Made-in-Ottawa rule helps patients with neck injuries in the emergency department

October 17, 2018

Dr. Ian Stiell uses C-Spine Rule with a patientA study led by Dr. Ian Stiell found that triage nurses in the emergency department can safely use a made-in-Ottawa rule to make wait times shorter and more comfortable for patients who have neck pain after a fall or car collision. Due to a very small risk of a broken neck, these patients often arrive on a back board with a collar to keep their head still. Emergency doctor then use the Canadian C-Spine Rule to find out which patients are at low risk and can safely wait without the board and collar. The research team found that triage nurses from nine Ontario hospitals were able to use this rule to safely take 41 percent of patients off back boards, reducing their time in the emergency department by 1.2 hours on average. Nurses usually saw these patients about 20 minutes after they arrived. Dr. Christian Vaillancourt is now leading a national study to see if this rule can also be used by paramedics.

“I was excited that we were able to harness the enthusiasm of so many nurses to embrace this rule and enact real change for our patients," said Dr. Stiell.

See Annals of Emergency Medicine for details.

Authors: Ian G. Stiell, Catherine M. Clement, Maureen Lowe, Connor Sheehan, Jacqueline Miller, Sherry Armstrong, Brenda Bailey, Kerry Posselwhite, Jannick Langlais, Karin Ruddy, Susan Thorne, Alison Armstrong, Catherine Dain, Jeffrey J. Perry, Christian Vaillancourt

Funding: This implementation study was funded by the Council of Academic Hospitals of Ontario through ARTIC (Adopting Research to Improve Care) and is an example of how The Ottawa Hospital is making Ontario healthier, wealthier and smarter. This research was also possible because of generous donations to The Ottawa Hospital for Research to Improve Patient Care.

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