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!
Alcohol Withdrawal Algorithm
1. If your patient fits DSM5 diagnostic criteria for alcohol withdrawal: NALTREXONE GABAPENTIN Naltrexone 25mg PO daily x 4d, then 50mg PO daily ~$2.81 per pill, or LU code 532 if on Ontario Drug Benefit/ODSP Contraindications: - Liver disease (LFTs >3x ULN)...
Distilling it Down Part I: Alcohol Withdrawal in the ED
In Ontario, Canada, alcohol-related ED visits have increased 4.4x faster than the overall increase in visits from 2003-2016, and was responsible for more admissions than heart attacks in 2016. In part 1 of this 2-part series, we will discuss tips for the diagnosis and...
Patient Handout for Help with Substance Use – Ottawa
Download PDF of Patient Handout HERE Patient Handout for Help with Substance Use Health care professionals can help you achieve your goals for your substance use. Depending on your situation, there are medications available to help decrease cravings and resources to...
Video Laryngoscopy Compared to Augmented Direct Laryngoscopy in Adult Emergency Department Tracheal Intubations: A National Emergency Airway Registry (NEAR) Study
Methodology: 2/5 Usefulness: 4/5 Brown CA 3rd, et al. Acad Emerg Med. 2020 Feb;27(2):100-108. Question and Methods: This was one the largest prospective, observational, ED-only airway studies to date comparing first-pass success (FPS) rates in “augmented” DL (A-DL)...
High Sensitivity Cardiac Troponin Testing (hs-cTnT) in ACS
Case: You are the emergency physician taking care of a 45-year-old male who has a background history of hypertension and dyslipidemia for which he is on a ACEi and a statin. He presents with 2.5 hours of ongoing non-radiating chest discomfort while at work. His...
Trust the Process
“Trust the process” – a promise that our assistant Program Director (PD), Jen Leppard, makes on our first day of the EM year. I am new here, and I am nervous. But, as I walk into the ED, this feeling quickly vanishes, as I am reminded of what drew me to Ottawa in the...
Does N-Terminal Pro-B-Type Natriuretic Peptide Improve the Risk Stratification of Emergency Department Patients With Syncope?
Methodology: 4/5 Usefulness: 3/5 Thiruganasambandamoorthy V, et al. Ann Intern Med. 2020 May 19;172(10):648-655. Methods: Prospective cohort study to evaluate whether adding NT-proBNP to the CSRS improves prediction of 30-day SAEs. Findings: Adding NT-proBNP provided...
Approach to the ECG
Full PDF: ECG PDF
Multicenter Emergency Department Validation of the Canadian Syncope Risk Score
Methodology: 4.5/5 Usefulness: 4.5/5 Thiruganasambandamoorthy V, et al. JAMA Intern Med. 2020 Mar 23;180(5):1-8. Question and Methods: Prospective cohort validation to predict 30-day serious outcomes among ED patients with syncope Findings: 3819 patients had an...
Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review
Methodology: 1/5 Usefulness: 2/5 Riley CM, et al. JAMA. 2019 Feb 26;321(8):786-797. Question: Aimed to review and provide practical information regarding the diagnosis and long-term management of patients with COPD in the outpatient setting. Methods: This was a...