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What on earth does a physiotherapist do in the emergency department?

Hello again! Here we go on the second instalment of my blogging adventure. My mission in today’s post – to answer the burning question “What on earth does a physiotherapist do in the emergency department?”

This is the inevitable question that I know will generally follow whenever I am asked what I do for a job. And fair enough, too. I can understand where the confusion lies. Physiotherapy is not generally a profession one thinks of when contemplating the care that might be received by someone attending the emergency department! The most common understanding within the general public of what a physiotherapist does usually involves sport or the management of injuries and back pain. Those who have had some experience in the health care field, either as an employee or a patient, may be aware that there are more aspects to physiotherapy than just managing sporting injuries. They may understand that physiotherapists assist in the management of respiratory conditions, neurological conditions, mobility issues and post-operative care, plus a whole host of other areas. Potentially not as glamorous as treating Rafael Nadal courtside at the tennis, but providing a crucial service nonetheless. Even amongst those working in health care, there are few that realise there are physiotherapists that work in emergency departments. Due, in part, to it being a relatively new service, and also to there being only a small number of physiotherapists undertaking this type of role.

So, what is it that I do in the ED? My job title is ‘Emergency Department Advanced Musculoskeletal Physiotherapist’, and I am a primary contact physiotherapist. There are actually two types of physiotherapists within the emergency department – there are physiotherapists that see patients that have been referred to them after being assessed and treated by a doctor, these are known as secondary contact physiotherapists, and there are physiotherapists that directly see patients who have presented to ED for management of an acute injury, these are known as primary contact physiotherapists. For patients seen by secondary contact physiotherapists, the overall responsibility for that patient’s care falls on the doctor that saw them initially. As a primary contact physiotherapist, I am in charge of the patient’s overall management, the patient will be seen by me in place of seeing an ED doctor.

How does that work, you may well ask. I have had many years of experience assessing and treating patients with musculoskeletal conditions, and have completed extra training and post graduate studies in the musculoskeletal field and in radiology, giving me expert skills in the diagnosis and management of musculoskeletal conditions. So, should you present to the ED with a musculoskeletal injury (muscle/tendon/ligament/bone injury) during my shift, you will likely meet me instead of a doctor. In my role I get to see a wide variety of conditions ranging from sprains and strains to dislocations and fractures, in a population ranging from babies to the elderly. Given the level of training and experience in dealing with musculoskeletal injuries that I have, I may also be called upon by the ED doctors to provide specialised musculoskeletal assessment for their patients. My role also involves providing education and training for ED staff on musculoskeletal assessment techniques and plaster casting as needed.

I really enjoy my job, it provides me with great variety and plenty of challenges and learning opportunities. And I love being able to make a difference to my patients, it is a really satisfying role to hold. It is a great example of where physiotherapy as a career can lead you – there are so many career path options, it really is an exciting profession to be a part of!

In my next post I will walk you through what a patient can expect to have happen if they present to the ED with a musculoskeletal condition that will be managed by me, and hopefully give you a bit more insight into how an Emergency Department Advanced Musculoskeletal Physiotherapist works. Thanks for reading!

14 Comments

  1. Ben west Apr 30 2014

    Hi jacqui I’m currently a 3rd year studying physiotherapy at Newcastle university and emergency Physio is something that I am interested in pursuing after I graduate. I was just wondering what I would need to do in order to become one? E.g do I need to do a radiolograhy course at university? Thanks Ben west

    • Peninsula Health May 22 2014

      Hi Ben, thanks for your question. At the moment, to be employed to work in a primary contact physiotherapy role in an Emergency Department, the prerequisite criteria are set by each particular health service. The Department of Health are currently working on a project to create a standardised set of competencies required to be undertaken to qualify someone to undertake such a role. Generally, you will be required to have a number of years of post-graduate work experience in the musculoskeletal field, have undertaken a post-graduate qualification, and have highly developed musculoskeletal assessment and diagnostic skills. Further education is radiology is very desirable. Due to the advanced nature and considerable responsibility involved in such roles, they take some time to prepare for. If it is a field you have a particular interest in, my advice would be to aim to get yourself plenty of experience working in the musculoskeletal field once you graduate, and look towards undertaking post-graduate studies relevant to the area once you have a some experience under your belt. Best of luck!

      Thanks,
      Jacqui

  2. Tarık Jun 04 2014

    Hello Jacqui !:)

    I am currently a 2rd year studying Physiotherapy at Poland and Emergency PT is really interesting for me and I’m so happy to find your article.I wanted to ask if I have any chance to do internship at Emergecy department as a physiotherapy student ?

    Thank u!

    • Jacqui Jun 20 2014

      Hi, thanks for taking the time to read my blog. My role as a physiotherapist within the Emergency Department is what is considered an advanced scope position, to perform this role requires a certain amount of post-graduate experience and post-graduate qualifications. Unfortunately we do not take undergraduate students for placements in the ED. Best of luck with your studies.
      Jacqui

    • hi jacqui

      this year i finish my diploma in physiotherapy and my final project is about the primary contact of a physiotherapist in the emergency department and in my country Lebanon it’s hard to let them see how important this is i just want to ask about the history of this idea and where we can find a primary contact physiotherapist (the countries and the name of the hospital you work in)
      and second i have a question about “extra training and post graduate studies”
      where can we go that ?
      thank you ! 😀

  3. Herbert Jun 24 2014

    Hi Jacqui. I am a secondary contact physio working at an ED for less than a year. Our physio dept is having a hard time to establish requirements and ideas to develop physio at ED. I want to know what kind of specific education and courses are better suit for physio at ED? Secondly, I want to know are there any oversea training or sharing for physio working at ED? Thirdly, how can you become a primary contact physio?

    Thanks!

  4. Hi Jacqui,

    It’s great to see a personal viewpoint from an ED physio and getting the message out that physiotherapy consults can be a very effective treatment pathway when presenting to ED.
    I am a current 3rd year physio student undertaking a research project regarding secondary contact physiotherapy within EDs. I was wondering if Peninsula Health currently has a secondary contact physiotherapy service? Also, if along your career pathway you have come across relevant papers/evidence (or personal experience) comparing the effectiveness of primary to secondary physiotherapy in ED?

    Thanks.

  5. Jacqui Aug 01 2014

    Hi Matt,

    Thanks for your comment. Here at Peninsula Health we don’t have a dedicated secondary contact physiotherapy service within the ED, however we do have a fantastic service called the RAD team (Response, Assessment, Discharge). This is a multidisciplinary team which consists of social workers, occupational therapists, physiotherapists and nurses. They work in a transdisciplinary manner, each receiving training in the basic aspects of all the disciplines within the team, to be able to facilitate safe discharge for patients from the ED. Best of luck with your research project and the rest of your studies.

    Jacqui

  6. javed Dec 26 2014

    Hi Jacqui,
    There’s one boy 20 yr of age, he has cervical disc bulging from c2 to c7. The main problem is that his upper arm with shoulder from one side( right side ) getting thin and atrophied. The neurologist said that problem not get normal in future.
    My qu is , can the nerve compression and atrophy get normal by physiotherapy treatment.

    • Jacqui Jan 13 2015

      Thank you for your query. There are many factors that contribute to prognosis, and it is very difficult to predict what recovery potential there is without physically assessing the patient and having all the history, details and investigations at hand. I would recommend that your question could be best answered by consulting a neurosurgeon or a physiotherapist that works in a neurosurgical clinic. Best of luck.

  7. whoah this blog is excellent i love studying your posts.
    Stay up the great work! You recognize, lots of people are searching around for
    this information, you could aid them greatly.

  8. I attended A&Ewith an acute infected lesion to my nasal bridge and was asked “was told I’d be seen by a physio ???as a retired RGN/RMidwife I question this and ask for Dr

  9. Carolina Guevara Oct 21 2016

    Hello! My name is Carolina and Im in my last year of physiotherapy here in Mexico, I’m making a school work about emergency physiotherapy, that doesn’t really exist here in Mexico, can you tell me, based on your experience, the impact of emergency Physiotherapy on the patient? Txhs!!!!

  10. Paolina Dec 22 2016

    Hello Jacqui,
    I am a Physiotherapist from Rome and just found your blog which is exactly what I was looking for =)
    I am writing a thesis on the role of physiotherapists in the ED, but for management of minor injuries, such as ankle sprains etc. This role does not yet exist in Italy. Here physiotherapists can not make a diagnosis either… we can only do a “functional diagnosis”.
    Do you also deal with these kind of musculoskeletal injuries?
    And can you tell me how does an ED benefit from the work of a physio? I mean organizationally and economically. What are the advantages compared to just having doctors and nurses working there?
    Thank you very much for your help.

    Paolina

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