CJEM Visual Abstract: Use of Ottawa Ankle Rules by non-physician providers in a paediatric emergency department

In Infographics, Medical Concepts by Kevin LamLeave a Comment

In this issue, we collaborated with the CJEM team to create a visual abstract on the article: “Accuracy of the Ottawa Ankle Rules applied by non-physician providers in a pediatric emergency department.”1

The use of the Ottawa Ankle Rules by physicians has reduced radiography, time spent in the ED, healthcare expenditures, while not missing clinically relevant fractures.2 MacLellan et al. wanted to build on the small literature base surrounding the sensitivity and specificity of non physician providers’ using the Ottawa Ankle Rules applied to a paediatric population.1 To do so, the team recruited non-physician providers to go through a learning module on using the Ottawa Ankle Rules.

The results are highlighted in our visual abstract. The sensitivity for foot fractures were 100%, while that for the ankle was 88%. There was poor inter-rater reliability, which suggests that more training is needed. The authors conclude that with training, non-physician providers can apply the Ottawa Ankle Rules to assess the need for ankle radiographs prior to being seen by a doctor.

A PDF version of the visual abstract is available here.


MacLellan J, Smith T, Baserman J, Dowling S. Accuracy of the Ottawa Ankle Rules applied by non-physician providers in a pediatric emergency department. C. October 2017:1-7. doi:10.1017/cem.2017.399
Anis AH, Stiell IG, Stewart DG, Laupacis A. Cost-Effectiveness Analysis of the Ottawa Ankle Rules. A. 1995;26(4):422-428. doi:10.1016/s0196-0644(95)70108-7
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Kevin Lam

Kevin Lam

Kevin is a third year medical student at McMaster University. He is a junior editor for CanadiEM and has interests in medical education, graphic creation and the intersections between design, urban design and medicine.
Kevin Lam
- 10 months ago
Alvin Chin
Alvin is currently a PGY5 in the FRCP EM program at McMaster University. He serves as Director of Design for CanadiEM and has interests in knowledge translation and health innovation.
Alvin Chin
- 1 year ago
Alvin Chin

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