Section 5


The Task Force would have preferred to make firm recommendations based on research findings of good quality in the literature. However, the virtual absence of such evidence made it necessary to develop these clinical guidelines from consensus and the knowledge of experts in many clinical fields who are members of the Task Force. It should be stressed that these are guidelines. We emphasize that the dates for early intervention and the dates for referrals to specialized consultants and to multidisciplinary teams are firm. These recommendations reflect the consensus of the Task Force that the prognosis of WAD can be altered by optimum management. In other specific matters we stress the importance of the clinical judgement of the practitioner taking care of the patient and the importance of taking into account that each patient is an individual. Both clinical judgement and individuality of patients, nevertheless, should not be taken as excuses for a laissez-faire, highly variable approach to management. An important dictum in clinical practice, that common things are common and exceptions are uncommon, should be remembered. This section, therefore, presents the Quebec Guidelines for Patient Care, shown as a flow chart. With it, the reader will find operational definitions that assist in the interpretation of the Guidelines. We encourage and endorse its printing in a larger chart form that can serve as a useful and convenient reference for busy practitioners.

In Appendix I we present the suggested data sheets for minimum information to be recorded at initial and follow-up visits. Form A (Initial visit) and C (Follow-up visit) can be completed by the patient, with or without assistance, or by the physician. It includes demographic and collision-related information, information on general health before the collision, post-collision symptoms and a pain drawing. The pain drawing is used to describe presenting symptoms and can also be scored for research purposes according to the method of Margolis et al.60 Form B (Initial examination) and Form D (Follow-up examination) record the physical examination, diagnostic tests and diagnosis, including the Quebec classification and management plan.