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Shatali AA1
1Ministry of Health, Emergency Physiotherapy Team Leader -Shifa Hospital, Gaza City, Palestine
Background: Hospitals In Gaza are overwhelmed and the health system has grown very vulnerable in light of shrinking resources and disproportionately high demand. Since March-2018, the Great-Return-March (GRM) demonstrations have resulted in high influx of causalities referred to emergency departments (ED) at the Ministry-of-Health (MOH). Shifa-Hospital recorded referrals of 465 causalities In one day.
In 2008, ICRC supported Shifa to improve Physiotherapy (PT) in-patient services at Orthopedic-Surgical Departments. Since then, PT team have developed their skills and are currently working vigilantly with ED teams.
PTs has a prominent role in helping ED staff to better manage patient flow and contribute in life-saving interventions , it is the first time experience in Palestine.
Purpose: This paper aims to highlight the intervention of PT team at ED during the GRM between March and May 2018 at Al Shifa Hospital.
Methods: Early preparations had taken place at Shifa by a qualified Emergency Physiotherapy Team Leader (EPTTL). The idea of (PT) intervention was prepared in cooperation with other ED staff through conducting four-meetings with head of ED-nurses, heads of orthopedic-surgery, and nursing-director at Shifa in order to explain the expected role of physiotherapy at ED. Cooperation with ED-staff members (doctors,nurses,and surgeons) was to avoid duplication of care, especially at Triage-area (Green-Zone). Basically, PT can participate in managing the non-critical/non-surgical GRM casualties, while other ED specialized medical-staff can manage critical and surgical ones.
This idea was approved by the Hospital General-Director,An emergency-physiotherapy (EDPT) team has been formed to provide additional support to other medical-staff at ED through integrating the WCPT guidelines on the Role of Physiotherapists in Disaster- Management Report (2016 ).
A duty-roster of assigned PTs was prepared and a meeting headed by EPPTL was held to clarify rules and assignment for each EDPT team members, including a training program.
Results: EPTTL was in ambulatory area (Green-Zone) with ED doctor, other 2-3 PTs together with orthopedic-surgeon were performing physical screening, examination, physical deferential diagnosis,management of both non-critical, non-surgical cases such as soft tissue,joint injuries, simple fractures,contusions, tear-gas inhalations. Many Referrals to other medical disciplines, patient health-education, and psychological first aid (PFA) were recorded.
Based on daily Patient-Services Department, The EDPT had intervened with 66.8% (No.973) out of (1456) causalities admitted to ED during nine weeks. Those 66.8% causalities were discharged home from ED as a result of EDPT intervention in cooperation with other ED staff.
The Role of Physiotherapy has scored high appreciation of members of emergency multi-disciplinary team and better patient satisfaction.
Conclusion(s): Shifa witnessed the first physiotherapy intervention at ED,where physiotherapists act actively in managing the GRM-causalities and they played a key role in the emergency multi-disciplinary team. As a result of great role of EDPT to help in freeing the ED for new flow of causalities as well as supporting the other ED-staff to focus in lifesaving interventions for critical and surgical cases.
Implications: This experience is expected to develop systematized intervention-guideline for practicing physiotherapists during mass-casualty (MC) incidents in the ED within the MOH, and promotion of MC PT subspecialty to raise up the physiotherapy profession in Palestine.
Keywords: Emergency, Physiotherapy
Funding acknowledgements: No funds were allocated for this study
In 2008, ICRC supported Shifa to improve Physiotherapy (PT) in-patient services at Orthopedic-Surgical Departments. Since then, PT team have developed their skills and are currently working vigilantly with ED teams.
PTs has a prominent role in helping ED staff to better manage patient flow and contribute in life-saving interventions , it is the first time experience in Palestine.
Purpose: This paper aims to highlight the intervention of PT team at ED during the GRM between March and May 2018 at Al Shifa Hospital.
Methods: Early preparations had taken place at Shifa by a qualified Emergency Physiotherapy Team Leader (EPTTL). The idea of (PT) intervention was prepared in cooperation with other ED staff through conducting four-meetings with head of ED-nurses, heads of orthopedic-surgery, and nursing-director at Shifa in order to explain the expected role of physiotherapy at ED. Cooperation with ED-staff members (doctors,nurses,and surgeons) was to avoid duplication of care, especially at Triage-area (Green-Zone). Basically, PT can participate in managing the non-critical/non-surgical GRM casualties, while other ED specialized medical-staff can manage critical and surgical ones.
This idea was approved by the Hospital General-Director,An emergency-physiotherapy (EDPT) team has been formed to provide additional support to other medical-staff at ED through integrating the WCPT guidelines on the Role of Physiotherapists in Disaster- Management Report (2016 ).
A duty-roster of assigned PTs was prepared and a meeting headed by EPPTL was held to clarify rules and assignment for each EDPT team members, including a training program.
Results: EPTTL was in ambulatory area (Green-Zone) with ED doctor, other 2-3 PTs together with orthopedic-surgeon were performing physical screening, examination, physical deferential diagnosis,management of both non-critical, non-surgical cases such as soft tissue,joint injuries, simple fractures,contusions, tear-gas inhalations. Many Referrals to other medical disciplines, patient health-education, and psychological first aid (PFA) were recorded.
Based on daily Patient-Services Department, The EDPT had intervened with 66.8% (No.973) out of (1456) causalities admitted to ED during nine weeks. Those 66.8% causalities were discharged home from ED as a result of EDPT intervention in cooperation with other ED staff.
The Role of Physiotherapy has scored high appreciation of members of emergency multi-disciplinary team and better patient satisfaction.
Conclusion(s): Shifa witnessed the first physiotherapy intervention at ED,where physiotherapists act actively in managing the GRM-causalities and they played a key role in the emergency multi-disciplinary team. As a result of great role of EDPT to help in freeing the ED for new flow of causalities as well as supporting the other ED-staff to focus in lifesaving interventions for critical and surgical cases.
Implications: This experience is expected to develop systematized intervention-guideline for practicing physiotherapists during mass-casualty (MC) incidents in the ED within the MOH, and promotion of MC PT subspecialty to raise up the physiotherapy profession in Palestine.
Keywords: Emergency, Physiotherapy
Funding acknowledgements: No funds were allocated for this study
Topic: Disaster management; Professional practice: other; Service delivery/emerging roles
Ethics approval required: No
Institution: Shifa Hospital -MOH
Ethics committee: General Director - Shifa Hospital
Reason not required: This experience is addressing new development of physiotherapy practice and intervention at Emergency Department at Shifa hospital ,for the first time in our country . EDPt is considered a new professional field worldwide as WCPT issued a report on the role of physiotherapy in disaster management. We at Shifa practiced this role in a new massive causalities situation .
All authors, affiliations and abstracts have been published as submitted.
