Postural Vital Signs

How To Assess for Volume Depletion

1.  Have the patient lie down for 5 minutes, to normalize V/S

2.  Take the Pulse & B/P

3.  Have the patient stand up abruptly
  • Do NOT have them sit first [you want to stress their system, not be nice to them]
4.  Patient remains standing for 2 minutes
  • You wait right beside them, to ease them back on the bed if they begin to fall

5.  Repeat the Pulse, also the B/P

Findings Suggestive of Volume Depletion

1.  Pulse rate increase (>20%)
2.  Pulse Pressure Narrows
3.  B/P Falls

Validity of Evidence

None.  I’ve searched countless reviews & PubMed entries without success.  But I still perform the test to help determine whether a patient with significant vomiting / diarrhea might benefit from an IV.