Abstract

Purpose: This project presents a case of an individual who presented to the Emergency Department (ED) following a mechanical fall due to weakness and answers the following PICO question: Is physical therapy (PT) evaluation and treatment in the emergency room effective in improving patient outcomes, reducing hospital length of stay, and reducing hospital readmission rates related to musculoskeletal injuries, vestibular disorders, and mechanical falls? Background: PT evaluation and treatment in the ED are becoming more common. The EMS has shown trends of increasing patient wait times, increased annual ED visits, decreased access to services, and decreased quality of care1. Physical therapists are in a unique position to help ameliorate these stresses on the EMS system. Case Description: 56 year-old female who presented to the ED following a mechanical fall, striking her head and cervical spine. Upon medical screening and diagnostic imaging, a longstanding urinary tract infection was identified. Physical therapy was called for an ED consult, PT found the patient continued to present as a high fall risk and would not be safe for discharge home. Outcomes: A review of the current available evidence revealed that PT within the ED lacks high quality evidence, with the majority of research being anecdotal, observational studies with few RCTs and a single SR. Discussion: Based on current best evidence, the efficacy of PT services within the ED cannot be ascertained. To be considered evidence-based practice, further high quality research is needed to determine the clinical outcomes of PT intervention within the ED. With the push for developing PT practice in the ED, the future may hold higher quality RCTs and SRs to validate the use of full time PTs within the ED

Provenance

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Document Type

Capstone

First Advisor

Ron Andrews

Keywords

Hospital Emergency Service; Length of Stay, Physical Therapy

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