felltoddman

I used to work in a cardiovascular outpatient unit where one of the procedures done called a Tilt Table Test. We would use the tilt table to stand them up about 70 degrees. The indication for the test is syncope and usually, the obvious causes had been ruled out. Basically, the patient stands for up to 45 minutes. The patient is on the monitor and the NIBP is set for every 2 minutes, and if there have been no significant symptoms at 30 minutes, we would give the pt. 0.4 mg of nitro SL (provided the doctor was either in the room or at the nurse station). The BP would then be checked at least every minute, although most of us just put it in "stat" mode. Many times we would see long pauses (up to 2 or 3 screens, sometimes). Sometimes patients would pass out and we'd only see a drop in BP but no significant drop in HR. At any time during the test, if the pt passed out, we'd put the table down to supine and the test was done. If they didn't pass out within 15 minutes of the nitro, we laid them down and the test was considered negative. I believe the doctors said that 25% of the time, a pt with vaso-vagal syncope would test negative. The point I'm trying to make is we would cause the patient to "vagal" then lay them down and give them half a liter of 0.45 NS. And they were usually ready to go home in about 45 minutes to an hr. I'd also give them water &/or juice to drink and offer them some food. In 10 yrs doing the test, I think I gave atropine twice. The patient would feel better after the IVF and even more so after eating.