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.
Drug Rashes
Drug rashes are fairly common, but like much of dermatology, diagnostic clarification can be hard to achieve. Here, we present a standardized approach to drug rashes in the Emergency Department. Differential Diagnosis Clinical Approach ...
BHP Corner: Decision Points in Cardiac Arrest
Case You and your partner arrive at a scene where a 67-year-old male had a witnessed collapse 5 minutes ago and CPR is in progress; he is in cardiac arrest. The initial rhythm is ventricular fibrillation. You continue CPR with a King LT and provide 3 shocks, along...
Testicular Torsion
Acute scrotal pain is a common in emergency departments, comprising ~ 0.5% of all presentations. However, torsion is another very time sensitive diagnosis that is ubiquitous across all ages as seen by this Rosen’s table. Incidence / Epidemiology Unfortunately,...
Approach to Priapism
As per the 2021 updated guidelines for the management of priapism by Ericson et al, priapism is defined as a penile erection that lasts longer than 4 hours after completion of sexual activity or that is unrelated to sexual activity. The European Association of Urology...
Diuretic vs. placebo in intermediate-risk acute pulmonary embolism: a randomized clinical trial
Methodology: 2/5 Usefulness: 1/5 Lim P, et al. Eur Heart J Acute Cardiovasc Care. 2022 Jan 12;11(1):2-9. Question and Methods: Does diuresis with single-dose IV furosemide improve hemodynamic parameters and prevent oligo-anuria in normotensive patients with...
Letter to my Younger (Staff) Self Redux
Five years ago, as a relatively new staff physician, I had written a letter to my younger-self, as to subscribe some wisdom to the to what I wish I had known heading into residency. Five years later, I've realized that early staff transition phase had a lot of growth...
Don’t Sweat It! Heat Related Illness
Global temperatures are increasing and are projected to continue warming. The rates of warming across out planet are not uniform. In Canada, the loss of snow and sea ice reduces the reflectivity of the surface leading to increased absorption of solar radiation and a...
Reduction of urea test ordering in the emergency department: multicomponent intervention including education, electronic ordering, and data feedback
Methodology: 2.5/5 Usefulness: 2/5 Mathura P, et al. CJEM. 2022 Sep;24(6):636-640. Editorial: When evidence-based medicine and quality improvement collide. Question and Methods: Can we decrease physician ordering of the BUN (blood urea nitrogen) test, using an...
Don’t go Breaking my Heart: 2022 Heart Failure Guidelines
Patients with heart failure are often newly diagnosed in the Emergency Department, or are the presenting location for those with decompensated heart failure. This is why it is important for ER Physicians to remain updated on the latest AHA/ACC/HFSA guidelines for the...
Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial
Methodology: 4/5 Usefulness: 3.5/5 Bouzat P, et al. JAMA. 2023 Mar 21:e234080. doi: 10.1001/jama.2023.4080. Question and Methods: This double-blind, randomized, placebo-controlled superiority trial aimed to assess whether 4F-PCC decreases 24hr blood product...