Electrical vs Chemical Cardioversion in ED patients with Atrial Fibrillation (RAFF2)

RAFF2 Ian Stiell and colleagues are back at it with atrial fibrillation; The RAFF2 trial (Electrical versus Chemical cardioversion for Emergency Department patients with Atrial Fibrillation (RAFF2); A partial factorial randomized trial) was published in The Lancet this week. Acute atrial fibrillation is an irregular dysrhythmia that should be treated within 48 hours to avoid significant complications such as stroke […]

Emerging Updates in Septic Shock

In September 2018, Dr. Bram Rochwerg and I wrote a blog post on the treatment of patients with sepsis and septic shock. Much of this was based on the 2016 Surviving Sepsis Campaign (SSc) Clinical Practice Guidelines [1]. However, in a little over a year, significant new research has already changed the way we care for patients with sepsis and […]

Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial

Methodology: 4/5 Usefulness: 4/5 Lyttle MD, et al. Lancet. 2019 May 25;393(10186):2125-2134. Question and Methods: Eclipse was an open label RCT that evaluated time to seizure cessation in pediatric SE between Keppra and Dilantin Findings: They found that Keppra was not superior (HR 1.2, 95%CI 0.91-1.60, p= 0.20) to Dilantin for the treatment of SE Limitations: Limited somewhat by study […]

20 things you can do imperfectly well for Climate Change

And on the 6th day Graham bellowed; “let thee environment be considered among thy seven dimensions of wellness.”  And so, the environment was added to the wheel of physical, social, spiritual, occupational, intellectual, financial and emotional wellness. Although I have to confess, compared to the authors of this week’s blogs; I am fairly green…to the environmentalist thing. I only started […]

System Change is Needed to Combat Climate Change

Increasing awareness of the urgency of climate change, led by the youth climate movement, and growing felt impacts of the health effects of climate change, including the devastating bushfires in Australia, are fuelling a global increase in interest in  the concepts of “eco-anxiety” and “ecological grief.”  How to cope with these emotions personally, and how to help our patients? Though […]

Danger, Climate Emergency Ahead

I’ll admit it, I’m scared. Every day, my newsfeed is filled with more news stories and scientific papers underlining the fact that our society’s current trajectory is akin to suicide as a species. As someone who has grown accustomed to civilization, even grown to love it, I fear for the future, and this feels like an Emergency. The sad reality […]

Introduction to Environmental Wellness

It’s hard to believe that EMOttawa and CAEP (Canadian Association of Emergency Physicians) are hosting the 4th annual Canadian Emergency Medicine Wellness Week (January 20th to 24th 2020)! Over the years, we’ve published blog posts from EM leaders across the country sharing personal stories and practical tips on how to be well in Emergency Medicine. Last year, based on the […]