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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, MB ChB. (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
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)
References: 1. Spitzer W, Skovron M, Salmi L, et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining ‘‘whiplash’’ and its management. Spine 1995;20(8 Suppl):1–73S. 2. Galasko CSB. The cost of whiplash-associated disorders. In: Gunzberg R, Szpalski M, eds. Whiplash injuries: current concepts in prevention, diagnosis, and treatment of the cervical whiplash syndrome. Philadelphia: Lippincott-Raven, 1998:283–90. 3. Verhagen A, Scholten-Peeters G, van Wijngaarden S, et al. Conservative treatments for whiplash. Cochrane Database Syst Rev 2007;(2):CD003338. 4. McClune T, Burton AK, Waddell G. Whiplash associated disorders: a review of the literature to guide patient information and advice. Emerg Med J 2002;19:499–506. 5. Williams M, Williamson E, Gates S, et al. A systematic literature review of physical factors and the development of late whiplash syndrome. Spine 2007;32:E764–80. 6. Williamson E, Williams M, Gates S, et al. A systematic literature review of psychological factors and the development of late whiplash syndrome. Pain 2008;135:20–30. 7. Burton K, Tim M, Gordon W. The whiplash book. London: TSO, 2005. 8. Carroll L, Holm L, Hogg-Johnson S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000– 2010 Task Force on Neck Pain and Its Associated Disorders. Spine 2008;33(4 Suppl):S83–92. 9. Cassidy JD, Carroll LJ, Cote P, et al. Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med 2000;342:1179–86. 10. Pennie B, Agambar L. Patterns of injury and recovery in whiplash. Injury 1991;22:57–9. 11. Edwards P, Roberts I, Clarke M, et al. Methods to increase response rates to postal questionnaires. Cochrane Database Syst Rev 2007;(2):MR00000. 12. Logan AJ, Holt MD. Management of whiplash injuries presenting to accident and emergency departments in Wales. Emerg Med J 2003;20:354–5.
URI: http://wrap.warwick.ac.uk/id/eprint/2415

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