Physical therapy role in an emergency department: Difference between revisions

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== INTRODUCTION: ==
== INTRODUCTION: ==
[[File:Images (4).jpg|thumb]]
[[File:Images (4).jpg|thumb]]
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.<ref name=":0">Verywellhealth. available from: http://www.verywellhealth.com/emergency-room-physical-therapy-4135939 </ref>. 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 individualised attention provided in a typical bedside evaluation and treatment session. This includes education on expected symptom trajectory, recommendations for activity modulation and facilitated outpatient follow-up<ref>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</ref>. 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.
Physiotherapy or physical therapy provision in the hospital emergency department (ED) is a growing area of practice. Physical therapists can help patients start on the road to recovery early in the injury process, facilitating the possibility to improve outcomes in certain injury types.<ref name=":0">Verywellhealth. available from: http://www.verywellhealth.com/emergency-room-physical-therapy-4135939 </ref>. Patients receiving emergency department physical therapy (ED PT) benefit from the physical therapist’s expertise in musculoskeletal, respiratory and vestibular conditions. This primary contact consultation can help to ease the burden of delay in treatment in the busy ED environment as well as decrease hospital length of stay and resources usage.  


== Function of emergency physiotherapist<ref name=":0" /> ==
The emergency department physiotherapist would typically be assigned the following types of presentations from triage:
1.      Patient education about their injury or illness and how that affects their mobility
 
- soft tissue injuries (sprains and strains)
 
- simple fractures
 
- mobility assessment
 
- stable respiratory conditions or respiratory exacerbations
 
- vertigo
 
- secondary care following clinician assessment
 
The range of assessment that can be conducted by physiotherapists varies depending on the location and experience of the therapist. Some departments will allow physiotherapists to take over care of a patient directly from triage (primary contact) whereas other locations may require clinician assessment before treatment by physiotherapy (secondary contact via referral). In terms of requesting imaging or providing intervention, this can also vary greatly. In some locations in Australia, suitably qualified and competent ED PTs may request imaging and even prescribe medications whereas at other locations, the patient is to be handed back to the speciality clinician with findings to dictate the pathway of care.
 
Common interventions that are provided by physiotherapists in ED include:
 
1.      Patient education about their injury or illness and the trajectory of healing or condition management


2.      Instruction in bed mobility, transfers and walking
2.      Instruction in bed mobility, transfers and walking


3.      Instruction in using assistive device like a cane, crutches or a walker
3.      Instruction in using assistive devices such as a walking stick, crutches or a walker


4.      Prescribe exercises to help treat conditions
4.      Prescribe exercises to help treat conditions


5.      Provide pain relief like ice or heat for injury
5.      Provide pain relief such as ice or heat for injury and compression bandaging


6.      Provide suitable immobilisation for fractures and ligamentous injury such as backslabs, moon boots and Richard splints for example.
6.      Provide suitable immobilisation for fractures and ligamentous injury such as backslabs, moon boots and splints  


References
References
<references />
<references />2. Makal K & Alkhouri H. & McCarthy S. Do NSW Emergency Physiotherapy Practitioners have an impact on Emergency Department Care for Patients with Musculoskeletal Injuries?

Revision as of 02:50, 2 June 2019

Original Editor - [Ayelawa Samuel] Top Contributors - Ayelawa Samuel, Claire Knott, Jeremy Bryan, Lucinda hampton, Amanda Ager, Amal Abbasi and Kim Jackson

INTRODUCTION:[edit | edit source]

Images (4).jpg

Physiotherapy or physical therapy provision in the hospital emergency department (ED) is a growing area of practice. Physical therapists 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]. Patients receiving emergency department physical therapy (ED PT) benefit from the physical therapist’s expertise in musculoskeletal, respiratory and vestibular conditions. This primary contact consultation can help to ease the burden of delay in treatment in the busy ED environment as well as decrease hospital length of stay and resources usage.

The emergency department physiotherapist would typically be assigned the following types of presentations from triage:

- soft tissue injuries (sprains and strains)

- simple fractures

- mobility assessment

- stable respiratory conditions or respiratory exacerbations

- vertigo

- secondary care following clinician assessment

The range of assessment that can be conducted by physiotherapists varies depending on the location and experience of the therapist. Some departments will allow physiotherapists to take over care of a patient directly from triage (primary contact) whereas other locations may require clinician assessment before treatment by physiotherapy (secondary contact via referral). In terms of requesting imaging or providing intervention, this can also vary greatly. In some locations in Australia, suitably qualified and competent ED PTs may request imaging and even prescribe medications whereas at other locations, the patient is to be handed back to the speciality clinician with findings to dictate the pathway of care.

Common interventions that are provided by physiotherapists in ED include:

1.      Patient education about their injury or illness and the trajectory of healing or condition management

2.      Instruction in bed mobility, transfers and walking

3.      Instruction in using assistive devices such as a walking stick, crutches or a walker

4.      Prescribe exercises to help treat conditions

5.      Provide pain relief such as ice or heat for injury and compression bandaging

6. Provide suitable immobilisation for fractures and ligamentous injury such as backslabs, moon boots and splints

References

2. Makal K & Alkhouri H. & McCarthy S. Do NSW Emergency Physiotherapy Practitioners have an impact on Emergency Department Care for Patients with Musculoskeletal Injuries?