Step 2 CS: Orthostatic vitals and other "non-routine" PE

[DrMetal]

---

Members don't see this ad.

Hi,

Do you actually take orthostatics VS during the patient encounter, if pertinent? Or, do u just write in your note that it should be done?

I know you dont do rectal/GU/GYn exams, but if indicated, we should state that to the SP, right? Will the SP ever give you simulated results?

Thanks

 

[emboli]

Hi,

Do you actually take orthostatics VS during the patient encounter, if pertinent? Or, do u just write in your note that it should be done?

I know you dont do rectal/GU/GYn exams, but if indicated, we should state that to the SP, right? Will the SP ever give you simulated results?

Thanks

The consensus is orthostatics should go in the work-up. just not enough time to do it the right way.

Regarding rectal/gu/gyn exam stuff... you should inform them that that is the plan. but they will always be in role.. so they won't give you any simulated results.

 

[zstranger2]

The consensus is orthostatics should go in the work-up. just not enough time to do it the right way.

Regarding rectal/gu/gyn exam stuff... you should inform them that that is the plan. but they will always be in role.. so they won't give you any simulated results.

Actually there is enough time to do it the right way. The problem is there won't be enough time to do other things that are more important for passing.

 

[DrMetal]

Regarding the diagnostic workup: do you (should you) provide some indication a to when you would do the specific test that you're suggesting?

For instance, in the case of a headache, you might suggest CT/MRI of the head, although of course that would not be the next step. Should you indicate that you'd want the scans 'later on', if the sx are persistent and the pt is unresponsive to first treatment?

 

[C5toC9]

in First Aid for CS, they mention orthostatics in the physical exam part, and not in the planned work-up

i assume this means we should do it during the physical exam?

 

[LossForWords]

in First Aid for CS, they mention orthostatics in the physical exam part, and not in the planned work-up

i assume this means we should do it during the physical exam?

I looked for this same thing online and I found many people that said they put orthostatics in their work up rather than try to fit them in in the 5 minute physical. The orientation video for CS says that you should accept the door vital signs as true, but you can repeat them if you want. However, whatever vital signs you obtain in the room don't go in your patient note and you should list whatever was on the door chart.

The way I interpret that is why take the time to repeat vitals if they can't go in your note and won't change your differential? You can't rule in or rule out orthostatic hypotension with your measurements, so just save the time and list it in your work up.

 

[DrMetal]

I looked for this same thing online and I found many people that said they put orthostatics in their work up rather than try to fit them in in the 5 minute physical. The orientation video for CS says that you should accept the door vital signs as true, but you can repeat them if you want. However, whatever vital signs you obtain in the room don't go in your patient note and you should list whatever was on the door chart.

The way I interpret that is why take the time to repeat vitals if they can't go in your note and won't change your differential? You can't rule in or rule out orthostatic hypotension with your measurements, so just save the time and list it in your work up.

Agree, well said .... The same logic could apply to other time consuming tests (I think they just wanna see that you're at least thinking about it)