There is some confusion, disagreement, and misunderstanding surrounding orthostatic vitals in the ED. Older patients have a high rate of incidentally-found positive orthostatic vital signs, typically because of heart-rate changes. So emergency physicians may be reluctant to request orthostatics. However, in patients with syncope or falls, the presence of orthostatic hypotension and of symptoms may actually be helpful. It can help clarify the cause of syncope, potentially help avoid unnecessary testing or hospitalization, and can also help direct treatment and interventions to prevent future syncope or falls. In this episode, Maura Kennedy (@MauraKennedyMD) talks us through a recent paper she authored on orthostatic vitals in older adults in the ED.
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