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The Ottawa Ankle Rules (OAR) are a well-validated set of guidelines for determining whether x-rays are necessary after an ankle injury. To determine the effect of triage nurse–initiated, OAR-informed ankle radiography on emergency department (ED) throughput, researchers conducted a prospective trial involving adults presenting with ankle injuries at a Vancouver, Canada, teaching hospital between August 2012 and August 2013.
A total of 146 patients were randomized to management by ED triage nurses using the OAR, with x-rays ordered if indicated, or to standard assessment by the same group of nurses. All patients had isolated ankle injuries without obvious fracture or deformity; all had normal mental status and were neurovascularly intact. The…