We are excited to introduce the fourth edition of The Ottawa Handbook of Emergency Medicine.
Highlights of the fourth edition include: acid-base disorders, approach to red eye, thyroid emergencies, vaginal bleeding, pericarditis and myocarditis, and monoarthritis.
Anger Management: Agitated Patients in the ED
The Emergency Department is no stranger to the acutely agitated patient. Agitation remains a broad and multifactorial syndrome with a high potential for significant morbidity or mortality if not recognized and managed appropriately. This can be tricky at times when...
Vaccination status: Does it Matter?
You have just seen an 10 month old previously healthy well-appearing female with 2 day history of fever (Tmax 39.5). No focus of infection is obvious on history of examination. Vitals are normal when ibuprofen is on board. She is completely unimmunized. What is your...
Defibrillation Strategies for Refractory Ventricular Fibrillation
Methodology: 4.5/5 Usefulness: 4.5/5 Cheskes S, et al. N Engl J Med. 2022 Nov 6. Question and Methods: A cluster-randomized open-label trial evaluating survival in adult patients with refractory ventricular fibrillation during OHCA treated by paramedics with standard...
Personal Wellness in a Crumbling System
We know that Physician burnout rates through the pandemic are escalating from already alarming numbers, prompting increased focus on personal wellness. But, at the same time its hard to feel the strain of the healthcare system. Headlines like this make the notion of...
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis
Methodology: 4/5 Usefulness: 4/5 de-Madaria E, et al. N Engl J Med. 2022 Sep 15;387(11):989-1000. Question and Methods: A multicenter, open-label, randomized control trial assessing the use of aggressive versus moderate fluid resuscitation in acute pancreatitis and...
BHP Corner – Atrial Fibrillation
It's time for another BHP Corner! This quarterly submission by the Base Hospital Physician Group for the RPPEO , aims to discuss topics specific to prehospital settings to educate paramedics and other healthcare providers interested in PTM on the realities of their...
CBRNE and HAZMAT: Be Prepared!
This post seeks to provide some insights and discussion around CBRNE events (Chemical, Biological, Radioactive, Nuclear and Explosive). We want to review procedures within a mass casualty CBRNE event, principles related to decontamination, PEE, and review the...
Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial
Methodology: 4/5 Usefulness: 3/5 Crombie N, et al. Lancet Haematol. 2022 Apr;9(4):e250-e261. Question and Methods: Multicenter RCT investigating prehospital resuscitation using PRBC and plasma vs normal saline to improve tissue perfusion or mortality in adult trauma...
Spontaneous Intracerebral Hemorrhage – 2022 AHA/ASA Guidelines
While most strokes we see are ischemic in nature, 10% of stroke presentations are intracerebral hemorrhages (ICH) 1. However, unlike ischemic strokes that have clear and evolving pathways for treatments, novel treatments for spontaneous intracerebral hemorrhages...
Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial
Methodology: 4/5 Usefulness: 3.5/5 Zwaans JJM, et al. Emerg Med J. 2022 Sep;39(9):650-654. Question and Methods: This study assessed non-inferiority between sterile and non-sterile technique for traumatic lacerations requiring EM-physician suture repair using a 2%...