We are excited to introduce the fourth edition of The Ottawa Handbook of Emergency Medicine.
Highlights of the fourth edition include: acid-base disorders, approach to red eye, thyroid emergencies, vaginal bleeding, pericarditis and myocarditis, and monoarthritis.
Awake Intubation in the ED: A Practical Update
Awake intubations are an uncommon procedure, so cognitively practicing the nuances can be critically important to success. Here, we present an updated practical guide on awake intubations in the ED intended to supplement a previously posted topic. You can see the...
BHP Corner – Pain and Analgesia
Pain - To Treat or Not to Treat, that is NOT the question! Every day, paramedics respond to patients in pain. Pain is responsible for approximately 40% of ambulance calls (1), making pain and analgesia a hot topic in prehospital medicine. Effective and safe...
Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion
Methodology: 3/5 Usefulness: 1.5/5 Wang L, et al. Ann Intern Med. 2022 Mar;175(3):344-351. Question and Methods: Using a convenience sample of 100 patients out of 4436 going for right heart catheterization in 2 US academic hospitals, the authors wanted to validate the...
ACE Inhibitor-Induced Angioedema
When encountering patients with angioedema, we have historically used a similar approach to anaphylaxis, mostly out of a lack of evidence supporting a particular practice. Here, we take a deep dive into ACE inhibitor-induced angioedema to provide the most up to date...
Le Genou: Everything you Knee-d to know!
The acutely injured knee can often be challenging to assess when there is no associated fracture. Identifying the possible non-bony acute pathology is important to help discern the most appropriate approach to treatment for the patient. Assessment History Mechanism...
Thriving on the Multiple Learner Shift
In many specialities, it is common to have more than one learner working with you at any given time. These are very challenging days/shifts, because you have to juggle so many cognitive priorities. Personally, I find these to be the most exhausting shifts that I work,...
BHP Corner – Death After Trauma
Traumatic Cardiac Arrest Paramedics often respond to patients who have no vital signs after being involved in a traumatic event. These cases are especially notable for the tragic and violent means by which persons suddenly meet their end. Most patients who do...
Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial
Methodology: 4/5 Usefulness: 4/5 Hosseinialhashemi M, et al. Ann Emerg Med. 2022 Sep;80(3):182-188. doi: 10.1016/j.annemergmed.2022.04.010. Question and methods: This was a double blinded RCT single center in a specialized ENT ED in Iran, comparing topical intranasal...
Sometimes, Empathy is hard
I understand. I've been there. 6th shift in a row, department is overcrowded, patients are upset, consultants are being rude, you're cognitive and emotionally fatigued - it becomes easy for empathy and compassion to fade. The problem is that because of overwhelming...
Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK.
Methodology: 4/5 Usefulness: 4.5/5 Perry DC, et al. Lancet. 2022 Jul 2;400(10345):39-47. Question and Methods: This large, multicentre, pragmatic RCT aimed to show equivalence between treating pediatric buckle fractures of the distal radius with soft bandage versus...