Prof. Dr. Th. Ettlin, 2005
HWS-Probleme
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l
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• Management of acute whiplash
• Management of late whiplash
Rheuma Top Zürich
26. August 2005
Workshop
Prof. Dr. med. Thierry Ettlin
Prof. Dr. Th. Ettlin, 2005
Prof. Dr. Th. Ettlin, 2005
z Standards are missing
z
Insecure doctor
z
Insecure patient
Probleme
) Contradictory medical opinions
) Divergent treatment approaches
) Late consultation of specialists
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l
ii
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• Real time documentation missing
• Beginning of pain-physiological
chronification after 6 weeks
Prof. Dr. Th. Ettlin, 2005
Swiss recommendations for
the diagnostic and therapeutic
management
of acute whiplash
Swiss Med Forum Nr. 47 20. Nov. 2002, S. 1119-25
Prof. Dr. Th. Ettlin, 2005
Royal Dutch Society of Physical Therapy
www.cebp.n/media/m9.pdf
Prof. Dr. Th. Ettlin, 2005
Initial Diagnostics
Therapy
Educating and Guiding the Patient
Swiss recommendations for
the diagnostic and therapeutic management
of acute whiplash
Swiss Med Forum Nr. 47 20. Nov. 2002, S. 1119-25
Prof. Dr. Th. Ettlin, 2005
History and Examination Sheet
it
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ti
t
Prof. Dr. Th. Ettlin, 2005
History and Examination Sheet
2. Precise history of the sequence of events gives indications for:
Loss of consciousness
yes duration ........... no
Memory gap
yes duration ........... no
Anxiety- and/or shock reaction
yes
no
Other disturbances of consciousness yes
no
If so, which?.......................................................................................
Prof. Dr. Th. Ettlin, 2005
History and Examination Sheet
1.
Precise mechanism of the accident
2.
Chronology of the accident
3.
Complaints and symptoms
4.
Previous history
5.
Clinical findings on medical examination
6.
Diagnosis
7.
Therapy
Prof. Dr. Th. Ettlin, 2005
Diagnostic Workup
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i
• Frontal / back / sideways / collision
with
• Distorsion of the neck
with / without
• Head trauma
with / without
• Mild traumatic brain injury
with / without
• Post traumatic stress reaction
Prof. Dr. Th. Ettlin, 2005
Acute management: first TRIAGE
Whiplash Injury of the