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!
“Is there a doctor on board?”: In-Flight Emergencies
As global COVID-19 travel restrictions loosen, many people are finally taking the vacations they’ve been putting off for the last two years. As passenger air traffic climbs, in-flight medical emergencies will become increasingly frequent. Will you be ready when...
Thrombectomy for anterior circulation stroke beyond 6 h from time last known well (AURORA): a systematic review and individual patient data meta-analysis
Methodology: 3/5 Usefulness: 2/5 Jovin TG, et al. Lancet. 2022 Jan 15;399(10321):249-258. doi: 10.1016/S0140-6736(21)01341-6. Editorial: Late thrombectomy for ischaemic stroke. Dippel D, et al. Lancet. 2022 Jan 15;399(10321):213-215. Question and Methods: This...
Confronting Implicit Bias and Microaggressions
We've previously spent some time talking about implicit bias and its impact on patient care.It is of course important to recognize that we all have elements of implicit bias - these blindspots are programmed within us, and recognizing them is an important step in...
Ultra-early tranexamic acid after subarachnoid haemorrhage (ULTRA): a randomised controlled trial
Methodology: 4.5/5 Usefulness: 4/5 Post R, et al. Lancet. 2021 Jan 9;397(10269):112-118. doi: 10.1016/S0140-6736(20)32518-6. Question and Methods: This prospective, multicentre, randomized, controlled, open-label trial investigated whether administering TXA...
Pericarditis and Myocarditis in the ED
Chest pain is one of the most common presentations to the emergency department (ED) and includes a wide differential diagnosis. In today’s post, we will review a less common cause of chest pain seen in the ED: pericarditis and myocarditis. We will also review...
A Prospective Evaluation of Clinical HEART Score Agreement, Accuracy, and Adherence in Emergency Department Chest Pain Patients
Methodology: 3/5 Usefulness: 2/5 Soares WE 3rd, et al. Ann Emerg Med. 2021 Aug;78(2):231-241. Questions and Methods: This study compared agreement in HEART scores derived by ED physicians and those derived by researchers using a prospective cohort study of adults with...
Did You Do a Pelvic Exam?
The role of the emergency department pelvic exam has come under debate for some time. Clinicians have raised concerns regarding whether or not it changes management, whether or not our findings are reliable, and of course the logistic barriers regarding space, time...
Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab
Methodology: 4/5 Usefulness: 4/5 Gupta A, et al. N Engl J Med. 2021 Nov 18;385(21):1941-1950. Question and Methods: COMET-ICE trial evaluated the efficacy and safety of sotrovimab in high-risk, mild-to-moderate Covid-19 not requiring oxygen, within 5 days of symptom...
Atrial Fibrillation/Flutter Best Practice Checklist
Atrial fibrillation (AF) is encountered with significant frequency in the Emergency Department (ED). In fact, atrial fibrillation is the single most common arrhythmia seen in the ED. As per the 2020 CCS review, AF resulted in 8815 same-day procedures, 76 964 ED...
Bariatric Surgery Complications in the ED
As emergency physicians, we frequently see patient with metabolic syndromes and obesity. Globally, a significant rise in obesity has been observed over the last 30 years, including a dramatic rise in Canada28,32. From 1985 to 2016, obesity increased by more than 300%...