Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kuppermann N, et al. N Engl J Med. 2018 Jun 14;378(24):2275-2287. Editorial: Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis. Question and Methods: 13 centre RCT with four arms to determine the impact of fluid resuscitation rate and type on development ofRead More →
Journal Club Summary: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al N Engl J Med. 2018 Jul 18. Editorial: Testing Epinephrine for Out-of-Hospital Cardiac Arrest. Callaway CW, et al. N Engl J Med. 2018 Jul 18. Question and Methods: Multicenter, randomized,Read More →
When we are caring for a septic patient in the ED, we know that aggressive care with early antibiotics and ensuring adequate preload saves lives. But what do we do when we aren’t sure if more fluid will help any longer? How can we finesse our fluid management in theRead More →
Comprehensively discussing sepsis in the Emergency Department (ED) in a three-page blog is quite frankly, impossible. You would be hard-pressed to find a disease process that has undergone such dramatic change over the past two decades. Through it all, we still do not have a complete grasp of what sepsisRead More →
As we were preparing for our “Critical Care Week” here at the EM Ottawa Blog, I was thinking I should definitely tap into the knowledge of an ICU physician whom I know very well. That physician is also my awesome wife, Dr. Erin Rosenberg. She’s been a staff intensivist atRead More →
Systemic fibrinolysis (SF) in acute pulmonary embolism (PE) remains a hot topic in acute care medicine. This post will examine the available literature regarding the use of SF in different subtypes of PE. Before examining the literature, we first must review the relevant nomenclature. Defining PE The American Heart AssociationRead More →
To open up Critical Care week, resuscitation and trauma expert Dr. George Mastoras provides us with some tips to improve your (and your team’s) resuscitation and crisis resource management skills. 1. Make teamwork everyone’s business ‘Team orientation’ is associated with higher team performance, especially among Flash teams, like those involved inRead More →
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Driver BE, et al. JAMA. 2018 May 16. doi: 10.1001/jama.2018.6496. Question/Methods: This single-centre, randomized clinical trial enrolled 757 patients to compare first-attempt intubation success facilitated by the bougie to ETT plus stylet, in an ED where use of the bougie wasRead More →
Most clinicians are familiar with and utilize the Glasgow Coma Scale (GCS) on a daily basis, but many are not aware of the updates and additions to the score that were made in 2014 and 2018, respectively. Clarifications in the wording of the scale attempt to increase the ease ofRead More →
Patients who receive solid organ or stem cell transplants are complex, but we see them frequently in the Emergency Department! This review summarizes the physiology of transplant and a few of the key issues to be aware of in these patients. Transplant by the numbers Locally, in Ottawa, there areRead More →