.
 
Meh, I'll have to see if I can't email the CVICU nurse who taught our academy, as I know he explained why. But this was nearly a year ago, and I haven't done a foley in a trauma patient in... ever.


Too bad he's now working down near Jimi...
 
Linuss said:
Meh, I'll have to see if I can't email the CVICU nurse who taught our academy, as I know he explained why. But this was nearly a year ago, and I haven't done a foley in a trauma patient in... ever..
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Occam's razor my friend. What I have found with a lot of nurses, etc is that they try to come up with the most overly complicated explanations for things that are ridiculously simplistic as a way of trying to show off how much they know.
 
Could it be simply to ensure that the bladder is still patent?
 
Just finished an IFT. Total time 9 mins 32 seconds from on scene time till the time we cleared. Now back to main for end of shift.
 
firefite said:
Just finished an IFT. Total time 9 mins 32 seconds from on scene time till the time we cleared. Now back to main for end of shift.
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what you transported from one floor to another? Do orderlies not exist anymore?
 
silver said:
what you transported from one floor to another? Do orderlies not exist anymore?
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5150 transport from a hospital to a physc facility .9 miles away.
 
firefite said:
5150 transport from a hospital to a physc facility .9 miles away.
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Royal Court Health Care (SNF) to Presbyterian Intercommunity Hospital (PIH). Right across the side street.
 
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