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!
Intracranial hemorrhage after head injury among older patients on anticoagulation seen in the emergency department: a population-based cohort study
Methodology: 3/5 Usefulness: 3/5 Grewal K, et al. CMAJ. 2021 Oct 12;193(40):E1561-E1567. Question and Methods: Retrospective cohort study evaluating risk of ICH post head injury in ED patients >65 years on warfarin or DOAC or no anticoagulant. Findings: Patients...
Healthcare’s Implicit Bias Problem
On an individual level, we all have implicit biases. It would be impossible to have a lived experience without having biases. They're a product of our genetics, environment, opportunities, experiences etc. We develop blindspots that we are often unaware of - and this...
Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial
Methodology: 4/5 Usefulness: 3/5 Driver BE, et al. JAMA. 2021 Dec 28;326(24):2488-2497. Question and Methods: Multicentre unblinded pragmatic trial comparing first pass success with the bougie compared to stylet in endotracheal intubation of critically ill patients ...
Managing Pediatric GERD in the ED
We're back this week with some new pediatric content -- Managing Pediatric GERD! Check out our recent peds post on managing pediatric agitation here. Reflux disease is often considered as a common etiology for infants presenting with vomiting and perceived discomfort...
Managing the Pediatric Patient with Acute Agitation in the ED
Pediatric mental health complaints are common presentations to the emergency department. Many providers are comfortable managing symptoms of depression, anxiety, suicidality. But what about pediatric patients with severe agitation and aggression? Between 6 and 10% of...
Artificial Intelligence to Detect Papilledema from Ocular Fundus Photographs
Methodology: 4/5 Usefulness: 3/5 Milea D, et al. N Engl J Med. 2020 Apr 30;382(18):1687-1695. Question and Methods: The authors developed a deep learning system for identifying optic discs with papilledema from ocular fundus photographs. Findings: The algorithm had a...
External validation of a low HEAR score to identify emergency department chest pain patients at very low risk of major adverse cardiac events without troponin testing
Methodology: 3.5/5 Usefulness: 2.5/5 O'Rielly CM, et al. CJEM. 2021 Jul 17. doi: 10.1007/s43678-021-00159-y. Question and Methods: Secondary analysis validation study that sought to validate proposed HEAR score’ ability to identify low risk patients for acute...
Living With Shiftwork – Part 2
Last week's post examined one of the most important elements to success for shiftworkers — SLEEP. Studies have shown that catching zzz's is a cornerstone of maintaining good health as well as patient and personal safety. This time, we'll chat about another necessity...
Living with Shiftwork – Part 1
Sleep and food are truly amongst the most basic of needs – in fact, they’re on the same level as breathing (and excretion!) on Maslow’s pyramid of needs. Even the CanMEDS framework of the Royal College states that as a Professional, physicians must be able to manage...
Self-obtained vaginal swabs are not inferior to provider-performed endocervical sampling for emergency department diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis
Methodology: 3/5 Usefulness:2/5 Chinnock B, et al. Acad Emerg Med. 2021 Jun;28(6):612-620. doi: 10.1111/acem.14213. Question and Methods: This prospective observational cohort trial sought to assess if self-obtained vaginal swabs were not inferior to...