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Tip/Trick of the Week- Orthostatic Vital Signs (assessing for hypovolemia)
Taking orthostatic vital signs on the scene, before, and after fluid therapy can be a big help to the ER when you are bringing in a patient who is complaining of dizziness, light headedness, or syncopal episodes and there is no clear cardiac cause such as bradycardia or other arrhythmia.
Orthostatic vital signs, also known as tilt testing or postural vitals, is an assessment tool used to identify patients with a fluid volume deficit such as dehydration. It assesses the patient in multiple positions and tests the cardiovascular response to the changes in position after a short period of time (usually 1 to 2 minutes).
Changes of greater than 20 mm Hg systolic in the blood pressure reading or greater than 10 to 20 BPM in the heart rate after a postural change may indicate that the person is low on fluids and may be a candidate for a fluid bolus. (Refer to your own protocols or to online medical control before administering such a bolus)
Follow the links below for more on vital signs and orthostatic or tilt testing.
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