What information is provided in Australian emergency departments about fitness-to-drive after mild traumatic brain injury : a national survey

Background/aim: Occupational therapists work together with their medical and nursing colleagues to ensure that patients are able to return to safe and legal driving upon discharge from the emergency department after a range of illnesses and/or injuries. This study aimed to determine the type of information that is provided nationally in emergency departments to people after mild traumatic brain injury (mTBI), with respect to fitness-to-drive. Methods: Cross-sectional electronic survey mailed to all emergency departments in Australia (N = 110). Responses were invited from medical, nursing, and allied-health professionals. The survey asked respondents to comment about the existence and use of fitness-to-drive management guidelines, as well as their opinion on when clearance should be given to return to driving post injury. Results: 104 clinicians completed the survey; the majority of respondents were medical staff (n = 46, 51%) followed by allied-health staff (n = 23, 25%), with the highest response rate provided from Victoria (n = 41, 45%). Just over one-third of respondents’ emergency departments (n = 34, 36%) recommended a period of ‘no driving’ after mTBI, and within these departments, this recommendation was usually provided by medical staff (n = 25, 80%). Consensus was not displayed with respect to the safest time to return to driving after mTBI. Opinions from respondents strongly suggested that a review of fitness-to-drive management guidelines was required for mTBI patients (n = 78, 88%). Conclusion: No consensus exists in the fitness-to-drive recommendations provided to patients after mTBI, and clinicians have reported the need for a review of fitness-to-drive management guidelines in Australian emergency departments. With their understanding about the complex interplay of the skills required for safe driving, occupational therapists are positioned to help guide the development of protocols in this area.