Establishing Standards of Orthostatic Measurements in Normovolemic Adolescents

Horam, William Joseph

doi:10.1001/archpedi.1992.02160190080026

Cited by 8 publications

(13 citation statements)

References 14 publications

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“…In a contrasting population, different blood pressure changes were found in a convenience sample of 100 normovolemic adolescent patients, ages 12 to 19 years, in a study by Horam and Roscelli (1992). The mean SBP change ranged from a 17 mmHg decrease to a 19 mmHg increase, and diastolic blood pressure change ranged from a 7 mmHg decrease to a 24 mmHg increase.…”

Section: Blood Pressurementioning

confidence: 97%

“…A review of definitions from the literature indicates that the assessment parameter labeled as orthostatic vital signs can be summarized by its: physiological variables, measurement method, and purpose. The physiological variables include blood pressure, heart rate, and stroke index (Durukan et al, 2009;Fuchs & Jaffe, 1987;Horam & Roscelli, 1992;KoziolMcLain et al, 1991;Levitt et al, 1992;Witting & Gallagher, 2003), as well as symptoms of dizziness or lightheadedness (Lance et al, 2009;Sarasin et al, 2002). Stated purposes of orthostatic vital signs assessment include identification of hypovolemia (both dehydration and blood loss) and treatment efficacy of pharmacological agents for neurological conditions.…”

Section: Summary Of Definitionsmentioning

confidence: 99%

“…For the purposes of this document, orthostatic vital signs are defined as a change in blood pressure, heart rate, or onset of symptoms after a change in position in individuals (adult, child, and adolescent) with a decrease in intravascular volume (Durukan et al, 2009;Fuchs & Jaffe, 1987;Horam & Roscelli, 1992;Koziol-McLain et al, 1991;Levitt et al, 1992;Witting & Gallagher, 2003).…”

Section: Summary Of Definitionsmentioning

confidence: 99%

“…These findings suggest the physiological response to position changes yields a different blood pressure response in adolescents compared to hypovolemic adults. Compensatory mechanisms that may influence the blood pressure response in adolescents include: baroreceptor activity, arteriolar vasoconstriction, capillary hydrostatic forces, renin aldosterone stimulation and antidiuretic hormone release (Horam & Roscelli, 1992). Given the wide variability of orthostatic vital signs in the adolescent population, further research is warranted.…”

Section: Blood Pressurementioning

confidence: 99%

See 3 more Smart Citations

Emergency Nursing Resource: Orthostatic Vital Signs

Naccarato¹,

Leviner²,

Proehl³

et al. 2012

Journal of Emergency Nursing

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Section: Blood Pressurementioning

confidence: 97%

Section: Summary Of Definitionsmentioning

confidence: 99%

Section: Summary Of Definitionsmentioning

confidence: 99%

Section: Blood Pressurementioning

confidence: 99%

See 2 more Smart Citations

Emergency Nursing Resource: Orthostatic Vital Signs

Naccarato¹,

Leviner²,

Proehl³

et al. 2012

Journal of Emergency Nursing

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“…Various studies have used lying times that ranged from 2 minutes to 30 minutes, with 5 to 10 minutes being the most common (Atkins, Hanusa, Sefcik, & Kapoor, 1991;Cybulski, 1996;Mader, Palmer, & Rubenstein, 1989;Nozawa, Imamura, Hashimoto, Nakayama, & Murakami, 1997;Nozawa, Imamura, Hisamatsu, & Murakami, 1996;Robertson, 1998) (see Table 1). The duration of standing also showed wide disparity, varying from immediately standing to 10 minutes, with 1 to 4 minutes being the most common (Atkins et al, 1991;Horam & Roscelli, 1992;Mader et al, 1989;Masuo, Mikami, Habara, & Ogihara, 1991;Nozawa et al, 1996Nozawa et al, , 1997Ooi, Barrett, Hossain, Kelley-Gagnon, & Lipsitz, 1997;Sidery & Macdonald, 1991;Walczak, 1991;Wieling, ten Harkel, & van Lieshout, 1991).…”

mentioning

confidence: 99%

Comparison of Different Methods of Obtaining Orthostatic Vital Signs

Lance

Link²,

Padua³

et al. 2000

Clin Nurs Res

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The purpose of this study was to compare two lying and standing procedures for measuring orthostatic vital signs. Thirty-five normotensive participants (mean age 21.6 years)participated in a randomized crossover study. Measures of blood pressure (BP), heart rate, and dizziness were collected at different lying and standing times. AU subjects participated in a standardized walk paced at 4 miles per hour prior to lying. Using analysis of variance (ANOVA) with post hoc contrasts, the mean systolic BP differed between 5 and 10 minutes of lying (F = 21.33, p < .001) and the mean diastolic BP tended to differ between those time points (F = 5.23, p < .03). The mean standing systolic BP and dizziness rating were different between 0- and 2-minute intervals (F = 8.36, p < .01 and F = 7.15, p < .10). In normotensive participants following standardized exercise, orthostatic vital signs stabilized after lying 10 minutes.

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Is This Patient Hypovolemic?

McGee

Abernethy²,

Simel

1999

JAMA

528

177

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In each of the following clinical scenarios, clinicians need to identify which physical signs reliably and accurately indicate volume depletion or dehydration. Case 1A 54-year-old man, taking ibuprofen for knee arthritis, presents with a 1-day history of melena. Physical examination reveals a pulse of 80/min and blood pressure (BP) of 140/82 mm Hg when supine, and 115 and 132/86 mm Hg when standing. There ismildepigastrictendernessandhemoccultpositive stool. The hematocrit is 0.39. Case 2A 62-year-old woman has 6 months of episodic vertigo and unilateral hearing loss, attributed to Ménière disease. She begins treatment with hydrochlorothiazide, but during a follow-up visit 3 weeks later, she reports her dizziness is slightly worse since starting the medication. Her heart rate is 80/min and BP is 160/84 mm Hg when supine, 88 and 134/72 mm Hg when standing. She experiences slight dizziness when standing. Case 3An 82-year-old nursing home resident presents to the emergency department with a 1-day history of nausea and vomiting. Her underlying medical problems include dementia, coronary artery disease, atrial fibrillation, emphysema, and hypertension. She has been treated with aspirin, isosorbide dinitrate, furosemide, bagonist inhalers, and lisinopril. The clinician diagnoses viral gastroenteritis or food poisoning because other members of the nursing home have an identical illness. On examination, the patient is afebrile, alert, and demonstrates normal speech and strength. Her mental status is no different from her baseline. The pulse is 75/min and the BP is 154/90 mm Hg supine, and 90 and 130/76 mm Hg when upright. The tongue, mucous membranes, and axillae are moist. Results of an examination of the heart, lungs, and abdomen and an electrocardiogram are normal. WHY IS CLINICAL EXAMINATION IMPORTANT?The term volume depletion describes the loss of sodium from the extracellular space (intravascular and interstitial fluid) that occurs after gastrointestinal hemorrhage, vomiting, diarrhea, and diuresis.

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Establishing Standards of Orthostatic Measurements in Normovolemic Adolescents

Cited by 8 publications

References 14 publications

Emergency Nursing Resource: Orthostatic Vital Signs

Emergency Nursing Resource: Orthostatic Vital Signs

Comparison of Different Methods of Obtaining Orthostatic Vital Signs

Is This Patient Hypovolemic?

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