What Evidence is There That a Physiotherapy Service in the Emergency Department Improves Health Outcomes? A Systematic Review

Kilner, Emily

doi:10.1258/jhsrp.2010.009129

Cited by 50 publications

(51 citation statements)

References 21 publications

(78 reference statements)

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“…Findings of this study with regard to waiting time to treatment and total time in ED are consistent with reports from other similar studies [6] [7], strengthening the likelihood that the incorporation of EPPs in ED can have a positive effect on reducing time for patients with musculoskeletal problems who can be seen by the EPPs. In addition, by enabling the EPPs to see many of the patients with musculoskeletal problems, other ED practitioners, such as medical and nursing staff can be available to manage patients attending ED with non-musculoskeletal dysfunctions, thereby having the potential to benefit all patients attending an ED.…”

Section: Discussionsupporting

confidence: 89%

Effectiveness of Musculoskeletal Emergency Physiotherapy Practitioners

Salt¹

2016

OJTR

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Relevance and Method: The purpose of this project was to evaluate the effectiveness of the Emergency Physiotherapy Practitioner (EPP) service against quality care indicators identified as part of the "gold standard" for emergency care in England. The study was prospective and evaluated time to initial assessment, total time in the emergency department and un-planned re-attendance rate within a seven-day period for all patients seen by the EPP's over a period of one year. Outcomes: One thousand and seven patients were seen by EPPs in the emergency department. The median wait time for treatment by an EPP was 34.5 minutes (95th percentile = 122). Regional median wait time was 45 minutes (95th percentile = 138). National median wait time was 55 minutes (95th percentile = 192). Median total time spent in ED for patients seen by EPPs was 99 minutes (95th percentile = 224). Regional median total time in ED was 223 (95th percentile = 239). Nationally median total time in ED was 136 minutes (95th percentile = 336). Three percent of patients seen by an EPP returned to the ED, compared to 6% regionally and 7.5% nationally. Conclusions: EPPs excelled in all three indicators and exceeded regional and national figures. The re-return rate met the current standard of being less than 5%. It could be justified that the addition of the EPPs to the emergency department was an efficient and effective service development.

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Section: Discussionsupporting

confidence: 89%

Effectiveness of Musculoskeletal Emergency Physiotherapy Practitioners

Salt¹

2016

OJTR

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“…[15] Also, introducing this service could potentially lead to increased health delivery costs. [8] However, despite all this research till date, the evidence for the effectiveness and benefits of using physiotherapy services at EDs is debated.…”

Section: Discussionmentioning

confidence: 99%

Potential impact of early physiotherapy in the emergency department for non-traumatic neck and back pain

Pothiawala

Hao

Mark

2017

World Journal of Emergency Medicine

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BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department (ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and outpatient orthopedic reviews. The study aimed to evaluate the impact of early physiotherapy evaluation and treatment (EPET) vs. standard care (SC) on clinical outcomes for patients presenting to the ED with non-traumatic neck and back pain. METHODS:A retrospective observational study of 125 patients who presented to the ED with non-traumatic neck and back pain with/without peripheral symptoms from July 2010 to February 2011. Neck Disability Index (NDI), Modifi ed Oswestry Low Back Pain Disability Questionnaire (MODI) and 11-point Numeric Pain Rating Scale were used as outcome measures and compared between groups at a mean of 34 days from their initial ED visit. RESULTS:We identifi ed a total of 125 patients. EPET group comprised 62 patients (mean age, 45 years; men, 63%) and SC group comprised 63 patients (mean age, 45 years; men, 43%). The EPET and SC groups received physiotherapy at a median of 4 and 34 days respectively from their fi rst ED visit. EPET patients had signifi cantly lower levels of disability (9.0% vs. 33.4%, Welch t-test, P<0.001) and pain (median value, 1 vs. 4 points, Mann-Whitney U-test, P<0.001) compared with SC patients.CONCLUSION: Early access to physiotherapy in ED was associated with reduced pain and disability levels. EPET protocol can potentially decrease the demand on outpatient orthopedic services, thereby freeing up available resources to treat patients who are more likely to benefi t from it.KEY WORDS: Physiotherapy; Emergency department; Non-traumatic neck and back pain World

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“…Plusieurs signes cliniques doivent être recherchés par le kinésithérapeute lors de son bilan pour évaluer la gravité du patient (Tableau 1) : [3] Hyper/hypotension artérielle [2] Pouls paradoxal > 20 mmHg (signe la gravité de l'insuffisance respiratoire ; il survient chez les patients dont les efforts respiratoires génèrent d'importantes différences de pressions intrathoraciques) [5] Marbrures cutanées [5] • au niveau du visage : une respiration buccale, des battements des ailes du nez, une cyanose des lèvres, une angoisse marquée au visage ou la présence d'une sudation abondante ;…”

Section: Présence De Signes De Gravitéunclassified

“…Bien qu'une étude récente observe une diminution du délai de prise en charge et du temps d'hospitalisation chez les patients admis pour des lésions musculosquelettiques simples et semi-urgentes [1], l'intérêt d'une prise en charge kinésithérapeutique dans ce service n'a jamais été clairement évalué [2].…”

Section: Introductionunclassified

Rôle du kinésithérapeute respiratoire dans un service d’accueil des urgences pour adultes

Jossen-Racine¹,

Wittebole²,

Roeseler³

et al. 2011

Réanimation

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What Evidence is There That a Physiotherapy Service in the Emergency Department Improves Health Outcomes? A Systematic Review

Abstract: research evidence does not support the use of physiotherapists in emergency departments.

Cited by 50 publications

References 21 publications

Effectiveness of Musculoskeletal Emergency Physiotherapy Practitioners

Effectiveness of Musculoskeletal Emergency Physiotherapy Practitioners

Potential impact of early physiotherapy in the emergency department for non-traumatic neck and back pain

Rôle du kinésithérapeute respiratoire dans un service d’accueil des urgences pour adultes

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