Are Orthostatic Vital Signs Helpful in the ED?

With Dr. Maura Kennedy

Christina Shenvi

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 talks us through a recent paper she authored on orthostatic vitals in older adults in the ED.


  • Kennedy et al. “Recondisering orthostatic vital signs in older emergency department patients” Emerg Med Australas. 2018, June 21. PMID 29931795

This podcast uses sounds from by Jobro and HerbertBoland

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Christina Shenvi


Dr. Christina Shenvi is an associate professor of Emergency Medicine at the University of North Carolina. She is fellowship-trained in Geriatric Emergency Medicine and is the founder of GEMCast. She is the director of the UNC Office of Academic Excellence, president of the Association of Professional Women in Medical Sciences, co-directs the ACEP/CORD Teaching Fellowship, is on the Annals of EM editorial board, is on the Geriatric ED Accreditation board of governors, and she teaches and writes about time management at

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