The reality of patient positioning is a bit more pragmatic. I've only heard about relieving thoracic pressure/uterine pressure on the inferior vena cava for pregnant women.Įxcept, aspiration pneumonia, ARDS, septic shock and the such develop into systemic problems regardless of the location of the initial insult. Even if you're in the 'airway seat' (immediately behind the driver), you've got to roll the patient back to the left (if they're right lateral recumbant), in order to do any interventions should the airway lose its patency. While in the ambulance, it's a little difficult to observe the patient's airway and signs of cyanosis if they're facing away from you. Since the great curvature is to the left, it stands to reason that any gastric content would therefore be spread out over a larger area, keeping the content level away from the cardia. While the 'stomach thing' actually makes sense, as even a half full stomach would put the fluid level below the cardia, reducing regurgitation and subsequent aspiration risk. I've heard the same things for the same reasons. But why is it this big rule I seem to hear all over? Why must it be to the left side? It would make sense as a position for a post-arrest patient who is now breathing or shock patients, perhaps. Fourth does make sense, but it has nothing to do with aspiration and it assumes that all patients are in some kind of blood pressure / preload distress. The third isn't great, because it only applies once patient is on gurney. The first two don't quite sound legitimate enough. It helps pre-load by not having thoracic pressure on inferior vena cava In the ambulance, attendant can watch him better facing toward him. Stomach curves to left, so contents won't be pushing against sphincter. Stomach curves to the left, so vomit would have an extra curve to overcome I was originally told it was to prevent aspiration, but no one can really explain why the LEFT side. Is there scientific reason for the LEFT side, specifically? You hear it a lot to put altered patient "left lateral" or in "recovery position" but on their left side (even if NOT pregnant).
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