"Collapse Following Rising" Traumatic Brain Injury Caused by Postural Orthostatic Tachycardia-Syndrome

After syncopy in young women the presence of a POTS should be considered. An overreaching rise of pulse-rate while getting up, sitting up or just standing with potential orthostatic collapse but without significance decline of blood pressure is the typical constellation. Thereby injuries by dropping may occur and have to be treated due to actual trauma-algorithms. A specific medication doesnt exist in EMS but a moderate management of infusion and titrated application of vasoconstrictors could be necessary. Deliberate tests of provocation should be deferred to systematic clinical diagnostics.