We are excited to introduce the Fifth edition of The Ottawa Handbook of Emergency Medicine. Your bedside guide for approaches to various Emergency Medicine presentations.
Highlights of the Fifth edition include the addition of: general surgery emergencies, pediatric orthopedic presentations, and updates in pediatric fever + more!
Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial
Methodology: 3.5/5 Usefulness: 3/5 Freund Y, et al. JAMA. 2023 Dec 19;330(23):2267-2274. Question and Methods: Multicenter RCT involving comatose patients with suspected acute poisoning and GCS <9 compared a conservative airway strategy of withholding intubation...
Lacerations: The secrets they don’t want you to know
Lacerations are a common presenting complaint to emergency department. In 2013, in the United States there were 7 million visits to the emergency department (ED) for lacerations making up a total of 5.2% of ED visits(1). Let’s review some of the evidence (or lack...
Ketamine and Etomidate: Into the Void
We're increasingly cognizant of the physiological importance of maintaining specific hemodynamics during resuscitation. Practice patterns vary broadly, so we've done a deep dive into the various evidence around the use of ketamine and etomidate in specific clinical...
Expedited transfer to a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest (ARREST): a UK prospective, multicentre, parallel, randomised clinical trial
Methodology: 5/5 Usefulness: 3/5 Patterson T, et al. Lancet. 2023 Oct 14;402(10410):1329-1337. Patients who sustain an out-of-hospital cardiac arrest without signs of ST elevation had no improvement in mortality or functional neurological outcomes when transported to...
Abortion Care in the Emergency Department
Abortion history in Canada is Complex. Countless hardships were overcome on the long journey to the legalization of medical induced abortion (IA). This blog post will focus on what you need to know as an acute care provider. Context: Unsafe abortions are the leading...
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...
Extracorporeal Life Support in Infarct-Related Cardiogenic Shock
Methodology: 4/5 Usefulness: 3.5/5 Thiele H, et al. N Engl J Med. 2023 Oct 5;389(14):1286-1297. Editorial: Routine Early ECLS in Infarct-Related Cardiogenic Shock? Question: Does early ECLS therapy confer a mortality benefit in patients with MI complicated by...
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,...
Randomized Trial Comparing Low- vs High-Dose IV Dexamethasone for Patients With Moderate to Severe Migraine
Methodology: 3.5/5 Usefulness: 4/5 Friedman BW, et al. Neurology. 2023 Oct 3;101(14):e1448-e1454. Question and Methods: This double-blinded RCT of 209 patients presenting to the ED with moderate to severe migraines compared high- to low- dose dexamethasone (16 mg vs...
Liver Let Die? Approach to Splanchnic Vein Thrombosis & Shock Liver
When working up your patient, how often do you think of problems related to the hepatic venous system? Have you suppressed those memories of time spent over your cadaver in medical school learning the anatomy? By the end of this, you will all be newly discovered...