Whiplash associated disorder in children attending the emergency department

Aims: 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.