Dear Mamame,
Yesterday was spent sending on the material and writing several long letters. I did utilize the F.E.A.S.T. site and got the DSM IV criteria from there. In the process, I wrote a "layman's" description of how to do orthostatic measurements. If you have any corrections or modifications and have a minute, please let me know. I think it would be helpful to have this described on the F.E.A.S.T. site under diagnosis. How would I go about suggesting that? Thank you for your help. I feel like I have a strong right arm that's the fastest draw in the west for getting these links! Cheers!!!
For the sake of time, I am writing this to you in my own words. If you need clinical documentation, please let me know. I will provide it.
1. Patient lies flat (no pillow), resting for 5 minutes
2. Blood pressure and pulse are taken and recorded
3. Patient stands quietly for 2.5 minutes
4. Blood pressure and pulse are again taken and recorded
Then the results are assessed by subtracting the beginning levels from the ending levels for pulse and systolic measurements:
Indications for monitoring of activity level:
Pulse: >15 bpm increase in heart rate. At this level all activity MUST be restricted. Fluid intake must be increased. This means no sports, no PE, and only walking between classes, not to and from school. A wheelchair is required if there is to be walking for any distance. Just consider, if the heart is working this much harder just to pump the blood from the feet to the brain after standing for 2 ½ minutes, it does not have the strength for anything more strenuous.
Indications for hospitalization along with clinical judgment:
Severe bradycardia (low pulse rate): <50 bpm (beats per minute)
Hypotension: Blood pressure <80/50
Orthostatic hypotension: >20-30 bpm increase in heart rate
>10-20 mm Hg drop in systolic BP
Please ask if you have any questions or need clarification.
Click to read inspiring messages from this community's members