Implementation of the Ottawa Ankle Rules by nurses working in an accident and emergency department. Issue 6 (November 1997)

• Record Type: Journal Article
• Authors: Salt, P; Clancy, M
• Is Part Of: Journal of accident & emergency medicine. Volume 14:Issue 6(1997)
• Page Start: 363
• Page End: 365
• Publication Date: 1997-11
• Subjects: Emergency medicine -- Periodicals; 616.025
• DOI: 10.1136/emj.14.6.363
• Languages: English
• ISSNs: 2633-6138

Abstract

Abstract : OBJECTIVE: To assess whether accident and emergency (A&E) nurses using the Ottawa Ankle Rules could detect all ankle fractures. DESIGN: Prospective observational study. SETTING: A&E department of a university teaching hospital. SUBJECTS: All patients who presented with ankle injuries who were initially assessed by a nurse taught the Ottawa Ankle Rules. OUTCOME MEASURES: (1) The numbers of patients referred by the nurse for ankle radiography; (2) of these, the number with ankle fractures; (3) of those not sent for radiography initially by the nurse, the number who subsequently had x rays (ordered by the doctor) and had a fracture; (4) of those having no x rays, the number who reattended later. RESULTS: 324 patients were eligible; 238 had x rays at the request of the nurse (73%); 48 of these (20%) were diagnosed as having a fracture. Of those 86 patients not sent for radiography by the nurse, 19 subsequently had x ray examinations at the request of a doctor and no fracture was detected. Of the 67 not sent for radiography, none returned within the subsequent eight weeks. CONCLUSIONS: Nurses can apply the Ottawa Ankle Rules safely without missing acute fractures; that is, of those who were not sent for radiography by nurses, none subsequently reattended the A&E department or the trauma service of the Bristol Royal Infirmary during the following two months.