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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

Rebellion in EM 2019: 3 Things That Have Changed the Way I Intubate

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lunes, 22 de abril de 2019

Orthostatic Vitals

R.E.B.E.L.EM - April 22, 2019 - By Anand Swaminathan 
..."Authors Conclusions: 
“In a cohort of older adult patients presenting with syncope who were able to have orthostatic vital signs evaluated, abnormal orthostatic vital signs did not independently predict composite 30-day serious outcomes.”
Our Conclusions: 
Abnormal orthostatic vital signs or symptoms are not associated with an increased risk of adverse outcomes at 30-days.
Potential to Impact Current Practice: 
This is another study demonstrating the disutility of orthostatic vital sign measurements in the ED. Not only are the performance characteristics poor for predicting mild to moderate volume loss, but they also cannot be used to risk stratify for bad outcomes. While there may be select patients that can benefit from obtaining orthostatic vital signs, they should not be routine for elderly patients presenting with syncope or near-syncope.
Bottom Line: 
In this secondary analysis of patients aged ≥ 60 years, abnormal orthostatic vital signs do not predict serious 30-day outcomes and should not be used as a routine assessment in syncope."