Physical Therapists in Emergency Departments: A 2011 Review and a 2011 Study

Reference:Kilner E. What evidence is there that a physiotherapy service in the emergency department improves health outcomes? A systematic review. J Health Serv Res Policy. 2011 Jan;16(1):51-8.
Taylor NF, Norman E, Roddy L, Tang C, Pagram A, Hearn K. 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. Physiotherapy. 2011 Jun;97(2):107-14.

This is a controversial topic where various health care professionals have strong opinions on the role of PTs in Hospital Emergency Departments. A recent systematic review concluded that due to the poor quality of the studies, the evidence does not yet support the use of PTs in emergency departments.

The truth is that not enough studies have been done on this topic, but the few that have been done are quite promising and conclude, “There is high-level evidence of benefits in terms of improved pain control and reduced disability in the short term.” (Kilner 2011)

This 2011 Australian emergency department study (Taylor et al 2011) evaluated if direct PT assessment and management of patients with peripheral musculoskeletal injuries would result in reduced length of stay without any increase in adverse effects compared with secondary contact PT, where PTs saw patients only after initial assessment by a doctor.

Basic Results:

1) Primary contact PT resulted in an average reduction in length of stay of 59 minutes
2) Primary contact PT resulted in an average reduced waiting time of 25 minutes
3) Primary contact PT resulted in an average reduced treatment time of 35minutes

4) There were no differences between the groups seeing a PT versus and MD with respect to imaging referrals

5) Greater than 82% of the patients strongly agreed that they were satisfied with their management

6) 96% of emergency department staff agreed that the PT had appropriate skills and knowledge to provide emergency care for musculoskeletal conditions

7) There were no differences in adverse effects for patients seen by direct PT or by an MD

Study Conclusion: The presence of experienced musculoskeletal PTs in emergency departments may result in decreased waiting times and length of stay for patients without any adverse effects.

Posted on: May 02, 2012


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