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!
Effect of Nebulized Magnesium vs Placebo Added to Albuterol on Hospitalization Among Children With Refractory Acute Asthma Treated in the Emergency Department: A Randomized Clinical Trial
Methodology: 4.5/5 Usefulness: 4/5 Schuh S, et al. JAMA. 2020 Nov 24;324(20):2038-2047. Question and Methods: RCT assessing the effectiveness of nebulized magnesium versus placebo in children presenting with an acute asthma exacerbation refractory to standard therapy,...
Episode One Shownotes: GI Bleeds & TTM
Dr. Rajiv Thavanathan sits down with Dr. Jim Yang to talk about some of the best high impact trials in the last year in Emergency Medicine. Which patients with a GI bleed need urgent endoscopy, and which patients ACTUALLY need targeted temperature management (TTM)...
Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation
Methodology: 3.5/5 Usefulness: 3.5/5 Costa ML et al. Lancet. 2020 Feb 8;395(10222):441-448. Question and Methods: The UKSTAR trial was a pragmatic, multicenter RCT that compared plaster cast against walking boot for non-operative management of Achilles tendon rupture...
Reframing your Charting
I've written about it previously - but, patient's 'bouncing back' to the Emergency Department (ED) after discharge has always been perceived as a negative thing, but I think that this is an inadequate lens to view patient care. The patient returned to the ED? Good,...
Hyoscine butylbromide versus acetaminophen for nonspecific colicky abdominal pain in children: a randomized controlled trial
Methodology: 4/5 Usefulness: 1/5 Poonai N, et al. CMAJ. 2020 Nov 30;192(48):E1612-E1619. Question and Methods: Randomized control trial assessing effect of hyoscine butylbromide (HBB) vs acetaminophen in nonspecific colicky pain in pediatric patients aged 8-17yo....
Pneumothorax in the Emergency Department – Part 2
In Part 1 of our 2-part series on Pneumothorax, Dr. Simon Wells walked us through the varying definitions, epidemiology, diagnostic criteria, and imaging findings of pneumothorax including on point of care ultrasound (POCUS). Click here to review Part 1. In today's...
Mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage (MifeMiso): a randomised, double-blind, placebo-controlled trial
Methodology: 4/5 Usefulness: 3/5 Chu JJ, et al. Lancet. 2020 Sep 12;396(10253):770-778. Editorial: Medical management of miscarriage with mifepristone Question and Methods: This multi-centre, randomized, double blind, placebo-controlled trial compares spontaneous...
Early Bird Catches The Burn: Hydrofluoric Acid Treatment
Case Presentation A 30-year-old male presents to urgent care with a complaint of excruciating pain in his left hand. He is a gardener, and earlier that day had been mixing a solution of pesticides. He had been wearing gardening gloves to open the solutions, including...
Blunt cerebrovascular injury: The case for universal screening.
Methodology: 2/5 Usefulness: 4/5 Leichtle SW, et al. J Trauma Acute Care Surg. 2020 Nov;89(5):880-886. Question and Methods: Existing BCVI screening guidelines misses important injuries; the authors evaluated the diagnostic characteristics of the Modified and...
Using Simulation for COVID-19 Preparation
In situ simulation, informally thought of as "crash testing the dummy", is defined as a team-based training technique conducted within the actual patient care environment, involving members of the healthcare team using equipment and resources from the unit1,2. It is a...