The test is most safely done with two observers: one to obtain blood pressure (BP) and heart rate (HR) values, and one to scribe, observe, and instruct. [...] Next: Ask the patient to sit on the edge of the table/bed, then stand straight up, and lean against the wall with only their shoulder blades touching the wall. [...] Once the patient is leaning against the wall: Start a timer and record the first standing BP and HR. [...] Observe patient for lightheadedness or signs of pre-syncope and stop the test if the patient is about to faint. [...] Exercise and heat orthostatism and the effect of heat acclimation and physical fitness.
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