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


CONCLUSIONS
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.
Lamb
S E
SE
University of Warwick, Coventry, UK. s.lamb@warwick.ac.uk
Williams
M A
MA
Withers
E
E
Perry
J
J
Gates
S
S
Williamson
E
E
Underwood
M
M
Cooke
M
M
D000698:Analgesia / Q000706:statistics & numerical data; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001510:Bed Rest / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000379:methods*; D005081:Exercise Therapy; D006306:Health Surveys; D006801:Humans; D007103:Immobilization / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011364:Professional Practice; D006113:United Kingdom; D014911:Whiplash Injuries / Q000628:therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal