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A national survey of clinical practice for the management of whiplash-associated disorders in UK emergency departments

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Lamb, S. E. (Sallie E.), Williams, Mark A., Withers, Emma J., Perry, Joanna, Gates, Simon, Williamson, Esther M., Underwood, M. (Martin) M.D. and Cooke, Matthew (Professor of clinical systems design). (2009) A national survey of clinical practice for the management of whiplash-associated disorders in UK emergency departments. Emergency Medicine Journal, Vol.26 (No.9). pp. 644-647. ISSN 1472-0205

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Official URL: http://dx.doi.org/10.1136/emj.2008.065276

Abstract

Objective: To undertake a national survey to determine current practice for the management of whiplash injuries in UK emergency departments (ED).

Methods: Postal questionnaire survey. 316 lead consultants from all UK ED with annual new attendances of over 50 000 people were asked to indicate the use of a range of treatments and the frequency with which these treatments were used. Samples of written advice were requested and content analysis was conducted and compared with survey responses.

Results: The response rate was 79% (251/316). The intervention most frequently used was verbal advice to exercise, reported by 84% of respondents for most or all cases, and advice against the use of a collar (83%). Other treatments reported as being used frequently were written advice and anti-inflammatory medication. 106 consultants (42%) provided a sample of written materials. Reference to expected recovery and encouragement for early return to activities were included in less than 6%. Nearly 50% of written materials contained information on how to use a soft collar and 61% contained information on solicitors and pursuing a personal injury claim. There were important differences between reported verbal behaviours and written advice.

Conclusion: Verbal advice is the primary method for managing whiplash injuries in ED and is usually supplemented by written advice. Within individual hospitals there is a lack of consistency between verbal and written advice. The promotion of personal injury claims is a common feature of written advice. Research is required to develop effective and consistent models of advice.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Whiplash injuries -- Great Britain, Emergency medical services -- Great Britain, Medical care surveys -- Great Britain, Neck -- Wounds and injuries -- Treatment
Journal or Publication Title:	Emergency Medicine Journal
Publisher:	BMJ Group
ISSN:	1472-0205
Official Date:	September 2009
Volume:	Vol.26
Number:	No.9
Number of Pages:	4
Page Range:	pp. 644-647
Identification Number:	10.1136/emj.2008.065276
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	NHS R & D HTA Programme (Great Britain) (HTA)
Grant number:	ISRCTN33302125 (HTA)
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URI:	http://wrap.warwick.ac.uk/id/eprint/2415