Back Clinic Health Care Providers Chiropractic Team. According to the (CDC), there are more than 18 million workers in the healthcare sector in the U.S., And almost 80 percent of them are women. These workers are exposed to many hazards each day. Healthcare practitioners, from nurses to chiropractors, specialize in providing the best health services available to the general population in order to implement outstanding care to individuals in need.
Health professionals are frequently involved in high-demand environments which require healthcare members to be constantly on their feet, helping as many individuals as possible for prolonged periods of time. Dr. Alex Jimenez’s collection of Healthcare Providers articles cover a variety of injuries or conditions affecting a majority of health professionals while on the field, paying close attention to and emphasizing the treatments and solutions available to care for these important individuals as well. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Faster Recovery After Spine Surgery: Enhanced Surgical Recovery (ESR) Programs at El Paso Back Clinic® in El Paso, TX
The doctor administers a local anesthetic into the patient’s affected area, using ultrasound to visualize the spine’s anatomical components.
Spine surgery can help treat serious back problems, such as pain from injuries, disc issues, or aging. At El Paso Back Clinic® in El Paso, TX, we focus on helping patients recover faster and more safely through modern methods. Enhanced Surgical Recovery (ESR), also called Enhanced Recovery After Surgery (ERAS), is a team-based plan that reduces the need for strong pain medications, shortens hospital stays, and lowers the risk of readmission. Led by Dr. Alexander Jimenez, DC, APRN, FNP-BC, our clinic combines chiropractic care, nurse practitioner expertise, and new tools to support healing. This article explains the main parts of ESR for spine surgery, how it cuts opioid use, shortens hospital stays, and reduces readmissions. We also cover the big roles of integrative chiropractic care and nurse practitioners, plus exciting new tech like virtual reality (VR) for building strength after surgery.
Many people in El Paso face back pain from work, accidents, or daily life. Surgery may be necessary, but traditional methods can make recovery challenging. ESR improves this process by planning care before, during, and after the operation. It uses simple steps, such as teaching patients, eating better, and moving early. Studies show these measures can cut opioid use a lot and help people go home sooner (Dagal et al., 2023). At El Paso Back Clinic®, we work with surgeons to add non-drug options for even better results.
What Is Enhanced Surgical Recovery (ESR)?
ESR is a proven plan to make surgery recovery easier and quicker. It started in other surgeries, but now helps a lot with spine operations, such as fusions or disc repairs. The idea is to lower body stress and speed natural healing. Instead of staying in bed and taking many pain pills, patients move soon and use gentler pain control.
Key parts of ESR include:
Team Approach — Doctors, nurses, chiropractors, and therapists all work together.
Step-by-Step Care — Planning starts before surgery and continues at home.
Personal Plans — Care fits each person’s health needs.
Research shows ESR helps with many spine issues, from small fixes to big ones (Zaed et al., 2023). Reviews find that most programs use around 12 key steps, such as better pain management and early walking (Berk et al., 2025).
Main Components of ESR for Spine Surgery
ESR has steps before, during, and after surgery to make things smoother.
Before Surgery (Pre-Op)
Getting ready early helps avoid problems.
Teaching Patients: Learn what to expect, how to manage pain, and why moving matters. This lowers worry and helps follow the plan (Zaed et al., 2023).
Better Nutrition: Check for low energy or anemia. Eat protein and carbs to build strength. Nutritious food helps healing (Soffin et al., 2022).
Pain Prep: Start gentle meds like acetaminophen. Quit smoking to lower risks (American Association of Nurse Anesthesiology, n.d.).
Prehab Exercises: Build strength with walks or stretches.
These make surgery safer.
During Surgery (Intra-Op)
The team uses ways to protect the body.
Better Anesthesia: Short drugs to wake up fast. Add non-opioid options (Dagal et al., 2023).
Careful Fluids: Just the right amount to avoid issues.
Small Cuts: Less muscle damage for quicker recovery (Dietz et al., 2019).
Pain Blocks: Numb the area for hours after.
Patients feel better right away.
After Surgery (Post-Op)
Focus on rapid healing.
Early Walking: Get up soon and walk daily (Zaed et al., 2023).
Mixed Pain Control: Use non-opioids, ice, and movement.
Quick Eating: Start foods and drinks early.
Checks for Safety: Watch for clots or other issues.
These steps lower risks.
How ESR Reduces Opioid Use
Strong pain drugs like opioids help, but can lead to problems like addiction. ESR cuts its use by at least half (Dagal et al., 2023). At El Paso Back Clinic®, we add chiropractic methods for even less need.
Mixed Pain Options: Non-opioids first, like NSAIDs and nerve meds. Some programs use almost no IV opioids (HCA Healthcare, n.d.).
Teaching Non-Drug Ways: Ice, breathing, and adjustments.
Blocks and Early Move: Numb areas and walk to ease pain.
In fusions, opioids dropped considerably without worse pain (Dagal et al., 2023). This helps avoid side effects and promotes natural healing.
Shortening Hospital Stays with ESR
Long hospital time raises costs and risks. ESR cuts stay by 1-2 days (HCA Healthcare Today, 2022).
Early Movement: Prevents issues and builds strength.
Fast Nutrition: Energy for recovery.
Good Pain Control: Less bedtime.
Team Reviews: Go home when ready.
One example shows noticeable shortened stays (Dagal et al., 2023). Patients heal better at home.
Lowering Readmission Rates
Going back to the hospital is tough. ESR lowers this risk (HCA Healthcare Today, 2022).
Home Care Teaching: Know warning signs.
Follow-Ups: Calls from our team at El Paso Back Clinic®.
Fewer Problems: Better prep means fewer infections.
Full Care: Controls swelling early.
Fewer complications overall (Berk et al., 2025).
Integrative Chiropractic Care at El Paso Back Clinic®
Chiropractic care fits perfectly with ESR. At our clinic, Dr. Jimenez uses hands-on adjustments to align and relieve symptoms.
Before Surgery: Improve posture and movement.
Pain Without Drugs: Soft tissue work eases tension.
After Surgery: Reduce scar tissue and build mobility (New York City Spine, n.d.).
Nerve Help: Better signals for less pain.
We complement therapy for smoother recovery (Active Health Center, n.d.).
Role of Nurse Practitioners
Nurse practitioners (NPs) like Dr. Jimenez coordinate care.
Team Links: Connect everyone.
Teaching and Meds: Focus on safe, non-opioid options.
Tracking Progress: Adjust plans.
NPs help stick to ESR paths (American Association of Nurse Anesthesiology, n.d.).
New Tech: Virtual Reality (VR) for Recovery
VR uses games and guides to make rehab more enjoyable. It helps spine patients build strength.
Fun Exercises: Improves engagement and movement.
Less Pain Feel: Distraction helps.
Strength Gains: Tailored for muscles and focus.
Home Options: Practice alone.
Recent studies show VR speeds recovery after spine issues, like in cervical cases or general neurorehab (Bolton et al., 2025; various 2025 trials).
Insights from Dr. Alexander Jimenez at El Paso Back Clinic®
Dr. Alexander Jimenez, DC, APRN, FNP-BC, leads El Paso Back Clinic® with dual expertise in chiropractic and nursing. He uses team care for pain management and rehab after injuries or surgery. His plans include adjustments, nutrition, and integrative methods for better mobility without heavy drugs. He stresses whole-body healing for lasting results (Dr. Alex Jimenez, n.d.; LinkedIn, n.d.).
Conclusion
ESR programs accelerate spine surgery recovery and make it safer. With education, nutrition, movement, and team support, they reduce opioids, shorten stays, and lower readmissions. At El Paso Back Clinic® in El Paso, TX, we add chiropractic care and NP guidance for full support. New VR tech adds exciting ways to build strength. If facing spine surgery, ask about ESR and our integrative options. Contact us at 915-850-0900 for help.
Tests Used for Brain Injuries at El Paso Back Clinic® in El Paso, TX
Doctor of Chiropractic and Nurse Practitioner show the imaging result to the patient post-auto-injury rehabilitation with mild brain injury
Brain injuries can strike without warning, from a simple slip at home to a tough hit during sports or a car crash on El Paso’s busy roads. At El Paso Back Clinic® in El Paso, TX, our team of wellness chiropractic care experts knows how vital it is to spot these issues early. We blend chiropractic skills with modern tools to help patients heal and get back to life. Led by Dr. Alexander Jimenez, DC, APRN, FNP-BC, our clinic focuses on whole-body wellness, using safe, non-invasive methods to check for head injuries.
This article dives into the tests we use at El Paso Back Clinic® to find brain injuries. We cover hands-on checks, brain function tests, and high-tech scans. Our goal is to give you clear info so you can seek help fast. Early detection means better recovery and fewer long-term problems.
The Importance of Spotting Brain Injuries Early at Our Clinic
Traumatic brain injuries (TBIs) happen when a bump or jolt shakes the brain. Mild ones, like concussions, might cause short-term headaches or dizziness. Serious cases can lead to lasting memory issues or mood changes. At El Paso Back Clinic®, we see many patients from local accidents or sports-related injuries, and we emphasize prompt action.
Our integrative approach mixes chiropractic care with nurse practitioner expertise. Dr. Jimenez uses his dual training to create custom plans. We check the spine, nerves, and brain together because a head injury often affects the neck as well.
Common signs: Headaches, confusion, nausea, or trouble balancing.
Why act fast: Stops swelling or bleeding from getting worse.
Our edge: Our wellness focus means we look at lifestyle and nutrition, too.
Research backs our methods—early tests lead to stronger outcomes (Pickett et al., 2024). At our El Paso, TX clinic, we guide you through every step.
Starting with Neurological Assessments for Head Injuries
At El Paso Back Clinic®, every brain injury check begins with basic neurological tests. These quick exams help us see how the brain responds right away. No need for big machines; it’s all about skilled observation.
We rely on the Glasgow Coma Scale (GCS) to grade injury severity. The Glasgow Coma Scale (GCS), which scores from 3 to 15, assesses eye opening, verbal response, and motor response. High scores mean mild issues; low ones signal urgency. Our team, including Dr. Jimenez, uses GCS to quickly decide on next steps (Bussières et al., 2022).
We also use the Standardized Assessment of Concussion (SAC). This tests memory and focus with simple questions. For athletes, the Sport Concussion Assessment Tool 5 (SCAT5) adds balance and neck checks. Kids receive the Child SCAT5 version.
GCS breakdown:
Eyes: 1 (none) to 4 (spontaneous).
Verbal: 1 (silent) to 5 (oriented).
Motor: 1 (none) to 6 (obeys commands).
SAC quick tips: Asks things like “What month is it?” or repeats word lists.
SCAT5 extras: Includes symptom checklists and coordination drills.
Dr. Jimenez notes that these tests often reveal neck problems linked to head injuries. At our wellness clinic, we adjust spines to ease related pain.
Hands-On Physical Exams to Uncover Hidden Issues
Physical checks are key at El Paso Back Clinic®. We touch and move areas to find pain, weakness, or limits. This builds on your story about how the injury happened.
Reflex tests tap spots, like the knees, to check nerve pathways. Odd responses might point to brain trouble. The Balance Error Scoring System (BESS) tests stability—stand in poses and count errors. It’s useful for detecting dizziness associated with TBIs (Sillevis et al., 2018).
We measure how far you can move your neck or head without pain. Strength tests have you push against our hands. These help link head injuries to spine misalignments.
BESS poses:
These include the double-leg stance, single-leg stance, and tandem pose.
Perform the exercises on both firm ground and foam to increase the challenge.
The errors to avoid include having hands off the hips, keeping eyes open, and falling.
Reflex checks: Hammer taps for quick reactions.
Motion tests: Gentle turns to spot restrictions.
For El Paso locals in car wrecks, these exams guide our chiropractic adjustments. Dr. Jimenez observes that early physical checks prevent chronic issues.
Cognitive Testing to Measure Brain Function
Head injuries can fog thinking. At El Paso Back Clinic®, we use cognitive tests such as ImPACT to assess memory and reaction time. This computer-based tool is perfect for concussion assessment, as it allows you to compare your scores to norms or baselines.
ImPACT includes modules for word recall, symbol matching, and symptom rating. It’s objective and tracks progress over time. We use it for return-to-work or play decisions (ImPACT Applications, Inc., 2023a).
Our nurse practitioners add deeper checks if needed, like repeating stories or drawing shapes. These rule out other causes.
ImPACT features:
Visual memory: Recall designs.
Reaction time: Click on the colors fast.
Symptom scale: Rate 22 items like fatigue.
Baseline testing: Ideal for athletes before seasons.
Retesting: Every 7-10 days to monitor healing.
Dr. Jimenez integrates ImPACT with chiropractic care, noting better results when spine health supports brain recovery.
Advanced Imaging for Clear Views of Injuries
Imaging lets us see inside. At El Paso Back Clinic®, we start with X-rays for bone alignment and fractures. They’re fast and help plan adjustments.
For deeper looks, CT scans catch bleeds quickly. MRIs show soft-tissue damage, such as bruising or tears—no radiation involved. We order these through our network for full pictures (NYU Langone Health, n.d.).
Digital Motion X-ray (DMX) is a favorite here—it films spine movement to spot instability from whiplash.
X-ray basics: Views bones in still shots.
CT strengths: 3D slices for emergencies.
MRI details: Magnets reveal hidden swelling.
DMX unique: Real-time video of neck motion.
Dr. Jimenez uses imaging to confirm diagnoses, ensuring safe, targeted care at our El Paso wellness clinic.
We love tools that avoid invasives at El Paso Back Clinic®. Surface Electromyography (sEMG) measures muscle activity via skin sensors. It identifies imbalances related to nerve issues post-head injury (Injury 2 Wellness Centers, 2023a).
Our INSiGHT scanners combine scans: Thermal for inflammation, Core for posture, Pulse for stress via heart rate. These insights help us create personalized plan maps (CLA Insights, 2023a).
sEMG benefits:
Detects tense muscles around the neck.
Guides gentle adjustments.
INSiGHT scans:
Heat patterns show hot spots.
Muscle scans check symmetry.
No risks: This procedure is safe for individuals of all ages.
These tools reduce the need for pokes or cuts, aligning with our wellness focus (Injury 2 Wellness Centers, 2023b). Dr. Jimenez says they boost patient involvement.
Nurse Practitioners’ Role in Comprehensive Testing
Our nurse practitioners at El Paso Back Clinic® expand options. They order blood tests for markers like inflammation or clotting risks. This rules out serious issues.
They incorporate a comprehensive approach by integrating chiropractic care into their holistic plans. If scans show problems, they coordinate referrals.
Blood work perks:
Checks for hidden infections.
Monitors healing proteins.
Team integration: NPs and chiros share findings.
Patient plans: Include rest, nutrition, and adjustments.
Dr. Jimenez, with his NP background, ensures seamless care.
Chiropractic Perspectives on Brain Injury Diagnosis
Chiropractors at our clinic see the spine-brain connection. Head hits often shift vertebrae, worsening symptoms. We use tools like Sigma for motion analysis (Kawa, n.d.).
Vestibular tests check eyes and balance. Does the patient experience pain during head movements? The source of the pain could be either the inner ear or the brain.
Spine focus:
Palpate for misalignments.
Grade Whiplash: 0-4.
Red flags: Send to ER for severe signs.
Recovery steps: Adjustments plus exercises.
Dr. Jimenez’s observations show that chiropractic care eases concussion symptoms more quickly.
Collaborative Care for Optimal Recovery
At El Paso Back Clinic®, teamwork rules. NPs order MRIs; chiros use them for adjustments. Shared tests like SCAT5 build complete views.
Plans cover therapy, diet, and follow-ups. Patients return stronger.
Benefits:
Full body healing.
Cost-effective.
Customized to you.
Success stories: Less pain, better function.
Dr. Jimenez’s integrative style shines in El Paso cases.
Insights from Daily Practice at the Clinic
We adapt tests to each patient. A work injury requires X-rays and ImPACT. Follow with BESS for balance gains.
Dr. Jimenez shares how INSiGHT scans catch early nerve stress, preventing long-term woes.
Patients love visual reports—they understand and stick to plans.
Overcoming Challenges in Brain Injury Detection
Access and cost can hinder. But our clinic offers affordable options and education.
Future tools, such as blood biomarkers, promise quicker diagnoses. We stay up to date for the best care.
Hurdles:
Rural limits in TX.
Insurance gaps.
Advances: AI for scan reads, more non-invasives.
Dr. Jimenez pushes for community awareness.
Final Thoughts: Seek Care at El Paso Back Clinic®
Brain injuries need prompt attention. At El Paso Back Clinic® in El Paso, TX, we use GCS, ImPACT, scans, and more for wellness-focused recovery.
If you’ve had a head hit, visit us. Our team, led by Dr. Jimenez, is here for you.
References
Bussières, A., et al. (2022). Concussion knowledge among North American chiropractors. Journal of the Canadian Chiropractic Association, 66(1), 17–26. https://pmc.ncbi.nlm.nih.gov/articles/PMC8791549/
Pickett, W., et al. (2024). Expanding concussion care in Canada: The role of chiropractors and policy implications. Journal of the Canadian Chiropractic Association, 68(2), 145–156. https://pmc.ncbi.nlm.nih.gov/articles/PMC11418793/
Sillevis, R., et al. (2018). Survey of chiropractic clinicians on self-reported knowledge and recognition of concussion injuries. Journal of the Canadian Chiropractic Association, 62(2), 84–95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000952/
Detecting Hidden Traumatic Brain Injury: How Chiropractors and Nurse Practitioners Work Together for Better Recovery
Patient answers the doctor’s traumatic brain injury questions.
Traumatic brain injuries (TBIs) affect millions each year, often in ways that are hard to spot right away. These injuries happen from falls, car crashes, sports hits, or other sudden jolts to the head or body. While severe cases show clear signs like unconsciousness or seizures, milder ones can hide in plain sight. This can lead to ongoing problems with thinking, feelings, and daily life if not caught early. Healthcare providers like chiropractors and nurse practitioners play key roles in spotting these hidden signs through careful talks with patients. By asking the right questions, they uncover subtle clues that point to brain damage.
An integrative approach combines chiropractic adjustments with nurse-led medical care. This team effort targets both the body’s frame and the brain’s wiring, helping people heal better after a TBI. Treatments include gentle spine work, muscle therapies, and custom exercises to fix imbalances and boost brain power. Nurse practitioners add layers of support for mood, energy, and overall health. Advanced tools help confirm diagnoses, starting from simple checks to high-tech scans. Missing a TBI is easy because symptoms mimic stress or fatigue, but thorough checks and treatments can change lives. This article dives into how to detect, treat, and recover from these “invisible” wounds.
The Sneaky Nature of Traumatic Brain Injuries
TBIs disrupt brain function through direct hits or shaking forces. Mild forms, like concussions, might seem minor at first but can linger. According to the Mayo Clinic, symptoms can start right after the injury or pop up days later (Mayo Clinic, 2023). This delay makes them tricky. For example, someone might walk away from a car accident feeling fine, only to struggle with focus at work weeks later. Without prompt care, these issues can worsen, leading to long-term changes in how a person thinks or feels.
The brain controls everything from movement to emotions, so damage shows up in varied ways. Physical signs include headaches that won’t quit or a constant feeling of tiredness. Cognitive hints involve forgetting simple things or zoning out during talks. Emotional shifts, like sudden anger bursts, strain relationships. Sensory changes, such as a weird metallic taste in food or a loss of smell, add to the puzzle. These aren’t always dramatic, which is why they’re often ignored. Friends or family might notice first, saying, “You’ve been off since the fall.” Early spotting is vital because the brain can rewire itself if helped soon (Hauger et al., 2024).
Statistics paint a stark picture: About 1.7 million TBIs occur yearly in the U.S., with many going undiagnosed (Reis, 2022). Military personnel and athletes face higher risks, but anyone can be hit. Children and older adults show unique signs, such as kids losing interest in play or elders stumbling more often. The key? Listen to the body’s quiet signals. Untreated TBIs raise the chances of depression, job loss, or even repeat injuries. But with awareness, recovery paths open up.
Spotting Hidden Signs: A Step-by-Step Guide for Providers
Chiropractors and nurse practitioners are on the front lines for catching TBIs. They start with a deep dive into the patient’s story. This isn’t a quick chat—it’s a series of targeted questions to peel back layers. For instance, a chiropractor might ask, “Have you noticed foods tasting off, or smells fading since your accident?” This uncovers sensory shifts linked to brain areas involved in taste and smell (Fisher Stark, P.C., n.d.). Such details often slip past standard checkups.
A thorough history covers the injury event, immediate aftermath, and ongoing quirks. Questions probe cognitive slips: “Do tasks that used to take 10 minutes now drag on for hours?” This flags concentration woes common in TBIs (BrainLine, 2023). Emotional probes include, “Have small frustrations sparked big anger lately?” Irritability or mood swings signal disrupted emotional centers (U.S. Air Force, 2017). Balance checks ask, “Do you feel wobbly in crowds or after standing quickly?” These point to coordination hits.
Symptom questionnaire:
Nurse practitioners layer in health checks, asking about sleep: “Are you crashing early but waking foggy?” Disturbed rest is a red flag (Mayo Clinic, 2023). Fatigue questions follow: “Does everyday stuff leave you wiped out?” Together, these inquiries build a full picture. Dr. Alexander Jimenez, a chiropractor and nurse practitioner, stresses personalized histories in his practice. He notes that linking subtle symptoms to past traumas helps tailor care, drawing from his work in integrative injury recovery (Jimenez, n.d.a). By cross-checking answers, providers spot patterns missed in rushed visits.
This method shines in real cases. One patient described headaches as “just stress,” but questions revealed post-accident timing, leading to TBI confirmation (Denver Chiropractic, LLC, n.d.). Multiple angles—physical, mental, sensory—ensure nothing hides. It’s simple yet powerful: Listen actively, ask openly, and connect dots.
Nuanced Symptoms: What to Watch For
TBI signs aren’t always obvious; they whisper through daily life. Cognitive disturbances top the list. Trouble focusing might mean rereading the same page over and over or missing deadlines. Memory lapses, like forgetting recent chats, disrupt routines (BrainLine, 2023). These stem from damaged brain pathways handling attention and recall.
Emotional turbulence follows closely. Anger flares over minor things, or flat moods replace joy. Depression creeps in, with unexplained sadness (U.S. Air Force, 2017). Loved ones often spot this first, as the injured person might downplay it. Dr. Jimenez observes in his clinic that these shifts strain families, urging early emotional screens (Jimenez, n.d.b).
Sensory oddities add intrigue. Taste changes turn meals bland or metallic; smells vanish, making cooking a chore (Fisher Stark, P.C., n.d.). Vision blurs, or lights sting eyes. These links to brain regions processing senses are hit hard by jolts.
Physical clues include relentless headaches, pulsing behind the eyes. Fatigue hits like a wall, even after rest. Sleep goes haywire—too much or too little, with nightmares or insomnia (Mayo Clinic, 2023). Balance falters, turning walks into teeters; coordination slips, fumbling keys or tripping.
In kids, signs differ: cranky spells, play changes, or nap shifts (BrainLine, 2023). Elders might show confusion mimicking dementia. These nuances demand vigilance. As one source notes, symptoms overlap with those of stress, delaying help-seeking (Reis, 2022). Recognizing them early prevents cascades, like poor sleep fueling more fatigue.
Building an Integrative Recovery Team
Recovery thrives on teamwork. Chiropractic care fixes body mechanics, while nurse practitioners oversee whole-body health. This blend heals the brain’s hardware and software. Spinal tweaks ease nerve pressure, boosting signals to damaged areas (Northwest Florida Physicians Group, LLC, n.d.). Nurses handle meds, nutrition, and mood support, creating balance.
Dr. Jimenez embodies this, merging his DC and APRN roles for seamless care. His clinic uses functional assessments to link spine health to brain function, echoing collaborative models (Jimenez, n.d.a). Studies back this: Teams reduce recovery time by addressing root causes (Holden et al., 2010).
Chiropractic Tools for Brain and Body Healing
Chiropractors target the spine-brain link. Adjustments realign vertebrae, improving fluid flow and nerve flow (Pinnacle Health Chiropractic, 2023). This cuts headaches and fog. Soft-tissue work kneads tight muscles, easing tension from impacts (Calibration Mansfield, n.d.).
Targeted exercises build strength and balance. Simple drills, like ball tosses, retrain coordination (HML Functional Care, n.d.). Vestibular therapies steady dizziness. Low-level lasers reduce swelling, aiding neuron repair (Reis, 2022).
Benefits stack: Better circulation delivers oxygen to the brain; balanced nerves sharpen focus (Apex Chiropractic, n.d.). One case saw a survivor return to EMT work after such care (Reis, 2022). It’s drug-free, focusing on the body’s own fixes.
Nurse Practitioners: Holistic Health Guardians
Nurses round out the plan with metabolic and emotional aid. They monitor blood sugar and electrolytes, preventing crashes that slow healing (Kim et al., 2024). Nutrition plans help fight inflammation, a key factor in TBI recovery.
Mental support includes therapy referrals and family coaching. Sedation eases agitation; family visits calm nerves (Kim et al., 2024). Dr. Jimenez integrates this, using coaching for stress and hormones (Jimenez, n.d.b). This full-spectrum care lifts mood, energy, and resilience.
Diagnostic Tools: From Basics to High-Tech
Diagnosis starts simple, scaling with needs. Basic tools include the Glasgow Coma Scale (GCS), scoring eye, verbal, and motor responses for quick severity checks (Mayo Clinic, 2023). Vital signs track blood pressure and heart rate, spotting brain pressure rises.
Next, CT scans image bleeds or swells—fast for emergencies (Mayo Clinic, 2023). MRIs detail soft tissue damage, revealing axon tears invisible on CT.
Advanced options: EEGs catch hidden seizures via brain waves (Kim et al., 2024). Neuropsychological tests probe memory and focus. Functional MRIs map active brain areas; diffusion tensor imaging traces nerve paths (HML Functional Care, n.d.).
Eye-tracking tools like RightEye assess gaze for subtle deficits (Calibration Mansfield, n.d.). Blood tests measure biomarkers for the extent of damage. Order matters: Basics rule out crises; advanced confirm and guide plans.
Why TBIs Slip Through Cracks—and How to Fix It
Traumatic Brain Injuries (TBIs) often go unnoticed because their symptoms can be mistaken for everyday life stresses. A headache? Blame work. Irritability? “Bad day.” This oversight delays care, worsening outcomes (BrainLine, 2023). Providers miss them without deep histories, as one study shows that up to 50% of mild cases go undiagnosed (Reis, 2022).
Meticulous evaluation changes this. Multi-question intakes and team huddles catch clues. Treatment urgency: Early adjustments prevent scarring; holistic plans build lasting gains. Paula’s story proves it— from bedbound to marathon training via integrated care (Reis, 2022).
In military settings, recognition cuts long-term woes (U.S. Air Force, 2017). For all, it means reclaiming life. Push for thorough checks; the brain deserves it.
Holden, C. Q., et al. (2010). Chiropractors and collaborative care: An overview illustrated with a case report. Chiropractic & Osteopathy, 18(21). https://doi.org/10.1186/1746-1340-18-21
Kim, J., et al. (2024). Nursing interventions to prevent secondary injury in critically ill patients with traumatic brain injury: A scoping review. Journal of Clinical Medicine, 13(8), 2396. https://doi.org/10.3390/jcm13082396
Chiropractic & Manual Therapies. (2018). Be good, communicate, and collaborate: A qualitative analysis of stakeholder perspectives on adding a chiropractor to the multidisciplinary rehabilitation team. Chiropractic & Manual Therapies, 26(17). https://doi.org/10.1186/s12998-018-0200-4
Enhancing Body Detox Through Exercise and Chiropractic Care at El Paso Back Clinic
Maintaining a healthy body in today’s busy world goes beyond just eating well. Your body naturally removes toxins through various organs, including the liver, kidneys, lungs, skin, and lymphatic system. Stress, poor posture, or injuries from accidents can slow these processes, leading to fatigue or discomfort. At El Paso Back Clinic®, led by Dr. Alexander Jimenez, DC, APRN, FNP-BC, we combine targeted exercise, chiropractic care, and integrative therapies to support your body’s natural detox systems. This 5,000-word guide explores sports and activities that boost circulation, stimulate lymph flow, and promote healthy sweating, paired with our clinic’s expertise in injury recovery and wellness to enhance overall health.
Your Body’s Natural Detox Systems
Your body is designed to eliminate waste daily. The liver filters blood, kidneys flush out liquids, lungs exhale waste gases, skin releases toxins through sweat, and the lymphatic system drains excess fluid and fights infection (Fontana Candle Company, n.d.). When these systems are sluggish—due to inactivity, poor alignment, or injury—toxins can accumulate, leading to fatigue, joint pain, or skin issues.
At El Paso Back Clinic®, we understand how spinal misalignments or injuries from motor vehicle accidents (MVAs), work, or sports can disrupt these pathways. Exercise gets blood and lymph moving, sweating clears the skin, and chiropractic adjustments align the spine to optimize nerve signals to detox organs. Integrative therapies, such as massage and acupuncture, further enhance flow by working together to support your body without replacing its natural processes.
Sports and Activities to Boost Circulation
Good blood flow is vital for detox, delivering oxygen and nutrients while removing waste. At El Paso Back Clinic®, we recommend cardio-based activities tailored to your needs, especially for patients recovering from injuries like whiplash or joint strains.
Brisk Walking or Jogging: These low-impact exercises increase heart rate and improve blood vessel health, reducing inflammation (Avicenna Cardiology, n.d.). For MVA patients, walking is a safe start to rebuild mobility.
Swimming: Ideal for those with joint pain, swimming works the whole body while supporting circulation. Dr. Jimenez often prescribes it for sports injury recovery due to its gentle nature (Jimenez, n.d.a).
Cycling: Stationary or outdoor biking strengthens legs and boosts lower-body circulation. It’s great for work-related injury patients, as it avoids high impact (One Leisure, n.d.).
Team Sports: Activities like soccer or basketball involve bursts of running and jumping, enhancing overall flow. These are excellent for younger patients or those in sports wellness programs at our clinic.
Start with 30 minutes, five days a week, adjusting based on your recovery plan. Our team assesses your condition—using advanced neuromusculoskeletal imaging—to ensure activities match your health goals (Jimenez, n.d.b).
Activating the Lymphatic System Through Movement
The lymphatic system, your body’s drainage network, relies on muscle movement to function. Without a pump like the heart, it needs activities to keep fluid flowing. At El Paso Back Clinic®, we integrate lymph-stimulating exercises into treatment plans for patients with swelling or pain from injuries.
Rebounding: Bouncing on a mini-trampoline creates a pumping action, moving lymph up to 15 times more effectively than walking (Cancer Schmancer, n.d.). It’s ideal for post-MVA recovery to reduce swelling.
Yoga: Poses like downward dog or cat-cow use gravity and muscle engagement to drain lymph nodes. Yoga also reduces stress, which can clog lymph flow. We offer guided sessions for patients with back pain or sciatica.
Pilates: Controlled movements strengthen the core, massage organs, and boost lymph circulation. It’s part of our rehabilitation for degenerative arthritis.
Hiking: El Paso’s trails provide uneven terrain that engages muscles, promoting lymph flow. It’s recommended for patients transitioning back to active lifestyles post-injury.
Dr. Jimenez’s dual-scope diagnosis—combining chiropractic and nurse practitioner expertise—identifies lymph blockages from injuries like sprains or MVAs. Using imaging, we create personalized plans to restore flow and prevent chronic issues (Jimenez, n.d.a).
Sweating for Effective Detox
Sweating is a powerful way to eliminate toxins through the skin, your largest organ. Research shows sweat can remove heavy metals and chemicals like BPA more effectively than urine (Samahita Retreat, n.d.). At El Paso Back Clinic®, we encourage healthy sweating as part of recovery and wellness.
Hot Yoga: Combining heat and movement, hot yoga opens pores and boosts circulation. It’s ideal for patients with musculoskeletal inflammation, as it reduces stiffness (HCMedSpa, n.d.).
Running: Moderate runs in El Paso’s climate induce clean sweat, flushing impurities. We recommend it for patients recovering from sports injuries to maintain their fitness.
Infrared Saunas: These use light to heat the body, promoting deep detox without excessive heat. They’re part of our integrative approach for patients with chronic pain (Pause Studio, n.d.).
Hydration is key—drink water before and after sweating. Dr. Jimenez often pairs sauna sessions with adjustments for MVA patients, as inflammation from injuries can trap toxins (Jimenez, n.d.b). Dry brushing before sweating further enhances lymph and skin detox.
Chiropractic Care at El Paso Back Clinic
Chiropractic adjustments realign the spine, relieving nerve pressure to optimize organ function, including the detoxification system. Misalignments from MVAs, work injuries, or poor posture can disrupt nerve signals to the liver or kidneys (Recovery Chiropractic, n.d.). At El Paso Back Clinic®, we use techniques like the Thompson Drop-Table to gently correct these issues, improving immune and detox function.
Dr. Jimenez’s clinic specializes in treating severe pain, sciatica, neck/back issues, whiplash, and sports injuries. Using advanced imaging, we diagnose misalignments or nerve impingements, then tailor adjustments to each patient. For example, a worker with a back strain from lifting might receive adjustments and therapeutic exercises to restore alignment and mobility (Jimenez, n.d.a). We also provide legal documentation for injury cases, ensuring proper care coordination with insurance or legal teams.
Integrative Therapies for Holistic Healing
At El Paso Back Clinic®, we combine chiropractic with integrative therapies to enhance detox and recovery:
Massage Therapy: Deep tissue massage releases toxins from muscles and improves lymph drainage. It’s used for MVA patients with whiplash or joint pain to speed healing (Bend Total Body Chiropractic, n.d.).
Acupuncture: Thin needles are inserted into specific energy points to reduce pain and enhance circulation. It’s effective for personal injuries or chronic conditions, such as arthritis, by balancing the body’s qi (Jimenez, n.d.b).
Nutritional Guidance: Our nutritionists design anti-inflammatory diets to support detox during recovery, especially for MVA or sports injury patients (El Paso Back Clinic, n.d.).
These therapies work synergistically with adjustments. For instance, a patient with a bicycle accident injury might receive spinal adjustments, massage to reduce muscle tension, and acupuncture to ease inflammation, preventing long-term complications.
How These Practices Work Together
Imagine visiting El Paso Back Clinic for an adjustment to align your spine, which improves nerve signals and helps detoxify organs. You follow with a yoga class to stimulate lymph and sweat, then a massage to release muscle toxins. Weekly walks keep circulation steady. This combination maximizes each method’s benefits: adjustments clear nerve pathways, exercise pumps blood and lymph, and integrative care reduces inflammation.
For athletes, this synergy prevents injuries and speeds recovery. A soccer player with a knee sprain may undergo imaging to assess the damage, receive adjustments to align the pelvis, and participate in targeted exercises to rebuild strength (Phoenix Rising Wellness Center, n.d.). For everyday El Pasoans, it’s about wellness—chiropractic keeps the spine healthy, exercise maintains fitness, and therapies like acupuncture promote balance.
Real-Life Benefits and Safety Tips
Patients at El Paso Back Clinic report increased energy, reduced pain, and improved mobility after combining these approaches. Studies show exercise and chiropractic care lower inflammation, aiding detox (HCMedSpa, n.d.). Our clinic’s MVA patients often see faster recovery from whiplash or spinal injuries when pairing adjustments with movement and nutrition plans.
Safety is a priority. Dr. Jimenez uses dual-scope diagnostics to assess injuries from work, sports, or MVAs, ensuring exercises suit your condition (Jimenez, n.d.b). Consult our team before starting, especially with heart issues or severe injuries. Hydrate during sweat sessions, and stop if you feel pain.
For accident cases, we provide detailed legal documentation, ensuring treatments align with insurance or court needs, as seen in our MVA recovery programs (El Paso Back Clinic, n.d.).
Your Detox and Wellness Plan at El Paso Back Clinic
Start with a chiropractic assessment at El Paso Back Clinic®, followed by three cardio sessions (like walking or cycling), two yoga classes, and a monthly massage. Add acupuncture for pain relief. Track your energy and mobility—feeling better is a sign it’s working.
Dr. Jimenez and our team in El Paso tailor plans to your needs, whether you are recovering from an 18-wheeler crash or maintaining wellness. Our advanced diagnostics and integrative approach address injury causes, promoting natural healing and long-term health (Jimenez, n.d.a).
Conclusion
At El Paso Back Clinic®, we believe in supporting your body’s natural detox through exercise, chiropractic care, and integrative therapies. From boosting circulation with swimming to stimulating lymphatic flow with yoga and clearing toxins through sweat, these practices work together to enhance overall health. Paired with Dr. Jimenez’s expertise in injury recovery and wellness, you can thrive in El Paso’s active community. Visit us to start your journey to optimal health.
Dr. Alex Jimenez: Pioneering Integrative Care as a Chiropractor and Nurse Practitioner
Dr. Alex Jimenez, a licensed chiropractor and board-certified nurse practitioner based in El Paso, Texas, brings over 25 years of expertise to his Injury Medical & Chiropractic Clinic practice. His dual licensure provides unique insights into the etiologies, pathogenesis, and treatment of complex clinical conditions, enabling him to deliver patient-centered, integrative care that bridges physical medicine, functional medicine, and advanced diagnostics. Combining chiropractic expertise with nurse practitioner-driven medical management, Dr. Jimenez offers comprehensive treatment protocols tailored to acute and chronic conditions, promoting metabolic resilience, longevity, and whole-person wellness.
Dual Expertise: Chiropractic and Nurse Practitioner Roles
Dr. Jimenez’s practice stands out due to his ability to integrate the biomechanical focus of chiropractic care with a nurse practitioner’s diagnostic and therapeutic scope. As a chiropractor, he specializes in restoring musculoskeletal function, particularly after trauma, neck, back, spine, and soft tissue injuries. His chiropractic interventions emphasize non-invasive techniques, such as spinal decompression, manual adjustments, and functional rehabilitation, to alleviate pain and enhance mobility.
As a board-certified nurse practitioner, Dr. Jimenez employs evidence-based medicine to address systemic and metabolic dysfunctions. His expertise extends to managing chronic degenerative disorders, hormonal imbalances, weight loss, sexual health, and pain syndromes. This dual perspective allows him to identify underlying disease causes, from biomechanical misalignments to physiological imbalances, and design treatment regimens that address symptoms and root causes.
The synergy of these roles enables Dr. Jimenez to offer a holistic approach that is particularly effective for complex conditions such as sciatica, fibromyalgia, disc herniation, spondylolisthesis, and chronic neck or back pain. His integrative protocols combine functional medicine assessments, lifestyle interventions, and advanced diagnostics to achieve homeostasis and physiological balance.
Treatment Protocols: Evidence-Based and Patient-Centered
Drawing from integrative protocols outlined on his website, www.chiromed.com, Dr. Jimenez employs a multidisciplinary approach to patient care. His treatment plans are grounded in evidence-based medicine, functional medicine, and lifestyle wellness strategies, tailored to each patient’s unique health profile, lifestyle, and medical history. Below are key components of his integrative care model:
1. Chiropractic Care and Functional Rehabilitation
Spinal Decompression: Non-surgical decompression therapy is used to relieve pressure on spinal discs, addressing conditions like disc herniation, sciatica, and spinal stenosis. This modality promotes healing by improving blood flow and nutrient delivery to affected areas.
Manual Adjustments: Targeted adjustments correct spinal misalignments, reduce nerve compression, and restore joint mobility. These are particularly effective for whiplash, scoliosis, and poor posture.
Functional Strength Training: Dr. Jimenez designs conditioning programs to enhance recovery and prevent re-injury. These programs are tailored for athletes and individuals seeking optimal performance and incorporate mobility, flexibility, and agility training.
2. Functional Medicine Assessments
Functional medicine tools evaluate metabolic, hormonal, and nutritional status. These assessments identify the root causes of conditions such as fatigue, weight gain, or chronic pain, enabling precise interventions.
Advanced diagnostic protocols, including blood panels and imaging, provide data-driven insights into etiologies and pathogenesis. This allows Dr. Jimenez to address underlying dysfunctions rather than merely masking symptoms.
3. Lifestyle and Nutritional Interventions
Weight Loss and Metabolic Resilience: Dr. Jimenez integrates nutritional counseling and metabolic optimization strategies to support sustainable weight loss and prevent chronic diseases like diabetes or cardiovascular disorders.
Hormone and Sexual Health: Personalized regimens address hormonal imbalances and sexual dysfunction, improving quality of life and overall wellness.
Pain Management: Nutritional and lifestyle modifications complement physical therapies to manage chronic pain syndromes, reducing reliance on pharmaceuticals.
4. Specialized Care for Complex Conditions
Sciatica and Disc Injuries: Dr. Jimenez employs targeted decompression and rehabilitation protocols to alleviate nerve compression and restore function.
Chronic Degenerative Disorders: Conditions like fibromyalgia, arthritis, and spondylolisthesis are managed through integrative plans that combine physical therapy, nutritional support, and metabolic optimization.
Sports and Auto Accident Injuries: Tailored rehabilitation programs address soft tissue damage, shoulder injuries, and whiplash, ensuring rapid recovery and long-term resilience.
5. Advanced Wellness Programs
Dr. Jimenez’s clinic offers comprehensive wellness programs on longevity, skin care, and hair loss. These programs integrate nutritional supplementation, lifestyle coaching, and cutting-edge therapies to promote vitality and aesthetic health.
High-level conditioning programs optimize performance for athletes, incorporating functional strength training and recovery-focused interventions.
Integrative Team and Clinic Highlights
Injury Medical & Chiropractic Clinic is El Paso’s largest mobility, flexibility, and agility center, integrating chiropractors, nurse practitioners, registered nurses, nutritionists, and physical performance trainers. The clinic’s multidisciplinary team collaborates to deliver personalized care, ensuring patients achieve measurable health outcomes. Key services include:
Acupuncture: A Complementary therapy to reduce pain and promote relaxation.
Advanced Nutritional Programs: Evidence-based dietary plans to support metabolic health and recovery.
Physical Performance Training: Programs to enhance fitness, prevent injuries, and optimize athletic performance.
The clinic accepts major insurances, including Aetna, Blue Cross Blue Shield, Cigna, and First Health, making care accessible to a broad patient base.
Insights from Dual Licensure
Dr. Jimenez’s licensure as both a chiropractor and nurse practitioner provides him with a comprehensive understanding of disease processes and treatment modalities. His chiropractic training equips him to address biomechanical dysfunctions, while his nurse practitioner expertise allows him to manage systemic conditions with a medical lens. This dual perspective enhances his ability to:
Clarify Etiologies: By combining musculoskeletal assessments with metabolic and hormonal evaluations, Dr. Jimenez identifies multifactorial causes of conditions, ensuring targeted interventions.
Understand Pathogenesis: His knowledge of disease progression informs proactive treatment plans that halt or reverse degenerative processes.
Design Appropriate Regimens: Integrating physical, nutritional, and medical therapies, Dr. Jimenez creates synergistic treatment plans that address both symptoms and underlying dysfunctions.
This integrative approach is particularly valuable for patients with chronic or multifactorial conditions, as it addresses the interplay between physical, metabolic, and lifestyle factors.
Patient-Centered Care: In-Person and Online
Dr. Jimenez’s practice emphasizes personalized attention, whether patients visit in person at 11860 Vista Del Sol, Suite 128, El Paso, TX 79936, or engage through telehealth. His functional medicine series, accessible via www.dralexjimenez.com, educates patients on holistic health principles, covering topics from spinal health to metabolic optimization. The website features:
Informative Content: Blog posts, articles, and videos provide insights into chiropractic care, functional medicine, and injury rehabilitation.
Patient Testimonials: Success stories highlight the transformative impact of Dr. Jimenez’s care, showcasing outcomes for conditions like sciatica, sports injuries, and chronic pain.
Appointment Booking: A user-friendly interface allows patients to schedule in-person or online consultations, with clear guidance on what to expect during their first visit.
Commitment to Education and Community Health
Dr. Jimenez is dedicated to empowering patients through education. His website is comprehensive, offering evidence-based information on health conditions, treatment options, and wellness strategies. By fostering health literacy, Dr. Jimenez enables patients to make informed decisions and take charge of their well-being.
His commitment extends to the El Paso community, where he aims to expand access to integrative care. Dr. Jimenez promotes proactive health management and preventive care through workshops, online content, and community outreach.
Conclusion
Dr. Alex Jimenez’s dual expertise as a chiropractor and nurse practitioner positions him as a leader in integrative medicine. His ability to bridge physical medicine with systemic health management allows him to address complex clinical issues with precision and compassion. Dr. Jimenez delivers personalized care that promotes healing, resilience, and longevity by leveraging evidence-based protocols, advanced diagnostics, and lifestyle interventions.
For more information or to schedule an appointment, visit www.dralexjimenez.com or contact the clinic at +1-915-412-6677.
Can healthcare professionals implement H.E.A.R.T. protocols for trafficked individuals while providing a safe space?
Introduction
Across the world, many local media and organizations are paying close attention to a phenomenon that many people should be aware of. This phenomenon is known as trafficking, and it can be associated with numerous activities, from forced labor to sex labor, and can affect a person’s sense of self-worth. While many people will correlate that trafficking affects many women and children, it can affect many individuals regardless of age, gender, and background. While many survivors of trafficking are dealing with the psychological and physical injuries that they obtain from their traffickers, many medical professionals can implement protocols and roles through the implementation of H.E.A.R.T. to provide a safe space for individuals suffering from trafficking. Today’s article focuses on the definition of trafficking, what H.E.A.R.T. is, and how it is used in a clinical setting. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in a clinical approach while providing a safe space. We also inform and guide patients while asking their associated medical provider intricate questions to formulate customized treatment plans for their pain and provide them with a safe space and positive experience. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Definition Of Trafficking
When it comes to defining trafficking, it can be challenging as it is frequently associated with other issues. However, the main definition for trafficking is “recruiting, transporting, transferring, or harboring many individuals or a person that are threatened or forced to achieve the consent of a person having control of the individuals for exploitation.” With human trafficking being a pressing public concern that affects all races, social classes, demographics, and genders, it can impact society and the individual who is being trafficked. (Toney-Butler et al., 2024) Additionally, many people often mistake trafficking and smuggling as they are completely different. Smuggling requires a person to be transported into a nation through voluntary illicit means. While trafficking can come in two forms, which are labor and commercial sex, it can happen within the person’s own home. (Rambhatla et al., 2021) This is because many survivors who are going to get healthcare services will feel various emotions of fear or shame that can prevent them from asking for help due to what they have been through with their trafficker. However, when many individuals who are trafficking survivors are suffering from significant physical, mental, and social health problems and are seeking healthcare services, many healthcare professionals play an important role by creating a safe and responsive space for them. (The Lancet Regional Health-Western, 2022)
Beyond the Surface: Understanding the Effects of Personal Injury- Video
What is H.E.A.R.T In A Clinical Setting
When it comes to creating a safe and positive space in a clinical setting, many healthcare professionals often miss the signs of trafficking due to a lack of training or confidence to identify and treat patients who are trafficking victims. (Lee et al., 2021) However, healthcare protocols should be implemented, and H.E.A.R.T. should be incorporated into a clinical approach to assess and develop a customized treatment plan for the patient. Healthcare professionals can engage with the patient in a one-on-one discussion away from their trafficker and can offer important medical and psychological care resources. (Exeni McAmis et al., 2022) By incorporating H.E.A.R.T. protocols in a healthcare clinic, many doctors and medical professionals can help many patients be in a safe environment. Below is what H.E.A.R.T. stands for.
H-Hearing
The “H” in H.E.A.R.T. is for hearing as many medical professionals not only to hear but to see what is going on in the clinic and to establish environmental awareness. This is due to looking at the patient and who is accompanied by them. With healthcare providers being at the front, they interact with patients and may not know what health concerns are affecting them. This could be due to the following:
By incorporating the hearing aspect in H.E.A.R.T., many healthcare professionals can provide a safe, thoughtful, and engaging approach to the patient and know what to look for when a patient is coming in for treatment.
E-Evaluating
The “E“ in H.E.A.R.T. is used to evaluate its importance in enhancing patient interactions in a trauma-informed care facility. This is highly important because the individual is seeking health care. For the patients being trafficked, it is important to notice the red flags the individual is experiencing. Some of the red flags that many healthcare providers should look for are:
Physical health
Behavioral Health
The patient is with a controlling person
The patient does not have possession of their I.D.
Additionally, it is always important to show compassion, be sensitive to the individual while addressing their needs and concerns, and use a non-judgmental approach during the interview process. This helps the individual ensure they are in a safe environment when discussing sensitive topics. At the same time, it is important not to let the patient be re-traumatized while avoiding the impulse to rescue and overpromise the patient to mental health as we want them to have their self-worth. At the same time, it is best to remember the four “Rs“ when doing a trauma-informed approach; they are:
Realize: Understanding how trauma can affect people.
Recognize: Recognizing the signs of trauma.
Respond: Have all staff trained, use evidence-based practices, and provide a safe environment.
Resist Re-trauma: Recognizing how some practices may trigger painful memories while avoiding re-traumatizing the patient.
By implementing the four “Rs“ and the “E“ in H.E.A.R.T., many healthcare professionals can provide valuable resources to trafficking survivors with a strong support system.
A-Activating
The “A“ in H.E.A.R.T. stands for activating, where healthcare professionals must have proper protocols to engage all employees. This allows the healthcare providers to understand how beneficial it is to develop a protocol for a person who is being trafficked, understand their state and federal reporting laws, and list key elements of effective trauma-informed screening procedures when assessing the patient. This allows a foundational structure to support a response for suspected patients who are being trafficked. At the same time, by following HIPAA laws and organization policies, many healthcare providers must explain the reporting process to the right officials. Additionally, the benefits of developing a protocol for trafficking are by:
Clarifying procedures
Enhance staff training
Optimize the interactions with the trafficking patients
Improve staff confidence
Prepare for any threatening situations
Maximizing preparedness to aid trafficking patients
Optimize support for patients
Develop collaborative outside resources
R-Resourcing
The “R“ in H.E.A.R.T. stands for resourcing, as many healthcare providers must identify the referral systems. This allows healthcare professionals to understand the important message to convey when assessing trafficking victims and the importance of responding to safety, emergency, and reporting requirements. When assessing and interviewing the patient, many will have to recognize that their patient may be a possible victim of trafficking, what their immediate needs are, and what long-term resources can help.
T-Training
The “T” in H.E.A.R.T. stands for training, as it is important that many healthcare providers continuously train to spot trafficking; this provides confidence to many healthcare workers and can help save a person’s life. By implementing H.E.A.R.T. protocols, the “T” allows the doctor to respect the individual’s decision to want help, providing a positive support system while encouraging them to come back, offering to help with a safety plan, and building a resource network. This is because if the patient is accompanied by someone who is controlling and answering for the patient, handing out information discreetly can provide a bit of hope to the individual to make the move. At the same time, providing local and immediate assistance resources can help the individual in the long run. This allows healthcare providers to build a trusting relationship and even help individuals to have a safe and positive experience on their health and wellness journey.
References
Exeni McAmis, N. E., Mirabella, A. C., McCarthy, E. M., Cama, C. A., Fogarasi, M. C., Thomas, L. A., Feinn, R. S., & Rivera-Godreau, I. (2022). Assessing healthcare provider knowledge of human trafficking. PLOS ONE, 17(3), e0264338. https://doi.org/10.1371/journal.pone.0264338
Gutfraind, A., Yagci Sokat, K., Muscioni, G., Alahmadi, S., Hudlow, J., Hershow, R., & Norgeot, B. (2023). Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes. Front Public Health, 11, 1243413. https://doi.org/10.3389/fpubh.2023.1243413
Lee, H., Geynisman-Tan, J., Hofer, S., Anderson, E., Caravan, S., & Titchen, K. (2021). The Impact of Human Trafficking Training on Healthcare Professionals’ Knowledge and Attitudes. J Med Educ Curric Dev, 8, 23821205211016523. https://doi.org/10.1177/23821205211016523
Rambhatla, R., Jamgochian, M., Ricco, C., Shah, R., Ghani, H., Silence, C., Rao, B., & Kourosh, A. S. (2021). Identification of skin signs in human-trafficking survivors. Int J Womens Dermatol, 7(5Part B), 677-682. https://doi.org/10.1016/j.ijwd.2021.09.011
How do healthcare professionals provide a clinical approach to recognizing trafficking to individuals seeking a safe environment?
Introduction
Around the world, there is a phenomenon that local media and organizations are paying more attention to and that many people should be aware of. This is known as trafficking, and it can encompass a wide range of activities, from forced labor in various industries to sex work. While most individuals of trafficking are usually young women or children, it can affect many individuals of all ages and backgrounds. Many survivors of trafficking are compelled to live with the psychological and physical injuries they sustained from the mistreatment they endured at the hands of their traffickers. This course aims to give medical professionals and others in allied fields an understanding of the realities of human trafficking, as well as the kinds of resources and interventions that can be used to help many individuals trafficking in this two-part series. Today’s article overviews trafficking and how it can impact the individual. In part two, we will discuss the roles and protocols of how healthcare professionals can identify trafficking while providing a safe and positive space for the individual. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic. We also inform and guide patients while asking their associated medical provider intricate questions to integrate a customized treatment plan for their pain and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Definition of Trafficking
It can be challenging to define trafficking since it frequently coexists with other problems like forced marriage, sexual assault, domestic abuse, and forced labor. (Hume & Sidun, 2017) As the United Nations stated, trafficking encompasses the following activities: “as recruitment, transportation, transfer, harboring, or receipt of many individuals using the threat or use of force to achieve the consent of a person having control over another person, for exploitation.” (United Nations Human Rights Office of the High Commissioner, n.d.) The following components of this definition include:
Act: This is a reference to the different forms of human trafficking, including the hiring, transferring, receiving, and harboring of individuals.
Means: Coercion, force, fraud, kidnapping, deception, abuse of power or weakness, or providing cash or other rewards to someone in a position of authority over the victim are typically used to carry out trafficking.
Purpose: Traffickers engage in forced labor, prostitution, sexual exploitation, forced servitude, slavery, and even organ harvesting to further their financial interests.
While the terms are occasionally used synonymously, human trafficking and people smuggling are not the same. Human smuggling is the transportation of a person into the nation by illicit means; it is voluntary, as the person smuggled usually offers compensation to another individual or party to achieve this purpose (Lusk & Lucas, 2009).
The broad term of human trafficking in the Trafficking Victims Protection Act includes both labor trafficking and sex trafficking. Sex trafficking is when someone is under the age of 18 and is obtained, patronized, or solicited for a commercial sex act by deception, force, or compulsion. The forced, coerced, or fraudulent submission of an individual to slavery, debt bondage, involuntary servitude, or peonage is considered labor trafficking. According to the U.S. Congress, the TVPA does not require that trafficking take place if a person is physically moved from one location to another.
The Statistics Of Trafficking
Determining the actual extent of the problem is challenging due to the complexity of the human trafficking issue and the fact that both the offenders and the victims frequently go unnoticed. A few published estimates from academics, researchers, and organizations and agencies responsible for recording and monitoring occurrences of human trafficking are as follows:
According to estimates from the International Labour Organization, there are over 40 million victims of human trafficking worldwide. (International Labour Organization, n.d.)
Over 51,000 complaints of cases of human trafficking have been received by the National Human Trafficking Hotline since 2007 (National Human Trafficking Hotline, n.d.).
The number of persons thought to be trafficked in the United States varies greatly from year to year, with estimates ranging from 40,000 to 50,000. (Weizter, 2007)
In 2017, the United States Department of Justice obtained 1,045 convictions for offenses related to human trafficking, a 78% increase from 2015. (International Labour Organization, n.d.).
According to the International Labour Organization, over 15 million people are in forced marriages, 4.8 million people are victimized by sex trafficking, and forced labor trafficking claims the lives of almost 25 million people globally. (International Labour Organization, 2017)
In the US, Florida is the third-most popular destination for victims of human trafficking. In 2018, there were 767 reports of human trafficking incidents in Florida and close to 1,900 contacts with the National Human Trafficking Hotline. There was almost 70% of sex trafficking, 16.5% of labor trafficking, and 7.5% of both sex and labor trafficking combined. Of the victims, 56% were adults, and 69% were female (National Human Trafficking Hotline, n.d.).
Data Collection Challenges
The current ICD-10-CM abuse codes could not adequately distinguish victims of human trafficking from other abuse victims, even though an increasing number of caregivers are trained to recognize and record individuals of different forms of human trafficking. Clinicians couldn’t properly identify a condition or arrange the resources needed to administer treatment without the right codes. Additionally, this made it impossible to critically monitor the existence and recurrence of human labor or sexual exploitation.
June 2018 saw the publication of the first ICD-10-CM codes for categorizing abuse related to human trafficking, as requested by the American Heart Association’s Hospitals Against Violence program. The proposal for the modification came from the AHA’s Central Office on ICD-10, which collaborated with Catholic Health Initiatives, the Human Trafficking Initiative at Massachusetts General Hospital, and the Freedom Clinic. With effect from FY 2019, certain ICD-10-CM codes can be used to collect data on adult or child forced labor or sexual exploitation, whether it is proven or suspected. These new codes may be issued in addition to other current ICD-10-CM codes for abuse, neglect, and other maltreatment. These codes received support from different hospitals and health systems. Furthermore, there exist novel codes that can be utilized to record an individual’s past labor or sexual exploitation history, examine, rule out, and observe instances of exploitation, and identify multiple, repeating perpetrators of maltreatment and neglect through an external cause of code (Macias-Konstantopoulos, 2018).
The ICD-10-CM provides specific abuse codes for a range of abuse experiences, such as physical abuse of an older adult, sexual abuse of a child, and violence against a spouse or partner. Similar to how disease diagnosis codes are used, tracking the frequency and trends of particular abuse types, their relationships to other injuries and illnesses, and the kinds of resources that might be needed to stop the abuse are all made feasible by recording abuse using the relevant ICD-10-CM code. Adopting prevention strategies, creating best practices for treatment, introducing new services and payment methods, and establishing new financing and research fields are all made possible by using these codes as the primary diagnosis (Macias-Konstantopoulos, 2018).
Documenting particular types of violence and abuse alone does not give a full picture of the abuse experience. Every abuse experience is a result of a complex interaction between several variables, including the physical surroundings, social and familial dynamics, and personal risks and vulnerabilities. Healthcare professionals can respond to illnesses and injuries connected to abuse as well as underlying health-related social and mental requirements more effectively when these aspects are assessed, documented, and coded using ICD-10-CM Z codes. Similarly, applying ICD-10-CM S, T, V, W, X, and Y codes to record and classify external causes of morbidity as well as the nature, purpose, and mechanism of injury can help shed light on how abuse and violence are committed and pave the way for further preventative measures (Macias-Konstantopoulos, 2018).
Required Actions
Coders should be aware of and start using the ICD-10-CM codes for forced labor and sexual exploitation as they examine a patient’s medical records to determine which ICD-10-CM codes to include.
Hospitals and health systems should inform those who need to know—doctors, nurses, other medical professionals, and coding specialists, among others—about the significance of gathering data on forced labor and sexual exploitation of people.
By keeping track of verified and suspected cases within the healthcare system, hospitals, and health systems can better monitor victim requirements and find ways to enhance community health.This practice also offers an additional means of gathering data to help the systemic creation of a service and resource infrastructure, as well as attempts to prevent harm and inform public policy.
The accompanying chart illustrates the distinction between focused and comprehensive assessment, documentation, and coding of abuse. It also highlights how these differences may affect medical professionals’ reactions to cases and their comprehension of the kinds of resources that may be required to help victims of human trafficking (Macias-Konstantopoulos, 2018).
Beyond the Surface: Understanding the Effects of Personal Injury- Video
Common Misconceptions of Trafficking
There is a misconception that trafficking entails the kidnapping and crossing of national or international borders for various activities to individuals. This misconception fails to acknowledge that individual trafficking can be of any ethnicity, gender, or country and that it can happen almost anywhere and in any sector of the economy. A handful of the widespread myths about human trafficking are as follows:
Myth: Physical violence is a common part of trafficking. Traffickers frequently employ nonviolent tactics, such as deception, manipulation, intimidation, and deceit, to coerce their victims into exploitative circumstances, even while physical violence plays a role in many of their crimes.
Myth: Sexual exploitation is a necessary component of trafficking. It’s likely the most well-known type of trafficking, but commercial sexual exploitation of victims is also a frequent practice. However, experts think that labor trafficking is more commonplace throughout the world.
Myth: Only undocumented foreign nationals are victims of trafficking.The Polaris Project operates the National Human Trafficking Hotline, which has handled thousands of cases of trafficking involving foreign nationals who are lawfully employed or residing in the United States.
Myth: Only illicit or covert sectors are involved in trafficking. Trafficking has been documented concerning several legitimate industries, including manufacturing, restaurants, cleaning services, and construction.
Myth: Transporting a person across state or national borders is a part of trafficking. Human smuggling is the illicit movement of persons across state or national borders. There can be trafficking even when there is no cross-border travel. A person may even become a victim of trafficking in their own house or hometown.
Myth: Trafficking is always a part of the commercial sex trade. Any commercial sex with kids is invariably seen as human trafficking. Adult commercial sex is only classified as trafficking when the victim is coerced, compelled, or deceived into doing it against their will.
Common Forms of Trafficking
There are many forms of trafficking as many individuals that were trafficked are categorized into the following:
Sex Trafficking
Bonded Labor/Forced Labor
Child Labor
Child Conscription
The Impact & Consequences of Trafficking on Individuals
For someone who has never experienced human trafficking, it might be challenging to understand why so many victims choose to remain silent or show such a strong willingness to cooperate with their traffickers (Johnson, 2012). According to Baldwin, Fehrenbacher, and Eisenman (2015), the victim’s compliance and quiet are influenced by the following elements, which the quiet Compliance Model explains:
Coercion: Traffickers use violence, intimidation, and depriving the individual of basic needs to force them into obedience. Traffickers may employ psychological strategies, including isolation, degrading treatment, and induced tiredness in addition to physical force. As a result, the individual experiences a distorted sense of reality and feels helpless.
Collusion: The victim’s cooperation with their traffickers in trafficking or other illicit activities may result from a combination of factors, including fear, loneliness, total dependence, and even a sense of identification with the trafficker.
Contrition: The victims’ guilt and regret for their acts, despite the coerced collaboration, only serve to guarantee their quiet (Johnson, 2013).
Trafficking individuals are susceptible to a wide range of health issues, including chronic illnesses brought on by inadequate working conditions or malnourishment, unwanted pregnancies, severe injuries, and STDs. It’s crucial to remember that emotional issues are often experienced as physical illnesses or sensations in certain cultures. For instance, depression, stress, or anxiety may manifest as symptoms of exhaustion, headaches, or gastrointestinal issues (Greenbaum, 2018; Zimmerman, Hossain, & Fun, 2008).
Conclusion
It is important to recognize the signs of trafficking in individuals who have been dealing with these issues. In part 2 of this series, we will look at how healthcare workers are identified and what procedures to take when a patient is trafficked. This allows the individual to know they are in a safe and positive environment to get the help they deserve.
References
Baldwin, S. B., Fehrenbacher, A. E., & Eisenman, D. P. (2015). Psychological Coercion in Human Trafficking. Qualitative Health Research, 25(9), 1171-1181. https://doi.org/10.1177/1049732314557087
Greenbaum, V. J. (2017). Child sex trafficking in the United States: Challenges for the healthcare provider. PLoS Med, 14(11), e1002439. https://doi.org/10.1371/journal.pmed.1002439
Hume, D. L., & Sidun, N. M. (2017). Human Trafficking of Women and Girls: Characteristics, Commonalities, and Complexities. Women & Therapy, 40(1-2), 7-11. https://doi.org/10.1080/02703149.2016.1205904
Lusk, M., & Lucas, F. (2008). The challenge of human trafficking and contemporary slavery. Journal of Comparative Social Welfare, 25(1), 49–57. https://doi.org/10.1080/17486830802514049
Macias-Konstantopoulos, W. L. (2018). Diagnosis Codes for Human Trafficking Can Help Assess Incidence, Risk Factors, and Comorbid Illness and Injury. AMA J Ethics, 20(12), E1143-1151. https://doi.org/10.1001/amajethics.2018.1143
Parreñas, R. S., Hwang, M. C., & Lee, H. R. (2012). What Is Human Trafficking? A Review Essay. Signs: Journal of Women in Culture and Society, 37(4), 1015–1029. https://doi.org/10.1086/664472
Saiz Echezarreta, V., Alvarado, C., & Gómez-Lorenzini, P. (2018). Advocacy of trafficking campaigns: A controversy story. Comunicar, 26(55), 29–38. https://doi.org/10.3916/c55-2018-03
Weitzer, R. (2007). The Social Construction of Sex Trafficking: Ideology and Institutionalization of a Moral Crusade. Politics & Society, 35(3), 447-475. https://doi.org/10.1177/0032329207304319
Zimmerman, C., Hossain, M., Yun, K., Gajdadziev, V., Guzun, N., Tchomarova, M., Ciarrocchi, R. A., Johansson, A., Kefurtova, A., Scodanibbio, S., Motus, M. N., Roche, B., Morison, L., & Watts, C. (2008). The health of trafficked women: a survey of women entering posttrafficking services in Europe. Am J Public Health, 98(1), 55-59. https://doi.org/10.2105/AJPH.2006.108357
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