Hear, hear, Rowley. Couldn't agree more with you. Had one of our sports
physios and his wife, a radiographer in yesterday. They'd been in a rear
end shunt the day before and both had neck strains. Both had started to
exercise immediately and both had a virtually full ROM - not painfree but
good. And their car is a write-off - it was not a minor shunt. Let's put
this collar thing to bed once and for all.
Cheers,
Rocky.
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, September 11, 2002 1:38 PM
Subject: Re: Clearance of c-spines
> Point 1. Stop referring to these neck injuries as a whiplash. This daft
> term was coined by a man called Crowe in 1928, and has been derided ever
> since. It does not represent what happens to the neck at all.
>
> Point 2. There are three GOOD studies showing that a neck collar leads
> to a worse outcome than physio or self directed exercise.
>
> Mealy, Brannon and Fenelon (1986)Early mobilisation of acute whiplash
> injuries BMJ 1986;292:656-7
>
> Mckinney Dornan & Ryan (1989)The role of physiotherapy in the management
> of acute neck sprains following RTAs Arch Emerg Med 1989;6:27-33
>
> Gennis et al (1996)The effect of soft cervical collars on persistent
> neck pain in patients with whiplash injury. Acad Emerg Med
> 1996;3:568-73.
>
> There is the evidence.
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Toby Fogg
> Sent: 09 September 2002 17:44
> To: [log in to unmask]
> Subject: Re: Clearance of c-spines
>
>
> Do they not come back for another reason too? Namely to have something
> to be able to take something to their insurance company. I realise
> there are many good reasons why some of our patients are unable to work
> after sustaining a whiplash injury but - and please correct me if I'm
> wrong - I think some are just playing up to get a payout. I usually get
> suspicious when they say something like "My friend suggested I get it
> checked out" when I have watched them moving easily around the waiting
> room.
>
> Toby Fogg
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of Robbie Coull
> Sent: 7 September 2002 10:31
> To: [log in to unmask]
> Subject: Re: Clearance of c-spines
>
> > More importantly the patients love them and
> >go away happy.
>
> And come back again next time because they think they 'need' a collar.
>
> That's paternalistic and it increases the medicalisation of minor
> problems (and therefore our workload) for no benefit.
>
> Robbie Coull
>
> email: [log in to unmask] website: http://www.coull.net
>
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