Vitals

• Normal SpO2 in a healthy person is 97–99%. A value of 95% is clinically acceptable in a patient with normal hemoglobin levels. A SpO2 of 90% is generally equivalent to a partial pressure of oxygen (PaO2) of 60 mmHg and warrants close monitoring. Values below 88% are typically a threshold to defer or stop therapy — see the defer guidelines below.

• Non-invasive, continuous monitoring of the heart's electrical activity. Telemetry is generally accurate, but position changes and patient movement can produce false readings — known as artifact. If a reading looks abnormal, check whether it coincides with movement before acting on it.

• An abnormal heart rate can signal that other vital signs are shifting. Always discuss cardiac rhythm with the nurse before entering the room.

  • Normal range: 60–100 bpm

  • Bradycardia: < 60 bpm

  • Tachycardia: > 100 bpm

• If telemetry accuracy is in question, check the radial pulse manually for confirmation.

The number of breaths per minute. Elevated RR can indicate respiratory distress, pain, anxiety, or physiologic decompensation — all relevant to therapy participation.

Normal range: 12–20 breaths/min
Defer therapy or consult the team: >40 breaths/min

Fever can indicate infection or systemic inflammation and may affect a patient's ability to tolerate activity. Hypothermia can also indicate physiologic instability.

Normal range: 97–99°F (36.1–37.2°C)
Low-grade fever: 99.1–100.4°F (37.3–38.0°C)
Fever: >100.4°F (>38.0°C) — discuss with the team before proceeding with a physically demanding session

• Normal range: Systolic 90–120 mmHg, Diastolic 60–80 mmHg

  • Check BP before and after treatment and any time the patient becomes symptomatic.

  • It is normal for patients on bed rest to experience brief light-headedness (10–30 seconds) with position change.

  • Orthostatics: Measure BP in supine, sitting, and standing. Orthostatic hypotension is defined as a drop in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3 minutes of position change.

• Be aware that certain neuro patients will have specific BP parameters in place to ensure adequate cerebral perfusion and prevent secondary brain injury. Always confirm your patient's BP goals with the team before beginning a session.

• MAP reflects the heart's ability to perfuse the body's tissues and is considered a better indicator of central arterial perfusion than systolic pressure alone.

  • Normal range: 70–110 mmHg

  • MAP < 70 mmHg is associated with poor outcomes in TBI — confirm patient-specific MAP goals with the team in neuro patients

• BP > 180/110–120 mmHg

• At this threshold, hypertension elevates from urgency to emergency due to risk of end-organ damage (cardiac, renal, neurological). Do not proceed with therapy. Notify the nurse immediately.

• Know your patient's BP goals before you begin — parameters vary significantly by diagnosis, particularly in neuro patients.

• MAP < 60–65 mmHg

• Sustained hypotension is generally defined as lasting more than 15 minutes. Episodic drops tend to occur within the first 30 minutes of activity. Stop the session, return the patient to a safe position, and notify the nurse. Do not restart therapy until MAP has stabilized and you have consulted with the team.

• Monitor continuously during sessions — BP can shift quickly in critically ill patients and requires ongoing reassessment throughout treatment.

• Normal Range: 60-80 mmHg

• <50 or > 70 mmHg: Defer Therapy

See the Cerebral Perfusion Pressure page for full detail

• Normal Range: 5-15 mmHg

• >20 mmHg: Defer therapy

See the Intracranial Pressure page for full detail