How to measure orthostatic vital signs

A patient involves the emergency room complaining of dizziness. Postural hypotension is suspected. The provider orders orthostatic vital signs. But how exactly do you get them?

When measuring orthostatic vital signs, blood pressure and heart rate are measured in two positions: supine and standing. Measurement in a sitting position might also be included.

Begin by asking the patient to lie on his back. Wait three to 10 minutes before taking your vital signs. Record your pulse and blood pressure. Then ask the patient to rise up (under supervision). Within three minutes of standing up, record your heart rate and blood pressure. Alternatively, you possibly can ask the patient to sit up and record their heart rate and blood pressure inside three minutes.

A drop in blood pressure of a minimum of 20 mmHg for systolic blood pressure or a minimum of 10 mmHg for diastolic blood pressure indicates orthostatic hypotension.
Remember…

• A digital oscillatory blood pressure cuff could also be helpful, allowing multiple readings and allowing the nurse to stay alert to the patient’s dizziness.
• For accurate readings, the suitable size blood pressure cuff is needed.

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and interviewing (thirteenth ed.). Wolters Kluwer Health: Philadelphia.