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!
Buprenorphine: A guide for ED providers
The opioid epidemic is not new to ED providers, but many will be shocked to learn about the true extent of the harm caused by opioids in Canada. In the first half of 2022, there were 3556 recorded deaths due to opioid toxicity in Canada. This amounts to 19 deaths...
Dexamethasone and ketorolac compare with ketorolac alone in acute renal colic: A randomized clinical trial
Methodology: 2.5/5 Usefulness: 2.5/5 Razi A, et al. Am J Emerg Med. 2022 Aug;58:245-250. Question and Methods: This single-center, RCT of 120 patients with acute renal colic compared pain control and antiemetic use with dexamethasone + ketorolac compared to...
To HEART score, or not to HEART score
To HEART score, or not to HEART score - now that is a question. In the past five years it has become increasing common to hear Emergency Medicine providers and residents reference the HEART score when reviewing chest pain cases. This is especially true when they are...
High-Sensitivity Cardiac Troponin on Presentation to Rule Out Myocardial Infarction: A Stepped-Wedge Cluster Randomized Controlled Trial
Methodology: 3.5/5 Usefulness: 3.5/5 Anand A, et al. Circulation. 2021 Jun 8;143(23):2214-2224. Raising the Bar for Clinical Cardiac Troponin Research Studies and Implementation Science. Question and Methods: Does implementation of an early rule-out (ERO) strategy...
Pacemakers and ICDs!
I read around pacemakers SO often throughout my residency, but it was a topic that I found was often a struggle to absorb. So, here we're going to tackle what the ED Physician should know about managing patients with pacemaker and ICDs: Pacemaker Basics Electrical...
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...