[Treatment duration of trauma and orthopedic patients in an emergency department].
BACKGROUND
The majority of emergency patients are admitted to hospital via the emergency department. Overcrowding in emergency departments results in dissatisfied patients, increased complication rates, and negative medicoeconomic consequences. To overcome these problems, sufficient personnel strength should be available depending on treatment duration and the patients' characteristics.


METHODS
First, trauma and orthopedic patients were classified into six categories: ABT (history, findings, and therapy), RABT (X-ray and ABT), WABT (wound care and ABT), WRABT (wound care and RABT), STAT (hospital admission), and SR (trauma life support). Furthermore, the duration of medical treatment was correlated with the physicians' educational level (specialist or physician in training after or during the common trunk period). Not included were waiting periods and nursing care measures. After analyzing the frequency of each category, the mean duration of treatment for an"average patient" was determined.


RESULTS
The duration of treatment of 900 patients was recorded. The average times were 9.5 min (ABT), 13.8 min (RABT), 17.3 min (WABT), 24.5 min (WRABT), 38.4 min (STAT), and 84.2 min (SR). The frequencies for the different categories were: ABT 18.8%; RABT 50.2%; WABT 14.5%; WRABT 4.4%; STAT 10.6%, and SR 1.4%. Thus, an average duration of medical treatment of 17.6 min was calculated. Especially in the RABT category, significant differences between specialists and physicians in training were evident. In children and adolescents, the duration of treatment was 12.5 min.


CONCLUSIONS
The duration of treatment of an average trauma and orthopedic patient depends on the level of care of the hospital and the qualification of the physician in charge. In order to avoid negative consequences of overcrowding in emergency departments, adequate personnel strength is essential. Personnel strength should be calculated based on the average duration of medical treatment of about 18 min.
Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland, thomas@ruffing.eu.
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Ruffing
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Danko
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Weiss
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Winkler
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Muhm
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D009985:Orthopedics / Q000193:education; D017060:Patient Satisfaction; D013997:Time Factors; D055815:Young Adult