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!
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%...
Restriction of Intravenous Fluid in ICU Patients with Septic Shock
Methodology: 4/5 Usefulness: 3/5 Meyhoff TS, et al. N Engl J Med. 2022 Jun 30;386(26):2459-2470. Question and Methods: International, stratified, parallel group, open-label, randomized clinical trial where ICU patients were randomized to restrictive or standard fluid...
Acetazolamide in Acute Decompensated Heart Failure with Volume Overload
Methodology Score: 4/5 Usefulness Score: 2/5 (Emergency) 4/5 (Internal medicine) Mullens W, et al. N Engl J Med. 2022 Sep 29;387(13):1185-1195. Editorial: New Decongestion Strategies in an Evolving Heart Failure Landscape. Question...
Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest
Methodology: 4/5 Usefulness: 4/5 Kjaergaard J, et al. N Engl J Med. 2022 Oct 20;387(16):1456-1466. Question and Methods: This was a double-blind, randomized trial assessing whether a higher or lower arterial blood-pressure target would be superior in preventing death...
Awake Intubation in the ED: A Practical Update
Awake intubations are an uncommon procedure, so cognitively practicing the nuances can be critically important to success. Here, we present an updated practical guide on awake intubations in the ED intended to supplement a previously posted topic. You can see the...
BHP Corner – Pain and Analgesia
Pain - To Treat or Not to Treat, that is NOT the question! Every day, paramedics respond to patients in pain. Pain is responsible for approximately 40% of ambulance calls (1), making pain and analgesia a hot topic in prehospital medicine. Effective and safe...
Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion
Methodology: 3/5 Usefulness: 1.5/5 Wang L, et al. Ann Intern Med. 2022 Mar;175(3):344-351. Question and Methods: Using a convenience sample of 100 patients out of 4436 going for right heart catheterization in 2 US academic hospitals, the authors wanted to validate the...
ACE Inhibitor-Induced Angioedema
When encountering patients with angioedema, we have historically used a similar approach to anaphylaxis, mostly out of a lack of evidence supporting a particular practice. Here, we take a deep dive into ACE inhibitor-induced angioedema to provide the most up to date...