Audit on Patient Referrals by ER Doctors vs. Orthopedic Intervention Needs at Dr. Ammar Altayb Unit, Omdurman Teaching Hospital

Background: Musculoskeletal injuries are common in emergency departments (EDs), necessitating effective referrals to orthopedic services to optimize patient care and resource management. The appropriateness of these referrals is crucial for ensuring that patients receive necessary interventions while minimizing unnecessary consultations that can burden healthcare resources. Methodology: A retrospective audit was conducted over three months, from January to March 2023, at Omdurman Teaching Hospital, focusing on the emergency room (ER). Results: A total of 1,854 patients were referred to orthopedic services, with a mean age of 35.2 years (range 18-85). The nature of injuries included fractures (53.3%), soft tissue injuries (26.7%), dislocations (13.3%), and other injuries (6.7%). Of the referred patients, 66.8% required orthopedic intervention, with 93.7% of fracture referrals appropriate, while only 49.9% of soft tissue injuries warranted intervention, indicating potential over-referral in this category. Conclusion: The audit underscores the effectiveness of emergency room (ER) referrals to orthopedic services, particularly for fractures and dislocations. However, the unnecessary referral of soft tissue injuries indicates the need for improved training and clearer referral guidelines