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!
BHP Corner – Death After Trauma
Traumatic Cardiac Arrest Paramedics often respond to patients who have no vital signs after being involved in a traumatic event. These cases are especially notable for the tragic and violent means by which persons suddenly meet their end. Most patients who do...
Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial
Methodology: 4/5 Usefulness: 4/5 Hosseinialhashemi M, et al. Ann Emerg Med. 2022 Sep;80(3):182-188. doi: 10.1016/j.annemergmed.2022.04.010. Question and methods: This was a double blinded RCT single center in a specialized ENT ED in Iran, comparing topical intranasal...
Sometimes, Empathy is hard
I understand. I've been there. 6th shift in a row, department is overcrowded, patients are upset, consultants are being rude, you're cognitive and emotionally fatigued - it becomes easy for empathy and compassion to fade. The problem is that because of overwhelming...
Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK.
Methodology: 4/5 Usefulness: 4.5/5 Perry DC, et al. Lancet. 2022 Jul 2;400(10345):39-47. Question and Methods: This large, multicentre, pragmatic RCT aimed to show equivalence between treating pediatric buckle fractures of the distal radius with soft bandage versus...
Is it worth it? Then REVERSE it! Anticoagulation in the ED
How many times on shift do you see a patient that is on an anticoagulant or antiplatelet agent? The answer is probably almost always. The use of these agents and their complications are extremely common. And in particular cases, such intra-cerebral hemorrhage...
Thromboembolic events following cardioversion of acute atrial fibrillation and flutter: a systematic review and meta-analysis
Wong BM, et al. CJEM. 2021 Jul;23(4):500-511. Methodology: 4/5 Usefulness: 3.5/5 Question and Methods: Systematic review and meta-analysis of 20 studies to evaluate the effect or oral anticoagulation on thromboembolic events post cardioversion for acute atrial...
BHP Corner – To TOR or not to TOR?
Medical Cardiac Arrest - To TOR or Not To TOR? Base Hospital Physicians Corner - or BHP Corner - is a new web-series we are introducing to be published in a quarterly fashion. Written by RPPEO Base Hospital Physicians, these publications will focus on targeting...
Evaluation of bedside sonography performed by emergency physicians to detect intussusception in children in the emergency department
Tonson la Tour A, et al. Acad Emerg Med. 2021 Aug;28(8):866-872. Methodology: 3/5 Usefulness: 3/5 Question and Methods: This prospective cohort study tried to identify whether PoCUS can be used to diagnose intussusception by emergency department physicians. Findings:...
Cardiovascular risk in Transgender and Gender Diverse Persons
Clinical case: You are working an urgent care shift and your next patient to see is Jessica, a 35 yo female with an upper extremity injury. The one-liner on the EMR reads: ‘Jesse’. When you go to speak with them, you see a young masculine-presenting patient who...
Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial
Methodology: 4.5/5 Usefulness: 5/5 Menon BK, et al. Lancet. 2022 Jul 16;400(10347):161-169. doi: 10.1016/S0140-6736(22)01054-6. Question and Methods: This multicentre, open label, randomized control trial at 22 primary and comprehensive stroke centres across Canada...