Tilt Table (Week 9) Flashcards
What is a Tilt Table
An electrically or manually controlled bed used to elevate a patient to upright position
What are the purposes of the tilt table exercises
-Reduction of osteoporosis and renal calculi
-Maintains vascular tone to prevent Orthostatic Hypotension
-Shifting of weightbearing to relieve pressure in other areas
-Preservation of morale
What is Orthostatic hypotension
The sudden drop of blood pressure upon assuming an upright position usually after prolonger bed rest
How many weeks of bed rest is there a complete impairment of the ability to adjust to an upright position
3 weeks of bed rest
What measures can be taken to prevent Orthostatic Hypotension (OH)
-Wrap pts lower extremities from the feet to the groin with elastic bandages
-Apply an abdominal binder
-Instruct pt to perform active ankle dorsiflexion-plantar flexion exercises frequently while supine or sitting
-Allow pt to accommodate to upright position in increments
What are the signs and symptoms of orthostatic hypotension
Pallor
Sweating
Dizziness
Lightheadedness
Low Systolic BP > or = 20mmHg drop
Low Diastolic BP > or = 10 mmHg drop
Increased HR; more than 20bpm
Fainting
What is the order in which you secure the patient on the tilt table
- Position Pt in proper alignment
- Feet flat on foot board
-Secure with Chest, Pelvic, and Knee straps
-Take vital signs
-Wrap legs with figure 8 pattern
What is the order in which you Tilt the patient on the tilt table IF BP is unchanged
- Tilt pt at 30 degrees
- Check BP and HR
-Remain at 30 degrees for 20 minutes
-Progress tilting by 5-10 degree increments
End goal is 75-80 degrees with stable vital signs
What do you do if the pts vital signs changes while on the Tilt table
Lower tilt by 5 degrees
Take BP and HR again
If unstable remain there for 15-20 minutes
If still unstable lower by 5 degree increments
What do you do if the end goal of the tilt table is achieved?
Progress to standing between bars
What can be done when the patient suddenly exhibits Orthostatic Hypotension
- Lower the tilt table
-Bandage lower extremities
-Massage the lower extremities from distal to proximal
How long should the patient be doing Tilt table exercises
At least 1x-2x a day for up to 10-30 minutes each session
What are the physiological effects of using the tilt table
- Increased circulation in upright position
-Increased urinary drainage
Musculoskeletal: Muscle tone increases in antigravity muscle, increased bone density
Neurologic: Sensory receptors of the soles of the feet, joint proprioceptors, muscle spindles, semicircular canals get stimulated
Respiratory: increased ventilation, gravity drains bronchioles
Tilt at 60 degrees onwards can give pt the physiological effect and sensation of standing upright
What are the indications for tilt table use
- Prolonged recumbence
-Generalized weakness
-Disturbance in balance
-Orthostatic hypotension/postural hypotension
What are the therapeutic benefits of tilt table usage
-Reintroduce patient to vertical position
-Facilitate early weight bearing
-Promote and maintain bone density in L/E
-Prevent muscle contracture
-improve lower limb strength
-increase arousal
-cardiovascular conditioning
-postural improvement
-decreases prolonged bed rest complications
