Modify & monitor
A factor requiring extra care, adaptation or closer observation. Treatment may still be appropriate depending on context and scope.
LEVEL 2 · LESSON 04Safety Screening
Safety Screening
& Red Flags
Skill paling penting bukan mengetahui bila perlu treat — tetapi mengetahui bila perlu modify, defer, stop atau refer. Screening berlaku sebelum dan sepanjang session.
BY THE END OF THIS LESSONDistinguish contraindication & precautionRecognise major warning patternsChoose treat / modify / defer / referRespond safely when symptoms change
SAFETYFIRST
SCREENDECIDEMONITORNot every risk means the same action.
Do not use that intervention
A reason a particular technique, area or treatment approach should not be used.
Stop & escalate
A concerning presentation suggesting the client may need appropriate medical assessment rather than routine therapeutic treatment.
Think in warning patterns.
Sudden/new significant weakness, numbness, speech/face changes, loss of coordination, concerning bladder/bowel or saddle-area sensory changes.
Major trauma, obvious deformity, inability to use/bear weight, rapidly increasing swelling or severe post-trauma symptoms.
Chest pain/pressure, severe or unexplained breathlessness, collapse or other acute concerning symptoms.
Sudden marked unilateral swelling, concerning colour/temperature change, severe unexplained limb symptoms.
Client appears acutely unwell, significant unexplained fever/systemic symptoms, rapidly worsening unexplained presentation.
Sudden severe headache, rapidly worsening unexplained pain or symptoms that do not fit routine musculoskeletal presentation.
Red flags are not a diagnosis checklist. They are signals that change the safety decision and may require medical assessment.
Use a four-way decision.
Appropriate, within scope, no concerning finding.
Precaution present; adapt position, load, technique or duration.
Do not proceed now; further clarification/recovery/assessment needed.
Presentation requires appropriate healthcare or emergency assessment.
Safety decision drill
Untuk setiap scenario, jangan diagnose. Tentukan tindakan paling selamat dan explain kenapa.
Client well + familiar mild stiffness → ?Recent local irritation, tolerates gentle movement → ?Acute injury with unclear severity → ?Sudden one-sided weakness + speech difficulty → ?
Expected thinking: Treat → Modify/monitor → Defer/assess → Emergency referral.Safety screening never ends at intake.
BEFORE→DURING→AFTER
history + baselineresponse + new symptomsreassess + advice
STOP RULE
Jika presentation berubah secara concerning semasa treatment, stop. Jangan tambah pressure, stretch atau manipulation untuk melihat sama ada symptom “hilang”.
Quick Knowledge Check
Client tiba-tiba menunjukkan facial droop, speech difficulty dan weakness pada satu sisi. Apa tindakan paling sesuai?
Client hadir selepas ankle twist. Swelling ketara, tidak mampu weight-bear dan pain sangat kuat.
Apa decision paling sesuai?
Life-threatening or time-critical symptoms require emergency services/urgent medical care according to local procedures. Practitioner tidak perlu menentukan diagnosis sebelum mendapatkan bantuan. Document what was reported/observed, action taken and relevant timing.