Understanding Hemoglobin Levels in the Acute Care Setting: Implications for Therapy

In acute care, lab values play a critical role in guiding safe and effective rehabilitation. Among these values, hemoglobin is particularly important, as it reflects the body’s ability to transport oxygen and tolerate activity. Occupational and physical therapists rely on hemoglobin thresholds to determine appropriate levels of intervention and to ensure patient safety during mobility and therapeutic activities.

Hemoglobin Levels and Therapy Guidelines

Hemoglobin ≥ 8.0 g/dL
Patients with hemoglobin levels at or above 8 g/dL can typically participate in routine occupational and physical therapy services. Standard interventions, mobility training, and functional activities may be performed as clinically indicated.

Hemoglobin 7.1–7.9 g/dL
Patients within this range may require modified or limited activity based on their medical status. Additional precautions should be followed:

• Clarify activity orders with the patient’s physician before initiating therapy.

• Monitor heart rate and blood pressure before, during, and after treatment to ensure hemodynamic stability.

• Confirm oxygen saturation ≥ 90% prior to beginning any therapeutic activity.

When to Terminate Treatment

Therapy should be discontinued immediately if any of the following symptoms or signs occur, as they may indicate reduced physiological tolerance or potential medical instability:

• Dizziness that does not resolve within 60 seconds of achieving an upright position

• Increase in heart rate by 30 beats per minute or more above baseline

• A change in systolic blood pressure of 30 mmHg, or a change in diastolic blood pressure of 10 mmHg

• Blurred vision

• Dilated pupils

• Chest pain

• Shortness of breath (SOB)