Short/Rapid Fire Oral Presentation ANZTS Trauma 2024 Conference

Establishing the safety, efficacy and value add of a Physiotherapy led Trauma Tertiary Survey (21099)

Sara Calthorpe 1 , Lara Kimmel 1 2 3 , Mike Noonan 4 5 6 , Asher Kirk 1 , Doug McCaskie 2 , Elizabeth Batchelor 1 , Melissa Webb 1 2
  1. Physiotherapy Department, The Alfred Hospital, Melbourne, Australia
  2. Allied Health Executive, The Alfred Hospital, Melbourne, Australia
  3. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
  4. Trauma Service, The Alfred Hospital, Melbourne, Australia
  5. The National Trauma Research Institute, Melbourne, Australia
  6. School of Translational Medicine, Monash University, Melbourne, Australia

Introduction

The Trauma Tertiary survey (TTS) is an essential part of trauma patient care and aims to identify injuries not diagnosed on primary or secondary survey. This ensures appropriate and timely management before hospital discharge and has been found to reduce rates of missed injuries, which in turn may improve patient outcomes.

Methods

Most TTS are completed by junior medical staff and/or specialist trauma nurses. This project aimed to provide additional training and supervision for experienced senior trauma physiotherapists to complete TTS within a shared model of care. Delayed diagnoses (found >48 hours after patient admission), missed injuries (found after hospital discharge) and outcomes of any injuries found were compared between baseline (six months), and the Physiotherapy led TTS service (12 months).

 

Results

The number of reportable delayed diagnoses (found after 48 hours) were 38 at baseline and 57 during the project, of which 13 were found on Physiotherapy led TTS (since most TTS were completed prior to 48 hours). Overall, there were 120 injuries found on Physiotherapy led TTS, with the majority undergoing a specialist team review (n=86) and eight requiring surgery. Some of these injuries have not been well recognised in previous TTS literature (such as acromioclavicular joint injuries, post traumatic vertigo and rotator cuff injuries). Other benefits and learnings from the role will be discussed.


Conclusion

This project used an innovative model of care to train experienced trauma physiotherapists in TTS completion. It was found to be safe, effective and well supported by the trauma medical and nursing teams.