By the Hammer of Thora: Pleural Effusions in the ED (part 1)

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and unclear. This is largely due to the lack of guidelines around pleural effusions in the ED. In this post, I’ve tried to highlight some key information about an approach to...

Invasive Group A Strep (iGAS).. It’s Backkkk (Part 1)

In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. We prepared the ED for the patient’s arrival....

These are the ‘Roids you are looking for – Steroids in the ED

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of...

Mechanical Ventilation Basics

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience,...

Posterior Circulation Strokes

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more...

Stable Vaginal Bleeding in Pregnancy

A common Emergency Department (ED) presentation, vaginal bleeding in pregnancy affects approximately 30% of pregnancies in the 1st trimester and 1-2% in the 2nd trimester. About half of these result in pregnancy loss. Here we will use cases to highlight an ED approach...

Lung Protective Ventilation

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we've learned. If you haven't read part...

Delirium revisited

Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever,...

Nailed it! A guide to Fingertip Injuries

A stable and functional fingertip is essential for sensation, fine motor skills, grip strength, and the overall durability and cosmetic appearance of the hand. Fingertips, often the first point of contact during daily activities, are particularly susceptible to...

Functional Neurologic Disorders

Note: This grand rounds presentation and summary had contributions from Dr. Anne-Marie Abe, a neuropsychiatrist specializing in functional neurological disorders in Ottawa.   Patients living with functional neurologic disorders (FND) have been deeply stigmatized...
Ottawa Handbook of Emergency Medicine

 

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! 

Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial

Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial

Methodology: 4/5 Usefulness: 3.5/5 Bouzat P, et al. JAMA. 2023 Mar 21:e234080. doi: 10.1001/jama.2023.4080.  Question and Methods:  This double-blind, randomized, placebo-controlled superiority trial aimed to assess whether 4F-PCC decreases 24hr blood product...

Psychology and Science of Waiting

Psychology and Science of Waiting

Preamble: This Grand Rounds was inspired in part by a conversation I had with Dr. Andrew Petrosoniak during my time at St. Michael’s Hospital where we discussed the growing concern of excessive ED wait times and the limited concerted effort on addressing the waiting...

CAEP 2023 in review!

CAEP 2023 in review!

Well, the CAEP 2023 (#CAEP23) (Canadian Associated of Emergency Physicians) conference is officially over. We've head back to our respective homes and departments, and by now the melancholy has fully kicked in. It was the first time, in a while, that the CAEP...

Topical NSAIDs for Acute Pain Management

Topical NSAIDs for Acute Pain Management

I was early in my PGY-1 year when I first witnessed an adverse effect from oral nonsteroidal anti-inflammatory drugs (NSAIDs). It was a busy morning with long patient wait times, and I picked up the chart of a 19-year-old female presenting with abdominal pain. She...

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World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.

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Mission Statement

World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.

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