Perry Jeffrey J, Stiell Ian G
Clinical Epidemiology Program, The Ottawa Hospital, University of Ottawa, Canada.
Injury. 2006 Dec;37(12):1157-65. doi: 10.1016/j.injury.2006.07.028. Epub 2006 Oct 31.
Traumatic injuries to the ankle/foot, knee, cervical spine, and head are very commonly seen in emergency and accident departments around the world. There has been much interest in the development of clinical decision rules to help guide the investigations of these patients in a standardised and cost-effective manner.
In this article we reviewed the impact of the Ottawa ankle rules, Ottawa knee rules, Canadian C-spine rule and the Canadian CT head rule.
The studies conducted have confirmed that the use of well developed clinical decision rules results in less radiography, less time spent in the emergency department and does not decrease patient satisfaction or result in misdiagnosis.
Emergency physicians around the world should adopt the use of clinical decision rules for ankle/foot, knee, cervical spine and minor head injuries. With relatively simple implementation strategies, care can be standardized and costs reduced while providing excellent clinical care.
踝关节/足部、膝关节、颈椎和头部的创伤性损伤在世界各地的急诊科和事故科极为常见。人们对制定临床决策规则以帮助以标准化和具有成本效益的方式指导这些患者的检查产生了浓厚兴趣。
在本文中，我们回顾了渥太华踝关节规则、渥太华膝关节规则、加拿大颈椎规则和加拿大头部CT规则的影响。
所进行的研究证实，使用完善的临床决策规则可减少放射检查、缩短在急诊科的停留时间，且不会降低患者满意度或导致误诊。
世界各地的急诊医生应采用针对踝关节/足部、膝关节、颈椎和轻度头部损伤的临床决策规则。通过相对简单的实施策略，在提供优质临床护理的同时，可实现护理标准化并降低成本。
