Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial
Methodology: 4/5 Usefulness: 3/5 Chu JJ, et al. Lancet. 2020 Sep 12;396(10253):770-778. Editorial: Medical management of miscarriage with mifepristone Question and Methods: This multi-centre, randomized, double blind, placebo-controlled trial compares spontaneous...
Early Bird Catches The Burn: Hydrofluoric Acid Treatment
Case Presentation A 30-year-old male presents to urgent care with a complaint of excruciating pain in his left hand. He is a gardener, and earlier that day had been mixing a solution of pesticides. He had been wearing gardening gloves to open the solutions, including...
Blunt cerebrovascular injury: The case for universal screening.
Methodology: 2/5 Usefulness: 4/5 Leichtle SW, et al. J Trauma Acute Care Surg. 2020 Nov;89(5):880-886. Question and Methods: Existing BCVI screening guidelines misses important injuries; the authors evaluated the diagnostic characteristics of the Modified and...
Using Simulation for COVID-19 Preparation
In situ simulation, informally thought of as "crash testing the dummy", is defined as a team-based training technique conducted within the actual patient care environment, involving members of the healthcare team using equipment and resources from the unit1,2. It is a...
Prospective Implementation of the Ottawa Subarachnoid Hemorrhage Rule and 6-Hour Computed Tomography Rule
Methodology: 4/5 Usefulness: 4/5 Perry JJ, et al. Stroke. 2020 Feb;51(2):424-430. doi: 10.1161/STROKEAHA.119.026969. Question and Methods: Prospective, multi-center before and after study looking at the implementation of the Ottawa Subarachnoid Hemorrhage Rule and...
Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial
Methodology: 2/5 Usefulness: 2/5 Jaung R, et al. Clin Gastroenterol Hepatol. 2020 Mar 30:S1542-3565(20)30426-2. Question and Methods: This study investigated non-inferiority of placebo vs antibiotic in management of uncomplicated diverticulitis by conducting an...
#FOAMed 2020 year in review
The end of the year is always a time for reflection, and while 2020 is a year that many of us want to forget, here at EMOttawa, we decided to take a look back at some of the most influential #FOAMed content to come out this year. We promise it isn't ALL COVID-19...
Ambulatory management of primary spontaneous pneumothorax: an open-label, randomised controlled trial
Methodology: 4/5 Usefulness: 3/5 Hallifax RJ, et al. Lancet. 2020 Jul 4;396(10243):39-49. Question and Methods: This multicentre open label randomized control trial aimed to determine whether primary spontaneous pneumothoraces could be safely and effective managed...
Pneumothorax in the Emergency Department – Part 1
Pneumothorax is a relatively rare emergency department presentation with a number of controversies existing regarding its management. Over the last decade, the standard of care has shifted from invasive strategies to more conservation management approaches. What...
Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding
Methodology: 3/5 Usefulness: 3.5/5 Lau JYW, et al. N Engl J Med. 2020 Apr 2;382(14):1299-1308. Question and Methods: Single centre RCT comparing whether urgent (<6h) endoscopy improved outcomes compared to early endoscopy (6-24h) in patients presenting with...