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!
The Status on Status: Management of Status Epilepticus
Status epilepticus (SE) is considered one of the most common neurological emergencies with an estimated incidence of 20 cases/100,000 people worldwide. Just the facts The distribution is bimodal, peaking in patients <1 and >60 years old. In children, the cause...
Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial.
Methodology: 4.5/5 Usefulness: 4/5 Stiell IG, et al. Lancet. 2020 Feb 1;395(10221):339-349 Editorial: Atrial fibrillation cardioversion in the emergency department. Question and Methods: This partial factorial randomized trial aimed to determine which rhythm control...
What a headache: Updates on Migraine Management
Migraine headaches are not a benign disease - they have a significant impact on quality of life, ability to function, and pose a considerable economic and societal burden. Prevalence tends to peak during peoples' period of highest productivity. According to...
Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs
Methodology: 2.5/5 Usefulness: 3/5 Daley JI, et al. Acad Emerg Med 26 (11), 1211-1220 Nov 2019 Questions and methods: In patients with abnormal vital signs, what is the sensitivity of FOCUS for the diagnosis of PE? Prospective, multicenter, observational...
You’re a doctor, Harry! Welcome to residency
It's July 1st. A brand new gaggle (gaggle: a flock of geese when not in flight) of residents has started at the hospital. The beginning of residency is a pretty stressful time, especially when the last few months of med school were on zoom. This year is certainly a...
Use of a Rapid Diagnostic for Chlamydia Trachomatis and Neisseria Gonorrhoeae for Women in the Emergency Department Can Improve Clinical Management: Report of a Randomized Clinical Trial
Methodology: 3/5 Usefulness: 2.5/5 Gaydos CA et al. Ann Emerg Med. 2019 Jul;74(1):36-44. doi: 10.1016/j.annemergmed.2018.09.012. Epub 2018 Nov 2. Question and Methods: RCT of women receiving pelvic testing for CT/NG comparing standard of care test (NAAT) vs....
Complications of Assisted Reproductive Technology
Assisted reproductive technology (ART) is an evolving field with many therapies that have a common goal: to maximize the chance of pregnancy while minimizing the risk of multiple gestations. As the Canadian infertility rate approaches 15%, the use of ART is steadily...
Outcome of Applying the ESC 0/1-hour Algorithm in Patients With Suspected Myocardial Infarction.
Methodology: 3/5 Usefulness: 3/5 Twerenbold R, et al. J Am Coll Cardiol. 2019 Jul 30;74(4):483-494. Editorial: Evaluating Suspected Acute MI in the Emergency Department: What Is and What Should Never Be. Question and Methods: Prospective international study...
Let’s talk about some drugs
Here, we seek to explore some controversial, poorly known, or irrelevant drugs in medicine in a menagerie of drug cocktails. 1. What drugs best treat SVT? A patient presents with the following rhythm strip, they're totally stable, on no medications and...
Anxiety, Depression and Everything in Between
In the past 5-10 years we have seen a significant increase in mental health-related complaints in the Emergency Department (ED), and during COVID this is especially noticeable. Historically, we've classically been taught to focus on performing safety assessments, and...