Management of soft tissue XXXX in an accident and emergency department: the effect of the introduction of a physiotherapy practitioner.

@entity1 @entity131 @entity174 @entity937 @entity1347 @entity3331 @entity130
OBJECTIVE: To assess the effect of the introduction of a physiotherapist with an extended scope of practice in the management of acute soft tissue @entity3331 in an accident and emergency (A_E) department. METHODS: The A_E department established an Acute Knee Screening Service (AKSS) in 1998. An experienced physiotherapist was appointed to run the AKSS after additional training. Local guidelines and protocols were developed in conjunction with @entity130 knee surgeons, radiologists, physiotherapists, and A_E doctors. This study describes 100 consecutive @entity1 managed by the AKSS over a three month period and comparisons are made over a similar period before the introduction of the AKSS. RESULTS: The initial diagnosis of @entity1 with @entity131 referred to the service showed @entity130 (38%), cruciate @entity130 (18%), @entity174 (2%), @entity130 (10%), and others (32%). Ninety five per cent of @entity1 referred to AKSS were seen within one week. Medical time was saved in both A_E and @entity130 clinic. Fifty nine per cent of @entity1 were treated and discharged from the service without further medical review. Thirty nine per cent (39) were referred to @entity130 clinic and of these 44% (17) had MRI scans performed as requested by the physiotherapist. Eighty eight per cent (15) of these scans showed significant abnormality: (nine, @entity1347 , one, posterior cruciate ligament tears, and nine @entity937 ). CONCLUSIONS: A physiotherapy practitioner working with an extended role is a valuable addition to an A_E department. The AKSS improves the quality of care of @entity131 , saves medical time, and fosters cooperation across services within the NHS.
