Prospective non-randomised controlled trial.
Three metropolitan emergency departments.
Adults (n = 315) presenting to emergency departments with peripheral musculoskeletal injuries were allocated to primary or secondary contact physiotherapy; 306 participants completed the study. Patients with serious pathology, open fractures and spinal pain were excluded.
A single episode of physiotherapy.
Primary outcome measures were patient length of stay, waiting time and treatment time. Secondary outcome measures were re-presentations to the emergency department, imaging referrals, patient satisfaction and emergency department staff acceptance.
Primary contact physiotherapy resulted in a reduction in length of stay of 59.5 minutes [95 % confidence interval (CI) 38.4 to 80.6] compared with secondary contact physiotherapy, with a reduced waiting time of 25.0 minutes (95 % CI 12.1 to 38.0) and a reduced treatment time of 34.9 minutes (95 % CI 16.2 to 53.6). There were no differences between the groups in imaging referrals or re-presentations. Patients strongly agreed (≥82 % ) that they were satisfied with their management, and 96 % of emergency department staff agreed that primary contact physiotherapists had appropriate skills and knowledge to provide emergency care.
Experienced musculoskeletal physiotherapists working in emergency departments can be the first point of contact for patients with simple, semi-urgent and non-urgent peripheral musculoskeletal injuries, resulting in decreased waiting times and length of stay for patients without any adverse effects.