Use of Ottowa knee rules to identify fracture

There is a large body of evidence to suggest that use of the Ottowa knee rules (OKR) (Stiell et al 1995) can ensure a consistent level of care for patients with acute knee injuries and that the OKR are a useful tool for autonomous practitioners. However, there is also evidence that in using the OKR, nurses tend to overestimate the extent of knee injuries. This article draws on a case study of a man who had sustained a knee injury while being tackled in a football match. During the consultation, the author, who was the duty student paramedic practitioner, and the author's mentor, who was the duty senior nurse practitioner, disagreed about the need for an X-ray of the patient's knee. After reflecting on the consultation, the author concluded that she lacked experience to deviate from a strict interpretation of the OKR when assessing knee injuries.