Orthostatic vital signs

Orthostatic vital signs are a series of vital signs of a patient taken standing, supine and sometimes sitting to form a baseline for analysis and comparison.^[1][2][3] Used to identify orthostatic hypotension,^[4] orthostatic vital signs are commonly taken in triage medicine when a patient presents with vomiting, diarrhea or abdominal pain; with fever; with bleeding; or with syncope, dizziness or weakness.^[1] Orthostatic vital signs are not collected where spinal injury seems likely or where the patient is displaying an altered level of consciousness. Additionally, it is omitted when the patient is demonstrating hemodynamic instability,^[1] which term is generally used to indicate abnormal or unstable blood pressure but which can also suggest inadequate arterial supply to organs.^[5] Orthostatic vital signs are also taken after surgery.^[6]

The process of taking orthostatic vital signs is also called a "tilt test".^[4] A tilt test is judged to be "positive" when the blood pressure of the patient falls by more than 20 mm Hg or the pulse rises by more than 20 beats a minute.^[4][6] A tilt test that results in the patient growing significantly dizzy or losing consciousness is also judged "positive."

References

1. ^ ^{a b c} Grossman, Valerie G. A. (1 April 2003). Quick reference to triage. Lippincott Williams & Wilkins. p. 12. ISBN 9780781740227. http://books.google.com/books?id=CHK736L85vwC&pg=PA12. Retrieved 11 May 2010. 
2. ^ Beebe, Richard W. O.; Deborah L. Funk (6 March 2001). Fundamentals of emergency care. Cengage Learning. p. 219. ISBN 9780766814981. http://books.google.com/books?id=0AuoxgI7kKUC&pg=PA219. Retrieved 11 May 2010. 
3. ^ Knies, Robert C.. "Orthostatic Measurement". Emergency Nursing World!. http://enw.org/Research-Orthostatic.htm. Retrieved 2010-05-11. 
4. ^ ^{a b c} Beebe and Funk (2001), 218.
5. ^ Bailey, James (November 2003). "Hemodynamic instability". Clinical Window. http://www.clinicalwindow.net/cw_issue_15_article1.htm. Retrieved 2010-05-10. ^{[dead link]}
6. ^ ^{a b} Hubbell, Kelly A.; Andrea Novak; Emergency Nurses Association (25 April 2002). Emergency Care Technician Curriculum. Jones & Bartlett Learning. p. 14. ISBN 9780763719135. http://books.google.com/books?id=PKqXqB0W7CgC&pg=PA14. Retrieved 11 May 2010.