Physiotherapy as a clinical service in emergency departments: a narrative review

Objectives To develop a narrative literature review using international research to describe the role and responsibilities of an emergency department physiotherapist considering the current focus on patient populations, clinical conditions managed, and the contribution that emergency department physiotherapy makes to service delivery and quality. Data sources Literature was sourced from medical database searches of MEDLINE, Cochrane, PEDro, PubMed and CINAHL, between 1966 and May 2006. Review methods Selection criteria included the description of physiotherapy based directly in the emergency department, emergency department physiotherapists working either as sole clinical practitioners or as members of a multidisciplinary team, systematic literature reviews and/or original emergency department physiotherapy research, publication in peer-reviewedjoumals, and full-text English language articles. Research was appraised critically using a validated critical appraisal tool. Data analysis involved extracting information via a process of content analysis. Results Nine studies were eligible for inclusion in this narrative review. Patients were almost always adults, with a particular focus on managing ageing patients. Clinical conditions were predominantly acute and subacute musculoskeletal conditions. Emergency department physiotherapy provides positive patient satisfaction and can have a positive influence on departmental service issues including patient waiting times. A significant paucity of literature remains, with further need for high-quality clinical trials to augment these proposed findings. Conclusions The evidence suggests an inclination for emergency department physiotherapy services to manage adult musculoskeletal conditions. However, the validity of these results is compromised by the small number and variable quality of studies, making it difficult to determine clinical efficacy within the reviewed sample. (c) 2007 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.