Whiplash associated disorder in children attending the emergency department.
OBJECTIVE
To determine the incidence, severity, and clinical course of whiplash associated disorder (WAD) in children aged 4-16 years involved as passengers in car crashes.


METHODS
Prospective surveillance of all paediatric attendances to three English urban emergency departments after car crashes over an eight month period. An initial structured telephone interview at day 2 after the car crash was performed. This was followed by clinical review of symptomatic patients on day 5 after the crash using the Quebec Task Force criteria for outcome assessment, with subsequent clinical review at 14, 28, and 56 days or until earlier symptom resolution.


RESULTS
105 children were identified as having been involved in car crashes as passengers. Forty nine children (47%) experienced symptoms of a WAD. Twenty nine children developed symptoms within 24 hours with the remainder developing symptoms by 48 hours. Forty children experienced a WAD grade 1 and nine children suffered a WAD grade 2 injury. The mean duration of symptoms was 8.8 days (range 3-70, SD 10.7). WAD grade 2 symptoms lasted significantly longer than WAD grade 1 symptoms.


CONCLUSIONS
The incidence of WAD in children in this series was higher than in other studies. The clinical course was more favourable than that reported for adults.
Boyd
R
R
Department of Emergency Medicine, Hope Hospital, Salford, UK. russellboyd@talk21.com
Massey
R
R
Duane
L
L
Yates
D W
DW
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D013021:South Australia / Q000453:epidemiology; D013997:Time Factors; D014911:Whiplash Injuries / Q000453:epidemiology*