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!
Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis
Methodology: 4/5 Usefulness: 4/5 WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Sterne JAC et al. JAMA. 2020 Oct 6;324(13):1330-1341. Question and Methods: Prospective meta-analysis of 7 RCTs investigating the utility of systemic...
Breaking the Brain Code: Elevated ICP in the ED Part I
This comprehensive, 2-part blog post by Dr. Hashim Kareemi reviews the current literature and guidelines on elevated ICP in the emergeny department. Part 1 reviews the pathophysiology and detrimental effects of sustained elevated ICP, and provides an excellent...
Boiling Point: Approach to Hypertension in th ED
It is not uncommon to see patients present to the Emergency Department with Hypertension. One in 4 Canadians has a diagnosis of hypertension, and chronic hypertension is the leading cause of disability-adjusted life expectancy (which considers for the quality of life...
EMOttawa Podcast Episode 3: Thunderclap Headache
On episode three of the Ottawa EM Podcast, Dr. Rajiv Thavanathan (R5) interviews Dr. Michael Hale (R5), on the ED presentation and diagnosis of subarachnoid hemorrhage in the context of the thunderclap headache. (Click here to access Podcast Main menu) Subarachnoid...
Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials
Methodology: 3.5/5 Usefulness: 2/5 Gaudry S, et al. Lancet. 2020 May 9;395(10235):1506-1515. Question and Methods: Gaudry et al performed a systematic review and individual patient data meta-analysis of randomized control trials to compare the benefits of early versus...
Medical Management of the Patient with Anorexia Nervosa
In this comprehensive guide, Dr. Tetyana Maniuk, a third-year FRCPC Ottawa Emergency Medicine resident summarizes the existing evidence on anorexia and eating disorders specific to the emergency department. Highlighting everything from signs and symptoms to watch out...
What you write matters! How your notes can seem offensive or judgemental to patients (and you didn’t know it).
Did you know that your patients could be upset with you and your care AFTER you see them? You’re wondering how could this happen, I was friendly, polite and approachable when I saw them. It turns out, in this new world of electronic medical records (EMR) with all...
Diagnostic Accuracy of Symptoms, Physical Signs, and Laboratory Tests for Giant Cell Arteritis: A Systematic Review and Meta-analysis
Methodology: 2/5 Usefulness: 2/5 van der Geest KSM, et al. JAMA Intern Med. 2020 Oct 1;180(10):1295-1304. Question and Methods: Systematic review and meta-analysis of 68 studies to identify clinical and laboratory findings that can help identify patients with GCA...
Breaking Down Medicine’s Hierarchy
There's a pretty standard hierarchy in medicine: Medical Student → Junior Resident → Senior Resident → +/- Fellow → Attending Similar to many things in medicine, this hierarchy stems from old habits and practices. In the ninetieth century, medical...
Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data
Methodology: 4/5 Usefulness: 3.5/5 Thomalla G, et al. Lancet. 2020 Nov 14;396(10262):1574-1584 Question and Methods: The authors evaluated the role of perfusion-imaging facilitated thrombolysis in strokes of unknown duration by way of a systematic review and...