We are excited to introduce the Sixth edition of The Ottawa Handbook of Emergency Medicine. Your bedside guide for approaches to various Emergency Medicine presentations.
Highlights of the Sixth edition include the addition of: Oncologic emergencies, approach to the pregnant patient, geriatrics and more!
The Way is Shut: Aortic Stenosis
Aortic Stenosis is the most common valvular heart disease in Canada. In fact, after hypertension and coronary artery disease, it is the third most common cardiovascular condition. The prevalence of valvular heart disease increases sharply with age. Approximately 1 in...
Decoding Code Status: A Goals of Care Framework
In general, the public perception of CPR is filled with inaccuracies, and recently the New Yorker wrote about the Hidden Harms of CPR. In the article, Dr. Sunita Puir, a palliative care doctor, talks about how it is an “open secret in medicine that CPR is brutal and...
Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial
Methodology: 2/5 Usefulness: 2/5 Jansen JO, et al. JAMA. 2023 Oct 12:e2320850. Editorial: Contemporary Adjuncts to Hemorrhage Control. Question and Methods: Multi-center pragmatic Bayesian RCT comparing 90d all-cause mortality and 10 secondary outcomes in trauma...
Change: Why Healthcare Reform is More Important Than Ever
As you've gleaned from the title of this blog post, today we are focusing our conversation on CHANGE; with a particular emphasis on its implications in healthcare. However, before we get deep in the weeds, it's important that we acknowledge the elephant in the room;...
Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury: The CRYOSTAT-2 Randomized Clinical Trial
Methodology: 3.5/5 Usefulness: 4/5 Davenport R, et al. JAMA. 2023 Oct 12:e2321019. Editorial: Contemporary Adjuncts to Hemorrhage Control. Question and Methods: In trauma patients with major hemorrhage, does early cryoprecipitate (6g fibrinogen) administration...
Climate Change – What can Healthcare do?
With our shorter, milder winters (no skating on the Rideau Canal this past year), and our warmer, drier summers (thick wildfire smoke blanketing Ottawa in June), along with accelerating extreme weather events; derechos, ice storms and tornados – it is clear that...
PTM Journal Club Recap: Trauma Care
Two articles pertaining to the prehospital care of trauma patients were reviewed at this month’s Prehospital and Transport Medicine Journal Club: Bossers et al. (2023) conducted a retrospective trauma registry analysis seeking to determine the relationship between...
Degenerative Cervical Myelopathy
Your next patient is an 80-year-old male, who had been functioning well until about a month ago. He has a history of type II diabetes, hypertension, and dyslipidemia, and has been working full-time. Upon reading the triage note and assessing the patient, you discover...
The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial
Methodology: 4/5 Usefulness: 4/5 Ma L, et al. Lancet 2023 Jul 1;402(10395):27-40. Question and Methods: Do 6 month outcomes improve after implementation of a goal-directed care bundle that corrects prognostically poor physiological abnormalities (systolic...
The Deep Freeze: A Review of Frostbite Management
Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1) These injuries...