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Hi,

Does anyone have or know of a service that has an MSK podiatrist working as part of the team within an Accident and Emergency department. This is something we are looking to develop within our Health Board and any help/advice would be gratefully appreciated.

Kathryn Mulroy

 

At Eastern Health we have a primary contact Physio in one ED and a secondary contact physio in the other 2. There has been some studies presented and published around this that should be able to translate to podiatry, as most of the MSK injuries are arms and legs, but the phsios also see a few backs

 

I dont understand how a podiatrist would help in the ED. One- they are not medically trained in emergency medicine, two- orthopods treat breaks, fractures, sprains ect., what role would they fufil other than diabetes cases??? Very little we treat is life or death and it certaily isnt immediately life threatening.

 

Get me a green Slimflex with 4 degree rear foot post, STAT!

It's not enough!

Alright, lets up the treatment, get me a Interpod control tech flex with 6 degree arch......better make it 8 deg. I'm not going to lose him. If we can't get a result from this, we're going to have to go for a Rothbart!

See Mitchell and Webb to see how this should be said

http://www.youtube.com/watch?v=HMGIbOGu8q0

 

Footfan,

Most ED presentations are not life and death. The vast majority are cat 3-5, and could usually be managed by a GP, but limited GP services, and in this country sometimes the cost causes people to attend an ED. MSK injuries are very common presentations, especially on weekends, and often best managed by a physio.
It is very difficult to get an Ortho review in most EDs, unless for a # requiring admission or urgent surgery. Simple fractures are usually cast in ED then reviewed in a fracture clinic a day or two after the ED presentation.

 

Hi,
Extended Scope Podiatrists are commonly used in Orthopaedic clinics requesting and interpreting imaging modalities, administering joint injections and diagnosing and discharging independently. This has become accepted practice and many Orthopaedic colleagues have come to appreciate our role in their clinics etc..
Many of the injuries coming through A&E are grade 1-3 ankle sprains and minor fractures etc all of which a suitably trained MSK Podiatrist would be the best person for the job. However when I say an MSK podiatrist I do not mean one who pretends he is a lower limb expert when in reality they have limited anatomy and no real orthopaedic knowledge and confine themselves to a small podiatry niche around a pseudo science in insoles...
Many of these acute injuries are poorly diagnosed, not immobilized appropriately and subsequently present in our MSK clinics as chronic debilitating conditions which are then difficult to resolve. If we do not become involved in this area then I am sure our Physio. colleagues will!!

 

Kathryn i couldn't agree more. We are ideally placed to assess and treat foot and ankle pathology in A+E. I spent some time in the US last year with Pod's covering the ER seen as the norm. Yes i know (to those that will mention this) they are trained in trauma surg etc however the majority of foot and ankle pathology seen were simple sprains, nails, lacs, infections.

All these could easily be treated by a podiatrist. Im just looking at trying to get some A+E experience at the moment. I think a good place to start is offering services to the local "same day" health centres.

oh and i agree with your comment regarding some people classing themselves as MSK pods :bang:

 

Thanks for your informative comments it is nice to know that someone else is on the same wavelength. If you have any further developments in this area please do let us know.