Emergency department turf war

Of course it would generate opposition from doctors. A lot of them are still back in the dark ages. Remember the reception Sr Kenny got from the medical profession for daring to suggest a treatment for polio victims back in the 50's. More recently, Dr Barry Marshall had to take his ulcer cure research overseas to get around the local medical "profession". The profession as a whole is extremely conservative, and resort to the Not Invented Here approach to anyone who suggest anything outside the accepted wisdom.

I was very surprised and disappointed when I read this ---- I thought Australia was very progressive, and WAY beyond this type of blatently egocentric, "good 'ol boy" mentality/politics oft encountered here in the USA. Of course, it is important to keep in mind that this is only ONE selected article, and it may very well NOT be an accurate representation.
DCs in ERs ----> "RADICAL"? HAHAHAHA!!! Incoll and Pesce are either being 1)misquoted(I am generously giving them the benefit of the doubt on this) 2)just plain ignorant, 3)dishonest, 0R 4) ignorant AND dishonest.

Emergency-Room Chiropractor
By John Cerf, DC
It is unlikely that you became a chiropractor to work in an ER. Imagine my surprise when members of our hospital's chiropractic department were asked to take a call in the emergency department (ED)! We are now in our second year of providing chiropractic coverage to the ED.
In our hospital, DCs do not work as pseudo-medical physicians. Hospitals and EDs do not need "want-to-be" medical physicians. While trained in diagnosis and knowledgeable of medical procedures, chiropractors in the ED provide services as chiropractors to increase the satisfaction of the most important people in the hospital - the patients. Perhaps you should also consider taking steps to provide care for patients in your local hospital.

In November 2000, Meadowlands Hospital Medical Center in Secaucus, New Jersey began offering chiropractic care in the ED. In an effort to satisfy the Joint Commission on Hospital Accreditation's mandate to better address pain management, Meadowlands ED Director Gina Puglisi,MD, and Albert Cataffi,DC, former chiropractic department chief, developed and instituted a "chiropractor on-call" program. Dr. Puglisi readied the chiropractors with an orientation program to define the roles of the chiropractors and the rest of the ED in treating neck and back pain patients.
Patients who present to the ED with neck or back pain are screened by the attending ED physician, who is responsible for ruling out serious pathology, fracture, neurological deficit, and other findings that might contraindicate spinal manipulation. The ED physician may order x-rays, blood work or other diagnostic tests. When a severe condition presents, orthopedists, neurologists or neurosurgeons are enlisted to take over the case. Historically, all patients without serious pathology were given prescriptions and discharged from the hospital, with or without adequate relief. With our chiropractor-on-call program, the ED physician now has the option of calling for a chiropractic consultation, which gives the patient the opportunity to receive additional relief.
The typical chiropractic patient in the ED is one that would present only on occasion in a chiropractic office. One such patient was a 33-year-old man who reported injuring his lower back by lifting a heavy airplane tire at work. He found himself immobilized by pain and supine on the cement floor of the aircraft hangar. He remained on his back for four hours before he would admit that he was not going to be able to get up. His coworkers called for the ambulance and he was brought into our emergency department. Following evaluation by the ED physician and radiographic examination, the patient was given injections of Toradol for pain and Flexeril to relax muscles. Due to his persistent inability to ambulate, he was later given an injection of Demerol, a narcotic analgesic. As the patient was still unable to move about, the ED physician called for a chiropractic consultation.
Upon my arrival, the ED physician gave me a summary of the patient's history, examination findings, and treatment. I reviewed the chart and the available x-ray films and test results. Upon meeting the patient, he was still unable to get out of bed. I performed a detailed history and physical examination to clarify the nature of the patient's disorder and to further rule out contraindications and the need for additional tests. I performed an analysis to determine the most appropriate type of chiropractic care.
The patient complained of severe lower back pain and paresthesia that radiated down his posterior left lower limb to his foot. My examination revealed severe muscle spasms and vertebral joint fixation. Orthopedic testing was positive for a strain/sprain injury to the lumbar spine. The patient was neurologically intact, with normally responsive deep tendon reflexes, equal bilateral dermatome sensations,+5/5 bilateral great toe strength, and a down-going Babinski's reflex.

This patient is a good example of a minor injury, by emergency department standards, accompanied by severe incapacitating pain. The medication had not given him sufficient relief. The attending ED physician did not want to resort to stronger narcotic analgesia or hospitalization. The patient would have obviously avoided additional diagnostic testing if something were done to relieve the severity of his pain.
Having determined that chiropractic care was both warranted and safe, I began treatment with the application of electrical muscle stimulation to the lumbar paraspinal muscles. The purpose of the adjunctive therapy was provided to supplement the effects of the medication to relieve spasm and reduce pain and make it easier to perform lumbar chiropractic adjustments. The patient and I discussed his injury and how his body was overreacting with severe pain and muscle spasms. We talked about how this would be an appropriate response if a vertebra had been fractured. He appeared to understand how his body's overreaction of pain, spasm, anxiety and joint fixation would slow his healing and prevent the quick resolution of his pain. I advised the patient of what I was going to do and what he could expect. I told him to alert me if he felt he would not be able to tolerate continuing the treatment.
The patient moved slowly to a lateral recumbent position in preparation for a side-posture adjustment. As he moved into position, I checked to see that he was not in additional pain. I performed a stretch in the side-posture position to check for patient tolerance. I demonstrated an adjusting thrust to his shoulder so he would know what to expect. As he exhaled, I performed a quick, light, lumbar adjustment to the fixated segments, and noticed a modest release. The patient did not report relief, but he was able to tolerate the procedure without complication. I performed the same procedure on the other side, with a good release noted. Returning to the first side, I repeated the procedure - this time with a good release.
Following the treatment, the patient appeared surprised, noting that his pain had lessened significantly, and that he no longer felt an abnormal sensation in his left lower limb. He was able to get out of bed, dress himself and be discharged from the hospital. On his way out, he stopped at the nurse's station. The nurses were equally surprised to see that the patient was able to leave the ED under his own power. Not only had the patient improved, but the improvement was witnessed by our medical counterparts.
In the past, it was rare for me to see a patient in this much pain in my office. The ambulance doesn't bring acute agonizing patients to the chiropractor's office. I would have likely suggested that the patient be seen first in the ED. Now, as part of that department's team, I can participate in the early treatment of the severe patient with the backup of a well-staffed and equipped hospital.
John Cerf,DC
Chief, Department of Chiropractic, Meadowlands Hospital Medical Center
Secaucus, New Jersey

Mild spinal manipulation is best performed on patients that present with uncomplicated non-radiculopathic low back discomfort.

The care given to this patient may or may not be reasonable. This patient seems to have sustained a moderate to severe strain/sprain. Was it reasoanble to "manipulate a severely sprained joint? Well, not usually. He was also first cleared by well trained emergency physicians. This is only one anecdotal story written by a chiropractor who has a clear agenda.

However,...

Most chiropractors engage in bizarre treatments and techniques that have research to support them.

For example, many thousands of chiropractors treat ALL, yes, ALL, their patients by lightly tweaking the upper cervical vertebrae ONLY. NO MATTER WHAT THEIR CONDITION.

Chiropractors love to call themselves "primary care physicians". Talk about misleading.

Chiropractors graduate from chiropractic school without ever examining or diagnosing truly sick patients.

That should raise grave concerns when putting your "health" into their hands.

No one expects chiropractors to treat truly sick patients,(except some chiropractors themselves), but it is reasonable that chiropractors spend several years diagnosing and examining hundreds if not thousands of sick patients to best be able to recognize those patients that should be referred out to the proper medical professionals. Chiropractic education severely lacks in developing differential diagnostic skills and experience.

Buyer beware.

Clarification ....."Most chiropractors engage in bizarre treatments and techniques that have NO research to support them."

Could the stroke the chiro student suffered in GA be due to a neck manipulation? Did anyone read that post? Is the family looking into this? Do the doctors even know to check the possiblity?

If neck manipulation causes stroke and this kid was a chiro student I can imagine that he was getting neck manipulation even from other students

Did he attend Life University

What does anyone think about this

I hope the family will look into this

"Important", Life chiropractic college is yet another chiropractic school that graduates tons of inferiorly trained chiropractors.

You mentioned "strokes". Chiropractic students graduate without ever examining, diagnosing or treating "stroke" patients. Indeed, while some chiropractors might recognize the "obvious" signs of stroke. many will likely miss the subtle neurological and physical changes that occur in stroke patients.

Chiropractors are desperate to be considered "primary care physicians" yet their clinical training is woefully inadequate.

Fact, most "life chiropractic school" graduates saw maybe a couple dozen "patients" with simple self limiting back and neck discomfort as their ENTIRE clinical experience. And sadly, many of those patients were family and friends.

You see, life students are required to provide their own "patients". How bizarre is that? And how dangerous is that to society?

The chiropractic diaper needs to be emptied.

Wisdom wrote:

"Important", Life chiropractic college is yet another chiropractic school that graduates tons of inferiorly trained chiropractors.
You mentioned "strokes". Chiropractic students graduate without ever examining, diagnosing or treating "stroke" patients. Indeed, while some chiropractors might recognize the "obvious" signs of stroke. many will likely miss the subtle neurological and physical changes that occur in stroke patients.
Chiropractors are desperate to be considered "primary care physicians" yet their clinical training is woefully inadequate.
Fact, most "life chiropractic school" graduates saw maybe a couple dozen "patients" with simple self limiting back and neck discomfort as their ENTIRE clinical experience. And sadly, many of those patients were family and friends.
You see, life students are required to provide their own "patients". How bizarre is that? And how dangerous is that to society?
The chiropractic diaper needs to be emptied.

Wisdom is desperate to discredit chiropractic with smoke and mirrors. He is desperate to be heard and taken seriously. Well, he's not. Wisdom is a liar and a fraud. Wisdom is simply a non-credentialed wannabe with a king sized chip on his shoulder. Wisdom IS the Lying King!

mr. baines, I'm guessing you are a life chiropractic school graduate?

Why else would you be so defensive. You can't deny the facts.

I'm sorry you were conned into buying the chiropractic charade.

I understand, many naive young people were also conned into joining the cult.

Wisdom wrote:

mr. baines, I'm guessing you are a life chiropractic school graduate?
Why else would you be so defensive. You can't deny the facts.
I'm sorry you were conned into buying the chiropractic charade.
I understand, many naive young people were also conned into joining the cult.

The angry, frustrated, jealous little man rises! WOW!! Look at the spector!! Wisdom is in the Hotel Loser. He can check out but he can never leave! Hahaahahahhah. Wisdom, stop being so angry. Get the help you need.

Only a Chiropractor can determine if a vaccine may cause a subluxation
Only a Chiropractor may dertermine of a person has or is at risk of a subluxation
Only a Chiropractor is trained to detect subluxations
Do not get a vaccine until your local PCP DC has given the ok that it will not cause subluxations
Life College is a great college
No, Chiropractic students DO NOT suffer strokes from cervical manipulations while students in college
MD/DO are not properly trained to diagnosis a subluxation
Choosing a DC as your primary care physicians is the wisest choice anyone can make
DC's are properly trained in diff diagnosis and spend more time in diagnosis than their counter parts MD/DO combined
Yes, DC do diagnosis very sick patients while in the student clinic
Subluxation is a serious condition
Chiropractors can in effect contribute to treating any disease if the neurological system has been compromised, they do this by not directly treating the disease but by helping the neurological system free itself of subluxations
DC's are just as qualified as any MD/DO to provide primary care, that is proven in state and federal law mandates
Sorry wisdom/botnick/barreter/novell avanilla and all of the anti chiro people, you have no idea what true chiropractic is, so step aside and let the expert take over
Make sure you choose your local DC as your primary care physician as it may just save your life one day

The future of health care are Chiropractic Urgent Care clinics

Chiropractic hospitals are also going to be the future as they out performed there competition when they were opened

Chiropractic urgent care THE WAY TO GO THE BEST PLACE TO GO IF YOU ARE SICK

You mentioned "strokes". Chiropractic students graduate without ever examining, diagnosing or treating "stroke" patients. Indeed, while some chiropractors might recognize the "obvious" signs of stroke. many will likely miss the subtle neurological and physical changes that occur in stroke patients.

Chiropractors are desperate to be considered "primary care physicians" yet their clinical training is woefully inadequate.

Fact, most "life chiropractic school" graduates saw maybe a couple dozen "patients" with simple self limiting back and neck discomfort as their ENTIRE clinical experience. And sadly, many of those patients were family and friends.

You see, life students are required to provide their own "patients". How bizarre is that? And how dangerous is that to society?

The chiropractic diaper needs to be emptied.

Wisdom wrote:

You mentioned "strokes". Chiropractic students graduate without ever examining, diagnosing or treating "stroke" patients. Indeed, while some chiropractors might recognize the "obvious" signs of stroke. many will likely miss the subtle neurological and physical changes that occur in stroke patients.
Chiropractors are desperate to be considered "primary care physicians" yet their clinical training is woefully inadequate.
Fact, most "life chiropractic school" graduates saw maybe a couple dozen "patients" with simple self limiting back and neck discomfort as their ENTIRE clinical experience. And sadly, many of those patients were family and friends.
You see, life students are required to provide their own "patients". How bizarre is that? And how dangerous is that to society?
The chiropractic diaper needs to be emptied.

Mothers, fathers, keep your children inside! Wisdom is mentioning diapers and bed wetting again. He writes these words at least two dozen times a day. How utterly creepy Wisdom is.