Medical emergencies in chiropractic practice are rare, but they do happen. A patient may become suddenly unwell, collapse, or show signs of a serious medical event such as a stroke. When this happens, patient safety depends not only on clinical judgement in the moment, but on the systems and preparation already in place.
For the 2025–26 CPD year, Principle B of the Code of Professional Practice focuses on ensuring safety and quality in clinical practice. This includes planning for first aid and other emergencies, recognising risk early, and acting to protect patients when there are concerns for their safety.
Emergency preparedness as part of Principle B
Principle B is not only about responding when something goes wrong. It is about preventing harm before it occurs, through robust systems of safety in practice.
Being prepared for medical emergencies is a clear example of Principle B in action. This includes:
- having clear emergency procedures in place
- ensuring first aid arrangements are appropriate and regularly reviewed
- knowing when and how to escalate concerns
- having emergency referral information readily accessible
- making sure everyone in the clinic understands their role if an emergency occurs
These are system‑level safeguards that support safe, high‑quality care, even if they are never needed.
Recognising and responding to emergencies
Medical emergencies can take many forms. They may be sudden and obvious, or develop gradually over the course of an appointment. They may involve patients, visitors, or members of staff.
Principle B requires chiropractors to be prepared to act where they have concerns for the safety of any patient. This does not mean being expected to manage medical emergencies beyond your scope of practice. Instead, it means recognising risk, responding appropriately, and escalating or referring when needed to protect patient safety.
Knowing your limits, and knowing when to seek urgent help or refer on, is an essential part of maintaining quality of care.
Emergency referral forms and escalation pathways
An accessible emergency referral form helps practices act quickly and safely when urgent escalation is needed. The Royal College of Chiropractors created this form for chiropractors to refer patients with suspected emergency conditions, such as cauda equina syndrome, fracture, stroke, MI, or other critical issues. Completing the form ensures all key details are provided for A&E triage.
These forms aim to:
- improve communication with healthcare services
- accurately record concerns
- help patients get appropriate care promptly
As part of your Principle B reflection, you may wish to consider:
- where emergency referral forms are stored in your practice
- how quickly you could access them if needed
- whether all relevant staff know where to find them
Learning from safety and improving quality
Principle B also emphasises learning - from incidents, near misses, and everyday experiences - to improve the quality of care provided.
Even if an emergency never occurs, reviewing emergency preparedness can highlight opportunities to strengthen systems, clarify responsibilities, and reduce risk. These small, preventative actions are often the ones patients never see, precisely because harm has been avoided. Reflecting on emergency preparedness and the systems that support it can help demonstrate how Principle B shows up in your everyday practice, even when nothing goes wrong.
Supporting resources
To support reflection on safety and quality in clinical practice, you may find the following helpful:
- Emergency referral form, available on the Royal College of Chiropractors (RCC) website.
- The Code of Professional Practice video on safety and quality in clinical practice, which explains how Principle B supports a culture of safety: including recognising risk, preventing harm, and knowing when to escalate or refer to protect patients
