patient is the order of the day.
Moving cautiously, being discrete is the approach that we need at that point for your interest and for the patient's interest. In the presence of a patient who expresses non-traumatic or post-whiplash neck pain as a new chief complaint, who refers to the pain as unlike anything they ever had before, who is exhibiting other neurological symptoms, referral for evaluation for possible VAD before adjusting is strongly recommended. You need to have someone in your sphere of influence and contacts, that you can pick up the phone and say, "Charlie, this is Gerry, I need you to humor me on this one. I think this is what's going on." Have them cooperate with you to make sure that patient gets a proper evaluation. If you have a neurologist that you can talk to, someone that you will cooperate with you to get the testing done, to make sure this patient is properly evaluated. You may save the patient a great degree of discomfort and a great degree of problem, and yourself as well the same. For those of you that use software to do all of your practice management and documentation, please understand this. If you have a patient that indicates something to you, pain in a certain area or anything that is not in the usual script of that software, make sure you add a note to the notes for that day. You don't want to leave something out just because it wasn't pre-scripted into the software that you happen to be utilizing. Statistically speaking, this is not going to happen to you, but that's what I hear from all the doctors that I speak with around the country. Unfortunately, it does happen to some and what I've experienced is when it happens it didn't matter if you used diversified adjusting procedure or if you're an upper cervical doctor or an activator doctor or any other type of technique that maybe utilized, it still happens. The most important thing from my perspective at this point, after the adjustment if you're finding that that patient is responding in a very negative fashion, especially with these types of symptoms where they're getting dizzy, that is not normal. If they're vomiting, that is not normal. It is imperative that you recognize these types of situations and act upon them immediately. Now when a patient show signs of a possible VAD following an adjustment, how do you handle it? Where do you go from there? The truth of the matter is, that your management of the situation and your documentation of the situation are the most important things that will determine the outcome of that circumstance. This management opportunity is one that is absolutely hands-on. You cannot be casual about this. You cannot be laissez-faire about this. You have got to be extremely attentive to what's going on with that patient, and if you do so, you will reduce the mortality, you will reduce the morbidity, and you'll reduce the liability that you or anyone else downstream will follow, that may follow. Your recognition of the post-adjustment symptomatic picture is critical. One of the things that we tend to do is assume that because it's extremely rare, "It won't happen to me, " or, "It didn't happen to me. It didn't happen in my office." It's a
Dr. Stu Hoffman:
Dr. Gerry Clum:
Made with FlippingBook HTML5