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!
Risk Scores for Clinical Risk Stratification of Emergency Department Patients With Chest Pain but No Acute Myocardial Infarction: A Systematic Review
Methodology: 3/5 Usefulness: 3/5 O'Rielly CM, et al. Can J Cardiol. 2023 Mar;39(3):304-310. doi: 10.1016/j.cjca.2022.12.028. Question and Methods: The authors conducted a systematic review to identify and synthesize prognostic performance of chest pain risk scores...
Rethinking Acute Pancreatitis in the ED
Acute pancreatitis is one of the most common gastroenterology conditions we see in the emergency department with a prevalence of 110-140 cases per 100,000 population. (1) At The Ottawa Hospital alone, we saw over an average of 1 case per day over the last year....
Multifaceted quality improvement initiatives improve rate of pediatric hand injury reduction
Methodology: 2/5 Usefulness: 3/5 Market M, et al. CJEM. 2022 Jun;24(4):426-433. Question & methods: Whether quality improvement interventions could decrease the rate of repeat reductions in pediatric hand injuries by plastic surgeons. The study was conducted...
A Dive into Drowning – Part Two
Previously in Part One, we reviewed the pathophysiology and pre-hospital management of patients who experienced non-fatal and fatal drownings. Now, in Part Two, let's take a deeper dive into the resuscitation of these patients in the Emergency Department as well as...
Hydrocortisone in Severe Community-Acquired Pneumonia
Methodology: 4/5 Usefulness: 4/5 Dequin PF, et al. N Engl J Med. 2023 Mar 21. doi: 10.1056/NEJMoa2215145. Question and Methods: Pneumosepsis can lead to pulmonary and systemic inflammation that can increase risk of organ failure and death. The authors attempted to...
A Dive into Drowning – Part One
Drowning accounts for over 360,000 worldwide deaths annually, including the deaths of hundreds of Canadians.[1],[2] Despite this, accurate drowning statistics remain obscured by significant under-reporting.[1] As an emergency physician you will see drowning patients...
Bite Club: Comprehensive Guide to Bite Management (Part 2)
In Part 1 of this 2 part series, we focused on animal bite management. In Part 2, we will look at our approach to human bites and considerations around addressing Rabies related concerns. Human Bites Human bites can present as: Occlusive bites: Bites from human...
Bite Club: Comprehensive Guide to Bite Management (Part 1)
On first glance, bite management may seem like a seemingly simple presentation in the ED. However, in today’s literature, there remains a lot of controversy regarding bite management. Who do you give antibiotics to? Can you suture the wound? When should you worry...
Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension
Methodology: 4/5 Usefulness: 3/5 National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; et al. N Engl J Med. 2023 Feb 9;388(6):499-510. doi: 10.1056/NEJMoa2212663. Epub 2023 Jan 21. Question and...
“What do you do for a living?”
“So, what do you do for a living?” “Oh, Emergency Medicine! You must have some wild stories, what’s the craziest thing you’ve seen?” If you work in Emergency Medicine (or to be honest any aspect of medicine) you have likely had some version of this conversation...