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...

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...

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...

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...

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...

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...

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....

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,...

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...

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,...
Ottawa Handbook of Emergency Medicine

 

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

Highlights of the Fifth edition include the addition of: general surgery emergencies, pediatric orthopedic presentations, and updates in pediatric fever + more! 

Test Characteristics of Emergency Medicine-Performed Point-of-Care Ultrasound for the Diagnosis of Acute Cholecystitis: A Systematic Review and Meta-analysis

Test Characteristics of Emergency Medicine-Performed Point-of-Care Ultrasound for the Diagnosis of Acute Cholecystitis: A Systematic Review and Meta-analysis

Methodology: 4/5 Usefulness: 3.5/5 Wilson SJ, et al. Ann Emerg Med. 2024 Mar;83(3):235-246. doi: 10.1016/j.annemergmed.2023.09.005. Questions and Method: To determine the diagnostic accuracy of emergency physician performed point of care ultrasound (POCUS) for acute...

Practical Management of Acute Hemoptysis

Practical Management of Acute Hemoptysis

Disclaimer: there is little high-quality evidence on the ED management of hemoptysis, particularly non-massive hemoptysis. The recommendations made below are heavily influenced by published case reports and expert opinion, as well as discussions with local specialty...

Effect of High-Intensity vs Low-Intensity Noninvasive Positive Pressure Ventilation on the Need for Endotracheal Intubation in Patients With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease: The HAPPEN Randomized Clinical Trial

Effect of High-Intensity vs Low-Intensity Noninvasive Positive Pressure Ventilation on the Need for Endotracheal Intubation in Patients With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease: The HAPPEN Randomized Clinical Trial

Methodology: 3/5 Usefulness: 3/5 Luo Z,  et al. JAMA. 2024;332(20):1709–1722. doi:10.1001/jama.2024.15815 Question and Methods: Multi-centre, randomized control trial to determine whether a high-intensity NIPPV strategy reduces the need for intubation in AECOPD...

Law and Disorder: Navigating medicolegal Issues (Part 1)

Law and Disorder: Navigating medicolegal Issues (Part 1)

On October 17, 2013, 27-year-old Philisha Sutherland was found at home by her parents—lethargic, weak, and slurring her speech. EMS transported her to Sault Area Hospital, where she was assessed by the attending emergency physician, Dr. Booth. Dr. Booth performed a...

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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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