Invasive Group A Strep (iGAS).. It’s Backkkk (Part 1)

In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. We prepared the ED for the patient’s arrival....

Functional Neurologic Disorders

Note: This grand rounds presentation and summary had contributions from Dr. Anne-Marie Abe, a neuropsychiatrist specializing in functional neurological disorders in Ottawa.   Patients living with functional neurologic disorders (FND) have been deeply stigmatized...

By the Hammer of Thora: Pleural Effusions in the ED (part 1)

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and unclear. This is largely due to the lack of guidelines around pleural effusions in the ED. In this post, I’ve tried to highlight some key information about an approach to...

Delirium revisited

Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever,...

Stable Vaginal Bleeding in Pregnancy

A common Emergency Department (ED) presentation, vaginal bleeding in pregnancy affects approximately 30% of pregnancies in the 1st trimester and 1-2% in the 2nd trimester. About half of these result in pregnancy loss. Here we will use cases to highlight an ED approach...

Mechanical Ventilation Basics

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience,...

These are the ‘Roids you are looking for – Steroids in the ED

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of...

Posterior Circulation Strokes

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more...

Nailed it! A guide to Fingertip Injuries

A stable and functional fingertip is essential for sensation, fine motor skills, grip strength, and the overall durability and cosmetic appearance of the hand. Fingertips, often the first point of contact during daily activities, are particularly susceptible to...

Lung Protective Ventilation

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we've learned. If you haven't read part...
Ottawa Handbook of Emergency Medicine

 

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! 

The Anxiety Prescription

The Anxiety Prescription

It is with increasing frequency that we are seeing higher volumes of patients presenting to their family physicians and the Emergency Department with complaints related to anxiety. It was certainly an issue that was noticed pre-COVID19, but the effect that the...

Effect of C-Reactive Protein-Guided Antibiotic Treatment Duration, 7-Day Treatment, or 14-Day Treatment on 30-Day Clinical Failure Rate in Patients with Uncomplicated Gram-Negative Bacteremia: A Randomized Clinical Trial

Effect of C-Reactive Protein-Guided Antibiotic Treatment Duration, 7-Day Treatment, or 14-Day Treatment on 30-Day Clinical Failure Rate in Patients with Uncomplicated Gram-Negative Bacteremia: A Randomized Clinical Trial

Methodology: 1/5           Usefulness: 1/5 von Dach E, et al. JAMA. 2020 Jun 2;323(21):2160-2169. doi: 10.1001/jama.2020.6348. Question and Methods: In a multi-center, noninferiority, randomized, double-blinded clinical trial, the authors compared the rates of...

Quality Improvement (QI) in the ED

Quality Improvement (QI) in the ED

As part of a Quality Improvement initiative you are tasked with improving ED length of stay for patients presenting with ankle pain. You remember learning about the Ottawa Ankle Rules to help screen which patients require ankle x-rays. How will you implement that...

Palliative Care in the ED – Part 2

Palliative Care in the ED – Part 2

We are back with Part-2 of our blog series on Palliative Care in the ED. If you haven't already check-out Part 1 HERE. In this series, we will delve into the subject further by exploring the following topics:  Screening Tools: The Old and the New Education and...

Palliative Care in the ED – Part 1

Palliative Care in the ED – Part 1

Pulling back the Pall from palliative care The word pall refers to a traditional death shroud or a dark cloud of dust or smoke. The aim of this blog post is both explore some of the inequities and recommendations for the palliative care landscape today, but also to...

National Day for Truth and Reconciliation

National Day for Truth and Reconciliation

This Thursday, September 30th, marks the inaugural National Day for Truth and Reconciliation, a new federal statutory holiday. As per the Canadian government, this day “honours the lost children and Survivors of residential schools, their families and communities”....

Flow Hacks for the Emergency Physician Round 2!

Flow Hacks for the Emergency Physician Round 2!

I've previously talked about flow hacks for the Emergency Physician - with emphasis on: Avoiding reassessment land Grabbing multiple 'charts' Increasing actions per minute An emphasis on 'shift rhythm' rather than number of patients seen when evaluating learners In...

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