Acute peripheral musculoskeletal soft tissue injury Injury, Occupational Diseases, Poisoning Soft tissue injury
Conditions
Interventions
Active control: Doctors (of all grades)
Intervention under investigation: Extended Scope Physiotherapist (ESP) and Emergency Nurse Practitioners (ENP). The intervention is the care provided by ESPs an
Sponsors
University of the West of England (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adults (17 years or older), male or female 2. Patients presenting to an ED with a peripheral soft tissue injury with no immediately apparent fracture and is eligible for management by any of the three professional groups 2. Patients who consent to the study 3. All three practitioners working concurrently when the patient is admitted to the emergency department, to enable randomisation 5. A traumatic injury 6. Soft tissue injury less than 72 hours old 7. Patients will be included if they have minor grazes or wounds that require no treatment
Exclusion criteria
Exclusion criteria: 1. Systemic disease 2. Recent surgery 3. Previous ongoing injury to extremity 4. Intoxicated patients 5. Patients unable to give informed consent (e.g. dementia) 6. Open wounds/wounds (patient will be included if minor and insignificant) 7. Major deformities 8. Patients requiring opiate analgesia 9. Systemic disease (e.g. rheumatoid arthritis) 10. Healing fracture (less than 3 months) 11. Recent soft tissue injury 12. Head injuries (patient will be included if minor and insignificant) 13. Chest/rib injuries (patient will be included if minor and insignificant) 14. Neurovascular deficits 15. Less than 17 years of age 16. Obvious associated fractures 17. Patients who attend the ED when there is no ESP, ENP, doctor service running concurrently 18. Prisoners
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary aspect of the study will evaluate the clinical outcome of STIs following attendance at an emergency department, and the impact on quality of life. This will be done at baseline, and at 2 and 8 weeks using telephone interviews. The trial is powered to detect differences at the 8-week follow up. Two validated and reliable functional outcome measures will be use in the trial: the Lower Extremity Functional Scale (LEFS) and the Quick Disabilities of the Arm, Shoulder and Hand ( Quick DASH) questionnaire. Quality of life will be measured using the Short Form-12 Health Survey Questionnaire, Version 2 (SF-12v2). | — |
Secondary
| Measure | Time frame |
|---|---|
| The secondary aspect of the study will be an economic analysis identifying, quantifying and comparing the costs of both the emergency department visit and subsequent costs to the individual, NHS and society. Process measures associated with the three different types of healthcare practitioner (e.g. number of patients treated per hour and referral rate) will also be considered. | — |
Countries
United Kingdom
Outcome results
None listed