Emergency Medical Technician (EMT) Intermediate Practice Exam

What constitutes positive orthostatic vital signs in a patient?

1. The heart rate increases upon standing

2. The systolic pressure drops upon standing

3. The diastolic pressure rises upon standing

4. The respiratory rate decreases upon standing

The correct answer is: The systolic pressure drops upon standing

Positive orthostatic vital signs are indicative of a patient's physiological response to changing positions, specifically when moving from a supine or sitting position to standing. In this context, a significant drop in systolic blood pressure is a hallmark of orthostatic hypotension, which occurs due to the body's inability to adequately adjust blood flow and maintain blood pressure in the upright position. When a person stands, gravity causes blood to pool in the lower extremities. The body normally compensates for this by increasing heart rate and constricting blood vessels to maintain adequate blood pressure. A drop in systolic pressure upon standing suggests that these compensatory mechanisms are inadequate, which can lead to symptoms like dizziness and fainting. This understanding is critical in assessing a patient's circulatory stability and can signal underlying conditions such as dehydration, heart issues, or significant blood loss. Other options describe physiological changes that may not necessarily indicate a positive orthostatic response. For example, an increased heart rate is a normal compensatory mechanism, not a definitive sign by itself. A change in diastolic pressure or a decrease in respiratory rate upon standing do not correlate with the diagnostic criteria for orthostatic vital signs, which primarily concern systolic blood pressure changes.