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North Carolina College of Emergency Physicians

Standards Procedure (Skill) Orthostatic Blood Pressure Measurement

Clinical Indications: Patient situations with suspected blood / fluid loss / dehydration. Patients > 8 years of age, or patients larger than the BroselowLuten tape



Procedure: 1. 2. 3. 4. 5. 6. 7. 8. 9. Assess the need for orthostatics. Obtain patients pulse and blood pressure while supine. Have patient stand for one minute. Obtain patients pulse and blood pressure while standing. If pulse has increased by 20 BPM or systolic blood pressure decreased by 20 mmHg, the orthostatics are considered positive. If patient is unable to stand, orthostatics may be taken while the patient is sitting with feet dangling. If positive orthostatic changes occur while sitting, DO NOT continue to the standing position. Document the time and vital signs for supine and standing positions on/with the patient care report (PCR). Determine appropriate treatment based on protocol.

Certification 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.

Version: 2005

Procedure 38