Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety.

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  • Author(s): To, Daphne; Tibbles, Anthony; Funabashi, Martha
  • Source:
    Journal of the Canadian Chiropractic Association (J CAN CHIROPRACT ASSOC), Apr2020; 64(1): 7-15. (9p)
  • Publication Type:
    Article - case study, research, tables/charts
  • Language:
    English
  • Additional Information
    • Affiliation:
      Canadian Memorial Chiropractic College
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Objective: To identify commonalities among cases of rib fractures after spinal manipulative therapy (SMT); discuss chiropractors' case management perspectives; and propose strategies for prevention and/or management of future cases. Methods: Semi-structured interviews were conducted with chiropractors who identified cases of rib fractures after SMT at a chiropractic institution's teaching clinics. Patient characteristics, incident characteristics, and chiropractors' perspectives were collected and analysed. Results: Three chiropractors were interviewed, each identifying one case. Patient ages ranged from 57-77; two were female; two had osteopenia; two cases involved thoracic SMT; and one involved lumbar SMT. Chiropractors agreed that verifying and updating potential contributing factors for rib fractures, transparent communication prior to SMT and/or after the adverse event (AE) occurrence, and enhancing student education on AE management were important. Conclusion: Important lessons can be learned from AEs, despite their infrequent occurrences. A more open and constructive patient safety environment is needed within the chiropractic profession.
      Objectif : Établir les points communs entre des cas de fractures des côtes après des manipulations vertébrales (MV); examiner des points de vue de chiropraticiens sur la prise en charge de cas; proposer des stratégies de prévention et/ou de prise en charge des cas à venir. Méthodologie : On a fait des entrevues semi-structurées avec des chiropraticiens travaillant à la clinique d'un établissement d'enseignement de la chiropratique et ayant identifié des cas de fractures de côtes après des MV. Les caractéristiques des patients, les caractéristiques des incidents et les points de vue des chiropraticiens ont été recueillis et analysés. Résultats : Trois chiropraticiens ont été interrogés, chacun ayant identifié un cas. Les patients étaient âgés de 57 à 77 ans; deux étaient de sexe féminin; deux souffraient d'ostéopénie; deux cas avaient été traités par manipulations thoraciques et un cas par manipulations lombaires. Les chiropraticiens ont convenu qu'il était important de vérifier et de mettre à jour les facteurs contributoires potentiels de fractures des côtes, d'informer le patient, en toute transparence, avant d'effectuer des MV et après la survenue d'un événement (ÉI) et d'améliorer la formation des étudiants sur la prise en charge des ÉI. Conclusion : Les ÉI, bien qu'ils soient rares, peuvent nous permettent de tirer d'importantes leçons. Une attitude plus ouverte et plus constructive envers la sécurité du patient s'impose chez les chiropraticiens.
    • Journal Subset:
      Alternative/Complementary Therapies; Canada; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed
    • ISSN:
      0008-3194
    • MEDLINE Info:
      NLM UID: 8009545
    • Publication Date:
      20200521
    • Publication Date:
      20200530
    • Accession Number:
      143305740
  • Citations
    • ABNT:
      TO, D.; TIBBLES, A.; FUNABASHI, M. Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety. Journal of the Canadian Chiropractic Association, [s. l.], v. 64, n. 1, p. 7–15, 2020. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740. Acesso em: 30 set. 2020.
    • AMA:
      To D, Tibbles A, Funabashi M. Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety. Journal of the Canadian Chiropractic Association. 2020;64(1):7-15. Accessed September 30, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740
    • APA:
      To, D., Tibbles, A., & Funabashi, M. (2020). Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety. Journal of the Canadian Chiropractic Association, 64(1), 7–15.
    • Chicago/Turabian: Author-Date:
      To, Daphne, Anthony Tibbles, and Martha Funabashi. 2020. “Lessons Learned from Cases of Rib Fractures after Manual Therapy: A Case Series to Increase Patient Safety.” Journal of the Canadian Chiropractic Association 64 (1): 7–15. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740.
    • Harvard:
      To, D., Tibbles, A. and Funabashi, M. (2020) ‘Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety’, Journal of the Canadian Chiropractic Association, 64(1), pp. 7–15. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740 (Accessed: 30 September 2020).
    • Harvard: Australian:
      To, D, Tibbles, A & Funabashi, M 2020, ‘Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety’, Journal of the Canadian Chiropractic Association, vol. 64, no. 1, pp. 7–15, viewed 30 September 2020, .
    • MLA:
      To, Daphne, et al. “Lessons Learned from Cases of Rib Fractures after Manual Therapy: A Case Series to Increase Patient Safety.” Journal of the Canadian Chiropractic Association, vol. 64, no. 1, Apr. 2020, pp. 7–15. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740.
    • Chicago/Turabian: Humanities:
      To, Daphne, Anthony Tibbles, and Martha Funabashi. “Lessons Learned from Cases of Rib Fractures after Manual Therapy: A Case Series to Increase Patient Safety.” Journal of the Canadian Chiropractic Association 64, no. 1 (April 2020): 7–15. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740.
    • Vancouver/ICMJE:
      To D, Tibbles A, Funabashi M. Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety. Journal of the Canadian Chiropractic Association [Internet]. 2020 Apr [cited 2020 Sep 30];64(1):7–15. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143305740