Abstract:
INTRODUCTION:One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. AIM:In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. RESULTS:Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. CONCLUSION:There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.
journal_name
Ir J Med Scijournal_title
Irish journal of medical scienceauthors
Ó Mír M,O'Sullivan Cdoi
10.1007/s11845-017-1611-2subject
Has Abstractpub_date
2018-02-01 00:00:00pages
131-140issue
1eissn
0021-1265issn
1863-4362pii
10.1007/s11845-017-1611-2journal_volume
187pub_type
杂志文章,评审abstract:BACKGROUND:Cardiac arrest due to ischaemia is frequently the first manifestation of cardiovascular disease. We sought to describe the characteristics and outcomes of patients admitted to the Intensive Care Unit (ICU) with a diagnosis of cardiac arrest secondary to acute coronary syndrome (ACS). METHODS:We performed a ...
journal_title:Irish journal of medical science
pub_type: 杂志文章
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
pub_type: 杂志文章
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更新日期:2014-09-01 00:00:00
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journal_title:Irish journal of medical science
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更新日期:2003-10-01 00:00:00
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
pub_type: 杂志文章
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
pub_type: 杂志文章,评审
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journal_title:Irish journal of medical science
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更新日期:2020-02-01 00:00:00
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Irish journal of medical science
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journal_title:Irish journal of medical science
pub_type: 杂志文章
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更新日期:2001-01-01 00:00:00
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journal_title:Irish journal of medical science
pub_type: 临床试验,杂志文章
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journal_title:Irish journal of medical science
pub_type: 杂志文章
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更新日期:1994-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-02-01 00:00:00
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journal_title:Irish journal of medical science
pub_type: 杂志文章
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