Dangling: a review of relevant physiology, research, and practice

Although dangling is a common nursing intervention, little research has been conducted to test its effectiveness or to compare various dangling methods. By contrast, abundant information is available about orthostatic responses. In this article the authors explain the physiologic principles underlying orthostatic responses, focusing on blood volume distribution and the role of the mechanoreceptors, discuss typical and atypical responses to dangling and standing, describe clinical manifestations of orthostatic hypotension and syncope, present research-based practice guidelines, and, provide specific recommendations for future research. Because of the wide variability in heart rate and blood pressure responses to orthostasis, the authors stress the importance of signs and symptoms such as nausea, pallor, dizziness, visual dimming, and impaired consciousness in assessing orthostatic tolerance. Studying rituals such as dangling can advance nursing practice, improve patient outcomes, and move nursing to a research-based practice.