These are the ‘Roids you are looking for – Steroids in the ED

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of...

Nailed it! A guide to Fingertip Injuries

A stable and functional fingertip is essential for sensation, fine motor skills, grip strength, and the overall durability and cosmetic appearance of the hand. Fingertips, often the first point of contact during daily activities, are particularly susceptible to...

Posterior Circulation Strokes

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more...

Mechanical Ventilation Basics

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience,...

Functional Neurologic Disorders

Note: This grand rounds presentation and summary had contributions from Dr. Anne-Marie Abe, a neuropsychiatrist specializing in functional neurological disorders in Ottawa.   Patients living with functional neurologic disorders (FND) have been deeply stigmatized...

Lung Protective Ventilation

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we've learned. If you haven't read part...

Stable Vaginal Bleeding in Pregnancy

A common Emergency Department (ED) presentation, vaginal bleeding in pregnancy affects approximately 30% of pregnancies in the 1st trimester and 1-2% in the 2nd trimester. About half of these result in pregnancy loss. Here we will use cases to highlight an ED approach...

Invasive Group A Strep (iGAS).. It’s Backkkk (Part 1)

In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. We prepared the ED for the patient’s arrival....

By the Hammer of Thora: Pleural Effusions in the ED (part 1)

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and unclear. This is largely due to the lack of guidelines around pleural effusions in the ED. In this post, I’ve tried to highlight some key information about an approach to...

Delirium revisited

Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever,...
Ottawa Handbook of Emergency Medicine

 

We are excited to introduce the Sixth edition of The Ottawa Handbook of Emergency Medicine. Your bedside guide for approaches to various Emergency Medicine presentations.

Highlights of the Sixth edition include the addition of: Oncologic emergencies, approach to the pregnant patient, geriatrics and more! 

JVP is Dead

JVP is Dead

The Tooth Fairy. The Easter Bunny. Two cardiologists trying to agree on a JVP measurement. These are myths we share with children — and, perhaps, with medical students. When it comes to estimating right atrial pressure, maybe it’s time we add JVP to that list. A study...

The ENT Tool Kit: Practical Pearls for Emergency Physicians

The ENT Tool Kit: Practical Pearls for Emergency Physicians

As an emergency medicine physician, whether you are working in the resuscitation bay or in urgent care, ENT complaints are common and will be encountered in both areas. The goal of this post is to provide you with a practical framework and highlight tips and tricks...

Blakemore Tube Insertion

Blakemore Tube Insertion

A 60-year-old male with a history of cirrhosis arrives in your ED in extremis; no vital signs, massive hematemesis en route, and a presumptive diagnosis of ruptured esophageal varices. Your team initiates the massive transfusion protocol, secures the airway, and...

Efficacy and safety of intravenous nerinetide initiated by paramedics in the field for acute cerebral ischaemia within 3 h of symptom onset (FRONTIER): a phase 2, multicentre, randomised, double-blind, placebo-controlled study

Efficacy and safety of intravenous nerinetide initiated by paramedics in the field for acute cerebral ischaemia within 3 h of symptom onset (FRONTIER): a phase 2, multicentre, randomised, double-blind, placebo-controlled study

Methodology: 4/5 Usefulness: 4/5 Christenson J, et al. Lancet. 2025 Feb 15;405(10478):571-582. doi: 10.1016/S0140-6736(25)00193-X.  Question and Methods: Double-blind, placebo-controlled RCT to determine if prehospital administration of nerinetide for suspected acute...

Are We Triage Monkeys or Gods? Big and Small Decisions in the ED

Are We Triage Monkeys or Gods? Big and Small Decisions in the ED

While the term ‘God Squad’ reflects a real committee from the 1960s, we use it here critically to examine the risks of unchecked decision-making power in emergency care. This is a photo of the Admissions and Policy Committee of the Seattle Artificial Kidney Centre,...

The Code Crew: Medications That Save the Beat!

The Code Crew: Medications That Save the Beat!

Out-of-hospital cardiac arrest (OHCA) is sudden, silent, and devastating, claiming 9 out of 10 lives before they ever reach a hospital. In Canada, approximately 60,000 OHCAs occur annually — that’s one every nine minutes — and fewer than 1 in 10 people survive1....

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World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.

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Mission Statement

World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.

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