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

Emerg Med J. 2009 Sep;26(9):644-7. doi: 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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesia / statistics & numerical data
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Bed Rest / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data*
  • Emergency Treatment / methods*
  • Exercise Therapy
  • Health Surveys
  • Humans
  • Immobilization / statistics & numerical data
  • Patient Education as Topic
  • Professional Practice
  • United Kingdom
  • Whiplash Injuries / therapy*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal

Associated data

  • ISRCTN/ISRCTN33302125