A benchmarking project of physiotherapy in Australian and New Zealand adult major trauma services

Abstract

Traumatic injury places a great burden on individuals and society. As mortality plateaus in mature trauma systems, there is an increasing shift towards understanding patients' morbidity and functional outcomes. Physiotherapy plays a key role in recovery after traumatic injury, but little is currently known about its role in the acute hospital setting for trauma patients. This study aimed to document physiotherapy service structure and practice in adult major trauma services (MTS) across Australia and New Zealand. A survey was distributed electronically to physiotherapists working within designated MTS (n=25), achieving a 92% response rate (n=23). Physiotherapy service delivery, expertise and availability varied greatly. Only seven sites (30%) had a dedicated trauma physiotherapist with this showing a trend towards an association with major trauma admissions (provided by the Australian Trauma Registry; p=0.07). Only eight (35%) had blanket referral systems for physiotherapy review, which was significantly associated with having a dedicated specialised physiotherapist (p =0.015). Most ran a five day/week service for all patients with priority cover over the weekends (78% n=18). Future research should explore the benefits of specialised trauma physiotherapy roles in optimising patient outcomes in order to standardise this across all trauma centres in Australia and New Zealand.

Physiotherapy management of patients with major chest trauma: Results from a global survey

“…There is limited literature evaluating specific physiotherapy interventions in patients with major chest trauma. Two surveys conducted in Australia and Canada reported on models of physiotherapy service structure and provision of care to patients with traumatic injuries, staffing levels and patient caseloads; 12,13 however, neither focused solely on patients with major chest wall trauma nor explored the use of specific physiotherapy interventions.…”

“…strength exercises, functional exercises, walking) in order to promote return to baseline physical level. 12 Two national surveys (from Canada and Australia) have investigated models of physiotherapy service delivery to patients with traumatic injuries, staffing levels and caseloads. 12,13 Both had excellent response rates (>92%) but demonstrated large variations in service provision with 22-30% of trauma units having a dedicated trauma physiotherapist.…”

“…6 There is a scarcity of evidence both investigating and supporting physiotherapy interventions used in adult patients with major chest trauma. The limited evidence in existence is primarily old 14 and descriptive of physiotherapy service provision 12,13 and investigates multidisciplinary approaches or interventions with no or little emphasis on specific physiotherapy treatment strategies. 8,10,11 Studies are often related to polytrauma (especially orthopaedic) rather than chest trauma, and are almost exclusively related to blunt chest trauma.…”

The Role of Physiotherapist in Hospitals Around the World: Use of Linkedin as a Support to Research

“…The physiotherapist works in different modes and in different sectors, accompanying the patient from admission until hospital discharge. (DABER; JACKSON, 1987) Most of the studies show the importance of physical therapy in the treatment of critically ill patients admitted in the Intensive Care Unit; however, the physiotherapist's work is also important in the wards, (SARKIES et al, 2018) trauma, (CALTHORPE et al, 2016) urgency and emergency,(BRUUN; NØRGAARD, 2014) and haemodialysis units. (BULCKAEN et al, 2011) Within each of these units, the physiotherapist acts to prevent or improve muscle weakness, joint stiffness, functional capacity, atelectasis, airway clearance, which can Revista Eletrônica Gestão e Serviços v.11, n. 2, pp.3150 -3166, Julho/Dezembro 2020.…”