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 →
Methodology Score: 4/5 Usefulness Score: 3/5 Venkatesh B, et al. N Engl J Med. 2018 Jan 19. Journal Club Bottom Line Question/Methods: This was a international, pragmatic, double-blind, randomized, controlled trial comparing hydrocortisone as continuous infusion to placebo in patients with septic shock on mechanical ventilation and at least 4-hoursRead More →
In this post, we will review the anatomy, essential history, and common presentations of tracheostomy patients in the ED, including obstruction, decannulation, bleeding, tracheal stenosis, and infection. Anatomy of a tracheostomy tube Outer cannula Sits directly in the tracheal stoma Proximal end designed to allow tube to be easily securedRead More →
The management of traumatic cardiac arrest differs significantly from the management of medical cardiac arrest, however the management is often lumped together. In this weeks Grand Rounds summary Dr. Nicholas Costain takes us through some controversies in the management of these difficult cases. Objectives: Review updated literature regarding indications toRead More →