Role of dangling when moving from supine to standing position

This article focuses on the cardiovascular adjustments that take place when an individual makes a change in his/her position, particularly when moving from the supine to the standing position (orthostasis). Some individuals may experience a drop in their blood pressure on assuming the standing position, which may lead to dizziness and/or fainting (orthostatic intolerance). Dangling, which is often an intermediary stage of assisting people into the sitting position with their legs hanging over the side of the bed, before moving them into the standing position, is therefore used to ensure that patients are moved safely. This can help to prevent notable reductions in blood pressure. Nurses, therefore, need to be aware of the cardiovascular changes and compensatory mechanisms that take place during orthostasis, in order to be able to make decisions not just about whether their patient can be moved out of bed, but so that it can be done safely without any of the adverse effects of orthostatic intolerance. Those at greatest risk of developing such adverse effects include those with diabetes mellitus, cardiovascular disease and also those with an age-related vagal dysfunction. Some pharmacological agents may also be implicated in contributing to orthostatic intolerance in some individuals. Recommendations for practice include ensuring that dangling the patient is incorporated as part of the procedure of slowly assisting patients out of bed, encouraging leg and foot movement and continually assessing the patient during the procedure. Should any patient show any sign of not tolerating the position change, the procedure should be halted and the patient assisted back into the supine position.