Referral Guidelines
Guidelines for Physician Referral
- No difference in blood pressure from one arm to the other after an intervention for vascular thoracic outlet syndrome
- Therapist should report patient’s suspected use of anabolic steroids to the physician
- Symptoms that are unrelieved or unchanged following physical therapy interventions
- Physician referral is strongly recommended before beginning treatment for patients with a medical history of cancer with symptoms of an unknown cause, especially without an associated movement system impairment
Guidelines for Immediate Medical Attention
- Sudden onset of acute chest pain with sudden dyspnea may be life threatening indicating a potential pulmonary embolism, myocardial infarction, or ruptured abdominal aneurysm
- Pain occurring without exertion, lasting longer than 10 minutes, or is not relieved by rest or nitroglycerin indicates a high risk for a heart attack in patients with known angina
- Women with chest, breast, axillary, or shoulder pain of unknown origin should be questioned about breast self-examinations. Refer patient to the physician for further examination if lumps, nodules, or lymph node changes are discovered
(Goodman & Snyder, 2007)