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Telephone triage may be better use of resources for lower extremity injury

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Researchers in Boston found that sprains and strains account for more than a third of lower extremity injuries treated at emergency departments and thus, have reasoned telephone triage and scheduled care appointments might be better uses of emergency health care resources.

The study was published online in Clinical Orthopaedics and Related Research.

“Given relatively low-acuity leg problems such as strains and sprains account for a substantial number of emergency department visits pertaining to leg problems, use of telephone triage, scheduled same or next-day urgent care appointments, and other alternatives to the traditional emergency room might result in better use of emergency health care resources,” the authors wrote.

The researchers used the National Electronic Injury Surveillance System (NEISS) to obtain data on 119,815 patients with lower extremity injuries in 2009. The injuries were categorized by region, disease category, patient age, injury circumstances and location of injury. Injury trends between 2000 and 2009 were also observed for year-to-year consistency.

While the team was able to identify 112 unique combinations of disease categories and anatomic regions, they found strains and sprains accounted for 36% of all lower extremity injuries. Ankle sprain was the most common injury reported and frequently occurred in younger patients. Older patients were more likely to have lower trunk fractures, contusions and abrasions.

The most common incidence for injury was at home, the authors noted.

“Different approaches to triage and evaluation of lower extremity injury might result in better utilization of emergency health care resources,” they concluded. “For instance, patients with ankle injuries might call an emergency phone number to be triaged for an urgent visit if necessary or a scheduled visit during regular business hours instead.”

Reference:

• Lambers K, Ootes D, Ring D. Incidence of patients with lower extremity injuries presenting to U.S. emergency departments by anatomic region, disease category and age. Clin Orthop Relat Res. 2011. doi: 10.1007/s11999-011-1982-z

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