Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 488
Clinical Information 72 CI

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

“The Doctor in All of Us”

A doctor called this morning and asked what to do… A patient, 3 months post-partum, directly after a flexion-extension adjustment experienced “chest-tightening.” He questioned the patient who was breast-feeding and attributed it to perhaps full glands. At the front desk, the patient felt very faint and nauseous and immediately threw up. She still felt not the same afterwards.
He let the patient go and the next day, the patient reported they went to their primary, who diagnosed a significant amount of gallstones and was scheduled for surgery.
He called me today for a “reality check” on how to handle this in the future.
My answer was simply “you dodged a bullet.” The patient could have been having a cardiac incident or ??. As a practitioner, we know when something is not right. Not perhaps what is wrong, but what is not right. In EVERY instance, you always err on the side of caution and send them directly to either the emergency room or their primary and document the encounter inclusive of your recommendations.
Years ago, a patient called me and felt weird pains in their chest.   I told them to go to the emergency room and documented that in my records. When the patient got to my office, she died in my arms in the parking lot due to a pulmonary aneurysm. When the district attorney called me the next day, it was to inform me that the only reason I was not going to jail for delaying emergency care was her friend who drove her to the office witnessed me advising her to go straight to the emergency room and I had also documented it in my charts. 
If not, I would have been subject to some felony mandating jail time… I don’t look well with a girlfriend named “Bubba” on my arms…or elsewhere!!!!!
The moral of the story… When In doubt, refer them out, ASAP and usually to the emergency room. If the patient is ashen or appears to have lack of color in their face, dial 911. If you need the number for 911, look it upJ


Adjunct Assistant Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences


Academy of Chiropractic
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