Aortic Dissection – A Needle in a Haystack
A 65-year-old male self-presents to the Emergency Department (ED) with sudden-onset severe chest pain. The pain was sharp, lasted 30 minutes, and has now resolved. His vitals and ECG are normal, and his high-sensitivity troponin testing is negative. He has a normal...
Vector-Borne Illness P2: the Chikun or Zika?
In part one of this two-part series, we took a bite out of Lyme disease and Malaria (see what we did there?). In this part, we'll be covering African tick-bite fever, African sleeping sickness, Dengue, Chikungunya, and Zika. Fever in the returning traveler is always a...
Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial
Methodology: 3/5 Usefulness: 2/5 Anton RF, et al. JAMA Intern Med. 2020 Mar 9;180(5):1-9. Question and Methods: Blinded randomized control trial comparing gabapentin to placebo in reducing the number of heavy drinking days in alcohol use disorder treatment. Findings:...
Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial
Methodology: 4/5 Usefulness: 4/5 HALT-IT Trial Collaborators. Lancet. 2020 Jun 20;395(10241):1927-1936 Questions and Methods: This was an international, randomized, double-blind, placebo-controlled trial with the objective to quantify the effect of TXA on death due to...
ROTEM in Trauma: Blood is thicker with Wine – Part 2
In Part 2 of ROTEM for Trauma: Blood is Thicker with Wine – we will review the approach to interpreting ROTEM and how it can guide massive transfusion in the injured and bleeding patient. We will also touch on the practical considerations for starting a ROTEM program...
ROTEM in Trauma: Blood is thicker with Wine – Part 1
In this post, we’ll discuss viscoelastic hemostatic assays (VHAs), namely ROTEM (Rotational Thromboelastometry), and how we can use this tool to enhance the care of traumatically injured patients. This is the first in a two-part series. This part reviews the Evidence...
Vector-Borne Illness: Lyme disease and Malaria
In part one of a two-part series on vector-borne illnesses, we seek to take a deep dive into Lyme disease and Malaria. For more on the other vector-borne illnesses, check out part two! The only helpful way to distinguish between all these illnesses is the...
Musculoskeletal Ultrasonography to Diagnose Dislocated Shoulders: A Prospective Cohort
Methodology: 3/5 Usefulness: 3/5 Secko MA, et al. Ann Emerg Med. 2020 Aug;76(2):119-128. Question and Methods: Attempted to validated the use of a posterior PoCUS approach in diagnosing shoulder dislocations and assessing the adequacy of reduction in the ED...
Point-of-Care Echocardiography
In non-emergency medicine literature, cardiac Point-of-Care Ultrasound is termed “focused cardiac ultrasound” or “FoCUS,” and has been the subject of national cardiology and intensive care guidelines. It is used by emergency medicine, trauma, internal medicine,...
Ottawa Handbook of Emergency Medicine
The Ottawa Handbook of Emergency Medicine is a peer-reviewed resource designed to help you succeed in the Emergency Department. Developed for clerkship students, junior residents, off-service learners, nurses, paramedics and any other interested allied health...