College of Massage Therapists of British Columbia (CMTBC) Practice Exam

When treating a patient with gastroesophageal reflux disease, which precaution is most important?

1. Check for high blood pressure

2. Avoid palpation of the abdominal area

3. Elevate head and shoulders in supine position

4. Check the abdomen for rebound tenderness

The correct answer is: Elevate head and shoulders in supine position

When treating a patient with gastroesophageal reflux disease (GERD), the most important precaution is to elevate the head and shoulders in the supine position. Elevating the upper body helps prevent the backflow of stomach acids into the esophagus, which can exacerbate the symptoms of GERD. By maintaining an incline, the therapist facilitates better digestion and comfort, reducing the likelihood that the patient's symptoms will worsen during treatment. This approach is particularly significant for individuals suffering from GERD, as lying flat can increase the likelihood of acid reflux and contribute to discomfort. Proper positioning not only aids in symptom management but also enhances the safety and effectiveness of the massage technique being used. The other options, while they may be relevant considerations in different clinical scenarios, do not directly address the primary concern of managing the patient's discomfort and health related to GERD. Avoiding palpation of the abdominal area and checking for rebound tenderness might be important in other contexts, such as with specific abdominal conditions, but they do not directly impact the management of GERD symptoms during treatment. Checking for high blood pressure is also essential in a broader assessment but is less specific regarding the immediate needs of a patient with GERD during a massage session.