Emergency Assignment: Article No 2

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Emergency Assignment
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Article no 2
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The role of physical therapy in musculoskeletal emergency
care.
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Article no 2
The role of physical therapy in musculoskeletal emergency care.
The professional services of physical therapists showed great work in emergency departments, while
there were two roles they were performing ,primary contact practitioners and secondary contact
practitioners (PCPs/SCPs respectively).The type of practitioners who accesses patient and manage their
illness after referral from triage is known as PCP whereas ,the type of practitioners who treats patient
after the patient is assessed by a doctor in emergency department and then referred to physical
therapy for services.
The patients with musculoskeletal disorders or injuries who are presented in emergency departments
have several advantages of physical therapy services such as it reduces the workload of emergency
department staff and also decreases waiting time. To deal with the increasing cases of emergency
department it is the main objective of health care providers to reduce waiting time and enhance
patients flow. It is reported that, in emergency department patients with musculoskeletal injuries are
more satisfied by physical therapists than other health care providers or physicians. The physical therapy
services are new as compared to physician services and hence less appraised. Patients with back pain
have shown less pain levels after physical therapy.
The alpha concern is whether the knowledge, skills, education and treatment capacities of physical
therapists are safe, effective, and up to the mark. The direct access allows physiotherapists to examine
patients without check up or referral from a physician , so it is very important that the physiotherapist
should have abilities to diagnose the disorder as well as provide emergency care procedures if needed.
Physiotherapists spend more time with patients to evaluate, diagnose and educate them about their
injury or disorder maybe this is the reason the satisfaction rate is higher in case of physical therapy
services . The final concern is how physicians, doctors and nurses will accept physical therapists as a
part of them in emergency care departments.
It was accepted more among health care services that senior physiotherapists with specializations in
musculoskeletal injury or experience of primary contact services can work in emergency departments or
private departments. It is appropriate that physical therapists should receive special training or have
certificate in special emergency program before becoming part of emergency care service. The junior
physical therapists and clinicians should provide secondary contact services.
Identifying the Red flags should be priority while examining a patient. Red flags like progressive local
neurological deficit, severe night pain, infection and unexplained weight loss should be excluded at first
visit. Patients with motor vehicle accident who presented with a open fracture ,open wound, loss of
consciousness , low back pain, low neck pain and unreduced dislocation should be referred to surgeon
without any kind of delay.
The length of stay, waiting time and treatment time was measured. The time difference between
coming to hospital and leaving is known as length of stay. The time of arrival and receiving first physical
therapy or medical treatment is known as waiting time. The time measured from getting first treatment
and going from hospital is called treatment time. The data of these timings was collected by the help of
hospital management systems by a researcher.
It was reported that 80% of the patients were not admitted to bed and their length of stay was not more
than 240 minutes. The patients with semi urgent cases took less than 1 hour in waiting time while non
urgent patients took less than 2 hours. Patient satisfaction was estimated using a survey tool and
knowledge of PCPs in emergency was evaluated by another survey instrument.
Another aim for measuring satisfaction of patient was checked by strongly agreed section of the
questionnaires. Satisfaction of staff members was also measured. Radiological referrals and re-
presentations were also checked.
The conclusion of the research study showed that the patients with musculoskeletal injuries or disorders
who presented in emergency department, had received more effective services by PCP and other
physiotherapists than routine doctors or physicians.
The study provided the evidence that physical therapy acting as PCPs help enhance the patient flow and
reduces the waiting times in the hospitals. The new expanded role of physiotherapists is helping the
emergency care services in every manner. A large number of cases presented in emergency have MSK
injuries and can be addressed effectively by qualified physiotherapist.
References
1-Primary contact physiotherapy in emergency departments can reduce length of stay for patients with peripheral
musculoskeletal injuries compared with secondary contact physiotherapy: a prospective non-randomised controlled trial.(parent
article).
2-S. Anaf, L. SheppardPhysiotherapy as a clinical service in emergency departments: a narrative review
Physiotherapy, 93 (2007), pp. 243-252
3-O.O. Jibuike, G. Oaul-Taylor, S. Mauvli, P. Richmond, J. FaircloughManagement of soft tissue knee injuries in an

accident and emergency department: the effect of the introduction of a physiotherapy practitioner
Emerg Med J, 20 (2003), pp. 37-39
4-Metropolitan Health and Aged Care Services DivisionBetter faster emergency care: improving care and access in
Victoria's public hospitals
MHACSD, Victorian Government, Department of Human Services, Melbourne (2007)
4-P. M.-Y. Lau, D.H.-K. Chow, M.H. PopeEarly physiotherapy intervention in an accident and emergency department

reduces pain and improves satisfaction with acute low back pain: a randomised controlled trial
Aust J Physiother, 54 (2008), pp. 243-249
5-C.M. McClellan, R. Greenwood, J.R. BengerEffect of an extended scope physiotherapy service on patient

satisfaction and the outcome of soft tissue injuries in an adult emergency department
Emerg Med J, 23 (2006), pp. 384-387

6-B. Richardson, L. Shepstone, F. Poland, M. Mugford, B. Finlayson, N. ClemenceRandomised controlled trial and
cost consequences study comparing initial physiotherapy assessment and management with routine clinical practice
for selected patients in an accident and emergency department of an acute hospital
Emerg Med J, 22 (2005), pp. 87-92
7-Australasian College for Emergency Medicine, West Melbourne (Australia). Policy document: policy on the
Australasian triage scale; 2010. Available
at: http://www.acem.org.au/media/policies_and_guidelines/P06_Aust_Triage_Scale_-_Nov_2000.pdf [last
accessed March 2010].
8-J. Considine, R. Martin, D. Smit, C. Winter, J. JenkinsEmergency nurse practitioner care and emergency

department patient flow: case control study
Emerg Med Australas, 18 (2006), pp. 385-390
9-Australasian College for Emergency Medicine, West Melbourne (Australia). Policy document: standard
terminology; 2001. Available at: http://www.acem.org.au/media/policies_and_guidelines/P02_-
_Standard_Terminology_16.04.09.pdf [last accessed March 2010].
10-J. Considine, R. MartinDevelopment, reliability and validity of an instrument measuring the attitudes and

knowledge of emergency department staff regarding the emergency nurse practitioner role
Accid Emerg Nurs, 13 (2005), pp. 36-43
11-R. Martin, J. ConsidineKnowledge and attitudes of ED staff before and after implementation of the emergency
nurse practitioner role
Austral Emerg Nurs J, 8 (2005), pp. 73-78
12-A.J. VickersParametric versus non-parametric statistics in the analysis of randomized controlled trials with non-
normally distributed data
BMC Med Res Methodol, 5 (2005), p. 35

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qwertyuiopasdfghjklzxcvbnmqwertyui

The role of physical therapy in musculoskeletal emergency care.

2-S. Anaf, L. SheppardPhysiotherapy as a clinical service in emergency departments: a narrative review

3-O.O. Jibuike, G. Oaul-Taylor, S. Mauvli, P. Richmond, J. FaircloughManagement of soft tissue knee injuries in an

Emerg Med J, 20 (2003), pp. 37-39

MHACSD, Victorian Government, Department of Human Services, Melbourne (2007)

4-P. M.-Y. Lau, D.H.-K. Chow, M.H. PopeEarly physiotherapy intervention in an accident and emergency department

Aust J Physiother, 54 (2008), pp. 243-249

5-C.M. McClellan, R. Greenwood, J.R. BengerEffect of an extended scope physiotherapy service on patient

Emerg Med J, 23 (2006), pp. 384-387

Emerg Med J, 22 (2005), pp. 87-92

8-J. Considine, R. Martin, D. Smit, C. Winter, J. JenkinsEmergency nurse practitioner care and emergency

Emerg Med Australas, 18 (2006), pp. 385-390

10-J. Considine, R. MartinDevelopment, reliability and validity of an instrument measuring the attitudes and

Accid Emerg Nurs, 13 (2005), pp. 36-43

Austral Emerg Nurs J, 8 (2005), pp. 73-78

BMC Med Res Methodol, 5 (2005), p. 35

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