Physical therapy role in an emergency department

Original Editor - [Ayelawa Samuel] Top Contributors - Ayelawa Samuel, Lucinda hampton and Claire Knott

INTRODUCTION:

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Physical therapy in the hospital emergency department is a growing area of practice. Physical therapists in the emergency room can help patients start on the road to recovery early in the injury process, facilitating the possibility to improve outcomes in certain injury types.[1]. Typically, once the treating physician has evaluated the patient, physical therapists are consulted by the treating Emergency department physician to assist in the evaluation and treatment of a number of movement and functional disorders, such as low back pain, peripheral vertigo, and various gait disturbances. Patients receiving Emergency department physical therapy (ED PT) benefit from the physical therapist’s expertise in Musculoskeletal and vestibular conditions and from the individualized attention provided in a typical bedside evaluation and treatment session, which includes education on expected symptom trajectory, recommendations for activity modulation, and facilitated outpatient follow-up[2]. As part the emergency department team, physical therapists have the opportunity to collaborate in the care of patients with a wide range of acute and chronic problems coming from the neuromusculoskeletal, cardiovascular, pulmonary and integumentary systems. The physical therapist in the ED serves a critical role in screening for appropriateness of care, consultation with other practitioner, and in the direct care of patients[3].

Function of emergency physiotherapist[1]

1.      Patient education about their injury or illness and how that affects their mobility2448px-Teenage boy on crutches with walking boot.jpg

2.      Instruction in bed mobility, transfers, and walking

3.      Instruction in using assistive device like a cane or a walker

4.      Prescribe exercises to help treat conditions

5.      Provide pain relief like ice or heat for injury

Patient with certain types of diagnoses may benefit from Physiotherapy in an emergency room. These may include:

  • Lower extremity sprains, strains or other injuries
  • Shoulder, wrist or elbow injuries
  • Back and neck pain
  • After motor vehicle accidents

Outcome with physical therapy in the emergency department

Referrals have increased and length of stay has decreased for patients receiving physical therapy. Preliminary surveys suggest high patient and practitioner satisfaction with physical therapy service[4]

Geriatric Emergency Departments

Recently-created guidelines and criteria for Geroatric emergency departments aim to improve the standard of care. Physiotherapist play a large role here to assess and identify eg falls risk patients. These issues can then be acted on at this early stage. Injuries that were once treated are now prevented.

[5]

References

  1. 1.0 1.1 Verywellhealth. available from: http://www.verywellhealth.com/emergency-room-physical-therapy-4135939
  2. Kim HS, Strickland KJ, Mullen KA, Lebec MT. Physical therapy in the emergency department: A new opportunity for collaborative care. The American journal of emergency medicine. 2018 May 24
  3. APTA. available from: http://www.apta.org/EmergencyDepartment/
  4. 1.      Fleming-McDonnell D, Czuppon S, Deusinger SS, Deusinger RH. Physical therapy in the emergency department: development of a novel practice venue. Physical therapy. 2010 Mar 1;90(3):420-6.
  5. CDC Stand STEADI: Fall Prevention in a Geriatric Emergency Department. Available from: https://www.youtube.com/watch?v=77uqmjfQNt4 (last accessed 26.4.2019)