A physical therapist plans to use a tilt table for a patient who is having difficulty tolerating upright sitting. The therapist should stop inclining the tilt table when the patient experiences which of the following signs and symptoms?

A physical therapist plans to use a tilt table for a patient who is having difficulty tolerating upright sitting. The therapist should stop inclining the tilt table when the patient experiences which of the following signs and symptoms?

• A. Decrease in diastolic blood pressure of 15 mm Hg
• B. Increase in systolic blood pressure of 10 mm Hg
• C. Increase in heart rate of 15 bpm
• D. Decrease in oxygen saturation to 93%

Answer: (A)

When a tilt table is used, the person’s cardiovascular system must adjust to upright posture as gravity pulls blood toward the legs. A key safety signal during this maneuver is an orthostatic-type drop in blood pressure, which means cerebral perfusion can fall and symptoms like dizziness or fainting may occur. A decrease in diastolic blood pressure by about 15 mm Hg indicates a meaningful failure of the circulatory system to compensate to the upright position, so the therapist should stop inclining to protect the patient. Increases in systolic blood pressure or modest heart rate increases can be normal responses to tilt and aren’t by themselves reasons to stop. A small dip in oxygen saturation to 93% might raise concern, but the primary immediate stop criterion during tilt-table tolerance testing is a notable fall in blood pressure, which more directly reflects inadequate perfusion and risk of syncope.

When a tilt table is used, the person’s cardiovascular system must adjust to upright posture as gravity pulls blood toward the legs. A key safety signal during this maneuver is an orthostatic-type drop in blood pressure, which means cerebral perfusion can fall and symptoms like dizziness or fainting may occur. A decrease in diastolic blood pressure by about 15 mm Hg indicates a meaningful failure of the circulatory system to compensate to the upright position, so the therapist should stop inclining to protect the patient.

Increases in systolic blood pressure or modest heart rate increases can be normal responses to tilt and aren’t by themselves reasons to stop. A small dip in oxygen saturation to 93% might raise concern, but the primary immediate stop criterion during tilt-table tolerance testing is a notable fall in blood pressure, which more directly reflects inadequate perfusion and risk of syncope.