orthostatics: useless?

8 Jan

came across this great video via LITFL: a quick talk 2410395945_a7240381d1by Anand Swaminathan, which looks at the (limited) evidence for orthostatics in the ED.

here’s the link (only 7-ish minutes, worth the watch):

http://lifeinthefastlane.com/futility-orthostatic-measurements/

 

QUICK TAKEAWAYS:

orthostatics (change in vital signs with positional change) is different from symptomatic orthostasis (stand up, feel lightheaded)  –[personally, I care about the latter, not so much the former]

a large number of asymptomatic patients have orthostatics by numbers (~50%)

orthostatics in moderate blood/fluid loss ~25%-range sensitivities (pulse change)

 

BOTTOM LINE:

orthostatic vital signs not particularly helpful

There you go.

 

References: LITFL post; picture

 

 

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