Objective-To assess whether the Ottawa ankle rules can be used to accurately predict which children with ankle and midfoot injuries need radiography. Methods-Prospective study with historical control group of all children aged 1-15 years presenting to Sheffield Children's Hospital accident and emergency department with blunt ankle and/or midfoot injuries during two five month periods before and after implementation of the Ottawa ankle rules.
LETTERS TO THE EDITOR Use of A&E wards EDrrOR,-I am not surprised that the physicians and surgeons at the Royal Liverpool University Hospital do not have to be convinced of the benefits of Dr A M T Good' organising the acute management of DVTs, ureteric colic, and acute gastrointestinal bleeds. This system, while appearing efficient, quite clearly offloads a lot of their work onto the A&E department. The inpatient management of these acute surgical and medical admissions should not become the remit of A&E. A&E wards already take cases such as intoxicated head injuries and drug overdoses that other specialties are not interested in. So-called short stay wards can easily backfire unless strict control over admissions and patient disposal are enforced. A typical example of this is illustrated by Rainer et al,' who showed that only 84% of
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