Canada rules OK

Ottawa and its links with clinical decision rules will be familiar to almost every reader of this journal; if not, where have you been for the last twenty years? This month we publish two papers that have their origins in that fine city. Frank Coffey and local colleagues in Nottingham, in collaboration with Ian Stiell in Ottawa set out to determine the potential of the Canadian Cervical Spine Rule to safely reduce the number of c-spine films performed in a UK emergency department (see page 873). Over 24 months and following intense training of 148 doctors their conclusion will be of no surprise to anyone familiar with the rule and with the other rules emanating from Ian Steill's unit. A pilot study by Canagasabey and colleagues looked at the role of ultrasound in detecting acute ankle and foot bony injuries (see page 838). A relatively small number of 110 patients were enrolled; the authors argue that ultrasound shows …