S5 - Risk Assessment and Safety

Question 1

What are red flags, and how should they be interpreted in clinical reasoning?

Answer 1

Red flags are potential indicators of something serious but are not diagnostic. Context and clinical reasoning are crucial in interpreting them.

Question 2

Why are red flags challenging to assess early in pathologies?

Answer 2

Most sinister pathologies present non-specifically and can have variable presentations, making early detection difficult.

Question 3

What are key neuro-specific risk factors to consider during treatment?

Answer 3

Cognitive issues and challenging behavior
Falls risk due to balance problems
Insight into safety awareness
Medical stability in acute conditions

Question 4

What are the key cardiovascular (CVR) risk factors?

Answer 4

Unstable angina
Hypertension
Atrial fibrillation (AF)
Exercise tolerance/physical activity levels

Question 5

What are common musculoskeletal (MSK) risk factors?

Answer 5

Malignancy
Cauda equina syndrome
Spinal fracture
Infection

Question 6

What is cauda equina syndrome, and what are the key signs?

Answer 6

A serious neurological condition affecting the lumbar plexus. Key signs include:

Acute low back pain
Radicular symptoms (radiating pain)
Saddle anaesthesia
Bladder and bowel disturbances

Question 7

What are common clinical features of a spinal fracture?

Answer 7

Sudden onset after trauma (fall, heavy lift)
Pain localized to the fracture site
Deformity (e.g., kyphosis)
AROM painful, tenderness on palpation

Question 8

What are key symptoms of infection to look for in MSK conditions?

Answer 8

Feeling unwell, fatigue
Pain
Localized redness and swelling (oedema)
Elevated temperature
Weakness

Question 9

What are the “5 D’s” to consider in C-spine or vertebrobasilar insufficiency (VBI)?

Answer 9

Dizziness
Drop attacks
Dysphagia
Dysarthria
Diplopia

Question 10

What are the “3 N’s” to consider in neurological assessments?

Answer 10

Nystagmus
Nausea or vomiting
Other neurological symptoms (e.g., saddle anaesthesia)

Question 11

What are the common (though rare) risks associated with exercise?

Answer 11

Cardiac arrhythmias/cardiac arrest/MI
Syncope
Musculoskeletal injury

Question 12

Why are people with cardiac disease at increased risk of sudden cardiac events?

Answer 12

People with cardiac disease are 7x more likely to die of a sudden cardiac event at rest compared to during vigorous physical activity.

Question 13

What are some risks to consider when performing CVR manual techniques and suction?

Answer 13

Increased intracranial pressure
Skin integrity issues
Cardiovascular instability
Severe bronchospasm
Clotting disorders or open wounds

Question 14

What are the risks associated with MSK manual techniques?

Answer 14

Skin integrity issues
Osteoporosis
Cancer diagnosis
Fractures or infections
Open wounds

Question 15

What risks must be considered during neurological facilitation (e.g., gait re-education)?

Answer 15

Falls risk due to balance deficits
Cognitive limitations and lack of insight
Cardiovascular instability
Variability in performance due to fatigue

Question 16

What risks should be considered when giving advice and education to patients and families?

Answer 16

Advising outside of scope of practice
Failure to refer to other professionals
Non-adherence to protocols
Not documenting conversations or meeting minutes