To Daphne, Tibbles Anthony, Funabashi Martha
Canadian Memorial Chiropractic College.
J Can Chiropr Assoc. 2020 Apr;64(1):7-15.
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.
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.
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.
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.
确定脊柱手法治疗（SMT）后肋骨骨折病例的共性；讨论整脊师的病例管理观点；并提出预防和/或管理未来病例的策略。
对在一家整脊机构教学诊所中确定有SMT后肋骨骨折病例的整脊师进行半结构化访谈。收集并分析患者特征、事件特征和整脊师的观点。
采访了三位整脊师，每人确定了一例病例。患者年龄在57 - 77岁之间；两名女性；两名有骨质减少；两例涉及胸椎SMT；一例涉及腰椎SMT。整脊师一致认为，核实和更新肋骨骨折的潜在促成因素、在SMT之前和/或不良事件（AE）发生后进行透明沟通，以及加强学生对AE管理的教育很重要。
尽管不良事件很少发生，但仍可从中吸取重要教训。整脊行业需要一个更加开放和建设性的患者安全环境。
