Vertebral Artery Issues Update - ChiroOrg – Providing ：椎动脉问题更新- chiroorg–提供.ppt

Arterial Circulation Anomalies, continued: Segment 1 is tortuous in 39% of specimens 7% of Vertebral arteries cannot be imaged with sonography due to the depth of the tissue A change in excess of 56% is needed to detect alterations using Doppler imaging * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * What Should I Do? Any of 5 D’s, the A, or any of the 3 N’s should cause you to pay attention immediately. If the symptoms are mild, monitor them for their decrease or their resolution If severe, consider emergency services immediately Each situation will require a different response Always monitor the patient’s vitals, as well as specific neurological responses that drew attention Availability of baseline vitals will allow this data to be more meaningful What Should I Do? If the symptoms are very transient, limited and resolve quickly, take a position of “watchful waiting” Consider the area adjusted, the type of adjustment given, and if an alternate approach would be in order Do not readjust the patient at this time What Should I Do? If the symptoms do NOT resolve quickly, monitor the patient and stay with the patient, no matter how the waiting room is stacked. Watch for the development of additional symptoms, note the mental status, degree of confusion if any, etc. If symptoms persist, or if they worsen, seek emergency services support. Monitor the patient while waiting for support services. Do not readjust the patient at this time. Why Not Readjust? IF the patient is experiencing a VAD, there is no form of adjustment that will minimize the consequences of the dissection, and the introduction of another force may serve to mobilize thrombi and create emboli, increasing the likelihood of an ischemic event. Importance of Immediate Action VAD—thrombus—emboli— cerebellar or brainstem ischemia Emergency pharmaceutical intervention, i.e. tPA, is most effective in the first 90 minutes, moderately effective for three hours