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Orthostatic Blood Pressure Measurement

Clinical Indications: Last update 02/2009

    Patient situations with suspected blood, fluid loss, or dehydration with no indication for spinal immobilization. Patients > 8 years of age, or patients larger than the Broselow-Luten tape

Procedure:

    1. Gather and prepare standard sphygmomanometer and stethoscope.

    2. With the patient supine, obtain pulse and blood pressure.

    3. Have the patient sit upright.

    4. After 30 seconds, obtain blood pressure and pulse.

    5. If the systolic blood pressure falls more than 30 mmHg or the pulse rises more than 20 bpm, the patient is considered to be orthostatic.

    6. If a patient experiences dizziness upon sitting or is obviously dehydrated based on history or physical exam, formal orthostatic examination should be omitted and fluid resuscitation initiated.

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure. Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations, or other mechanisms as deemed appropriate by the local EMS System.

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