PT  - JOURNAL ARTICLE
AU  - J Ryan
AU  - M Ghani
AU  - P Staniforth
AU  - G Bryant
AU  - S Edwards
TI  - "Fast tracking" patients with a proximal femoral fracture.
AID  - 10.1136/emj.13.2.108
DP  - 1996 Mar 01
TA  - Journal of Accident & Emergency Medicine
PG  - 108--110
VI  - 13
IP  - 2
4099  - http://emj.bmj.com/content/13/2/108.short
4100  - http://emj.bmj.com/content/13/2/108.full
SO  - Arch Emerg Med1996 Mar 01; 13
AB  - OBJECTIVE--To assess the management of elderly patients presenting to the accident and emergency (A&E) department with a proximal femoral fracture. METHODS--A retrospective audit carried out on 30 patients with proximal femoral fracture showed an unacceptably long waiting time in the A&E department. A new "fast track" system for managing these patients, involving the use of a flow chart for expediting admission, was devised. A prospective study of 100 patients > 60 years of age with proximal femoral fracture admitted by fast track system was then carried out. RESULTS--Implementation of the fast track system resulted in earlier admission to the ward (median time to admission 2.5 h v 4.5 h in the retrospective audit, P < 0.001). Eighteen patients were not admitted by fast track during the study period, in some cases because of inconclusive diagnosis or because there was no identifiable orthopaedic bed; mean admission time for this group was 4 h 8 min. CONCLUSIONS--The fast track system was of benefit to all involved, including the patient, A&E staff, ward staff, and orthopaedic personnel.