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ADVANCE Perspective: Physical Therapy & Rehab Medicine

CSM 2012: A New Place for PT?

Published February 9, 2012 2:24 PM by Danielle Bullen

Chicago--The emergency department is not the first place one thinks of when thinking of physical therapy. However, some PTs at Barnes Jewish Hospital in St. Louis are trying to change that. At a CSM session today, Vision of PT in the ED, they presented their case for a physical therapy presence in a bustling urban emergency department.

One full-time physical therapist staffs the ED weekdays from 11-7.  "Very complex patients and I find that exciting," said speaker Susan S. Deusinger, PT, PhD, FAPTA. At Barnes Jewish, physical therapists want to be considered specialty consultants. Even when there's no PT patients, they spend their shift educating other clinicians on what physical therapy can do for ED patients.

Two of the therapists who work at Barnes Jewish, Debbie McDonnell, PT, DPT and Pamela Wendl, PT, DPT spoke about their experiences. They look at the EMR for a patient and assess whether as physical therapists, they agree with the triage label. Sometimes they can see diagnoses in a patient that the triage nurse or ED physician missed."We're movement experts," said McDonnell. "We know normal movement."  The goal is to differentiate between the patients with musco-skeletal pain and those without. For those with musco-skeletal diagnoses, the most important aspect is follow-up. After discharge, the PT refers patients to either the Barnes Jewish pro bono clinic, gives them home exercises or has the MD refer them to outpatient physical therapy.

The speakers proposed 3 hypotheses for physical therapy intervention in the emergency department. They believed they could reduce 72 hour return for the same diagnosis, reduce medication cost, and reduce diagnostic imaging costs. They're currently studying two groups of ED patients--one that did not see a PT and one that did to see if their theories have any merit. The study is ongoing but one preliminary conclusion is that patients who saw a physical therapist self-reported less pain after discharge than those who did not.

The role of physical therapy in the emergency department is still in its infancy. It holds much potential, though. As Deusinger said, "Cultural transformation is a major privilege in our world." Perhaps the presence of PT in the ED will be next health care shift.

1 comments

What a wonderful idea.  We're trained to assess patients differently than doctors and nurses.  I might not be able to add  much for a poly-trauma patient but someone who complains of dizziness, HA and stroke-like symptoms is another story.  I hope the idea catches on.

Toni February 10, 2012 5:47 AM

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