Musculoskeletal Pain
Conditions
Keywords
Emergency department, musculoskeletal disorder
Brief summary
The purpose of this study is to estimate the number of patients who come to the emergency department with a musculoskeletal referral, to describe the different types of diagnosis for these patients and their treatment and discharge.
Detailed description
There is a crisis in the emergency department (ED) in France, as their number of consultations have constantly increased over the past ten years . Musculoskeletal disorders (MSK) are the most common cause of consultations in ED, as an example there is an average of 30% of ED consultations being for traumatic issues . Moreover, 90% of all patients coming in ED in France have a favourable prognosis of evolution (no risk of seriousness). In this situation, one of the propositions to help to reduce the ED burden is to allow a direct access to physiotherapists. They are the recommended profession to treat patients for musculoskeletal conditions and several studies showed physiotherapy assessment and treatment in an emergency service is safe and beneficial both for the patients and the hospital teams. They have reported to increase satisfaction, to reduce medications and requirement for expensive imaging on one hand, and to reduce the costs and to give more time to the medical team on the other hand This role does not exist yet in France, although more than 48 countries across the world have implemented it, and French physiotherapists are advocating for it. A recent text has been adopted by the French government allowing patients with recent ankle sprain or low back pain to self-refer to physiotherapists working in hospitals or in care home. . However, this access is very restricted, which will make the implementation difficult as it might not be sufficient to assist the ED. Moreover, there is a lack of information on the number and the type of diagnostic of patients with a MSK label coming to the ED, which makes it difficult to assess the impact this role could have on French ED. In this context, a retrospective survey, describing how many patients with a musculoskeletal label are coming to the ED, and how they are managed, could help to estimate the worthiness of physiotherapist direct access in French ED. Question : What is the proportion, the type of diagnostic and the management of musculoskeletal disorder in emergency department in one hospital in France?
Interventions
OTHERData collection
Collection of various data from patients' medical file, such as demographic data, diagnostic results, discharge, treatment....
Sponsors
University of Brighton
Hôpital NOVO
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 68 Years
Healthy volunteers
No
Inclusion criteria
: * Patients aged between 18 and 68 * Patients admitted to emergency with a triage by the Reception and Referral Nurse of 0, 1 or 2 * Patients who consulted for one of the following reasons: Lower limb pain (T13.9) Lower limb trauma (M79.61) Upper limb pain (T11.9) Upper limb trauma (M79.60) Spinal pain (M54.9) Lumbar or flank pain (R10.3) Diffuse/unspecific pain (R52.9) Loss of sensitivity/paraesthesia \- Patients informed of the study and who did not object
Exclusion criteria
: * Patients with another reason for consultation associated with the first * Patients under guardianship / curatorship and patients under safeguard of justice.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Description of the population (diagnoses and treatment) considered to have a potential musculoskeletal disorder after nursing triage | At the end of the study, an average of 3 month | The description of the patients, triaged by the emergency reception and referral nurse as having a potential musculoskeletal pathology, will be carried out by collecting the different types of diagnoses, based on the International Classification of Diseases - 10th revision (ICD10) and their severity, as well as their age and gender, and the treatments that have been prescribed (medication, imaging, physiotherapy, other…). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Description of the management of patients (duration) with a potential musculoskeletal disorder after nursing triage | At the end of the study, an average of 3 month | Collection of the duration of care (from registration at the emergency department to the patient's discharge) |
| Description of the management of patients (number of patients per day of the week) with a potential musculoskeletal disorder after nursing triage | At the end of the study, an average of 3 month | Collection of the number of patients per day of the week (Monday to Sunday) and by time slots between 8am and 8pm during the day and between 8pm and 8am at night |
| Description of the management of patients (end-of-care orientation) with a potential musculoskeletal disorder after nursing triage | At the end of the study, an average of 3 month | Collection of different referrals (hospitalization, return home..) at the end of patient care |
| Assessment of the prevalence of people with a potential musculoskeletal disorder after nursing triage | At the end of the study, an average of 3 month | Number of patients with a potential musculoskeletal disorder, after nursing triage, out of the total number of people consulting during the same period |
Countries
France
Outcome results
None listed