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!
Thrombolytics redux! A rebuttal
Hey everyone! Buckle up. This is a long one. To provide context, I recently presented a 2-part blog post regarding thrombolytics in acute ischemic stroke. In these posts I explored the foundational literature for this tPA, as well as some of the common controversies I...
Development and Validation of a Penicillin Allergy Clinical Decision Rule
Methodology: 3/5 Usefulness: 2/5 Trubiano JA, et al. JAMA Intern Med. 2020 May 1;180(5):745-752. Question and Methods: Prospective derivation and subsequent retrospective validation of a clinical decision rule for the detection of patients at low risk for true...
#CAEP21 – CAEP at the Forks: Rising to the Challenge
Hey everyone! Are you an emergency medicine provider? Whether you are a seasoned attending or interested medical student there is something for you at #CAEP21. The annual meeting of the Canadian Association of Emergency Physicians (CAEP) is happening virtually on June...
Are We Ready for ECMO on the Ground Floor?
Extra Corporeal Membrane Oxygenation (ECMO) has significantly progressed over the past decades. It has become an invaluable tool in the care of adults with severe cardiac and pulmonary disease refractory to conventional management. The implementation of ECMO has even...
Prevalence of Pulmonary Embolism Among Patients With COPD Hospitalized With Acutely Worsening Respiratory Symptoms
Methodology: 3/5 Usefulness: 3/5 Couturaud F, et al. JAMA. 2021 Jan 5;325(1):59-68. Question and Methods: This study used a multicenter, cross-sectional methodology with prospective follow up to determine the rates of PE in 740 COPD patients using the rGeneva score....
Thrombolytic Therapy: A Stroke of Luck? Part 2
Addressing the Controversies Around Thrombolytic Therapy (tPA) In our previous blog post, we reviewed the formative literature supporting the currently used tPA time window. The figure below highlights a summary of the time windows investigated within each study and...
Thrombolytic Therapy: A Stroke of Luck? Part 1
Review of the formative literature of our current tPA time window in Acute Ischemic Stroke After numerous case series and smaller prospective studies suggesting benefit for thrombolytic therapy (tPA), the early 90s ushered in the era of thrombolytic RCTs for acute...
Reducing Diagnostic Errors: Using Cognitive Science
Have you ever sat at M&M rounds, seeing the same lists of biases and the same diagnostic errors being discussed over and over again? I know I have. I am often left wondering how can we do better? The solution seems simple - learn the biases, know the biases, don't...
The Use of Tranexamic Acid to Reduce the Need for Nasal Packing in Epistaxis (NoPAC): Randomized Controlled Trial
Methodology: 3/5 Usefulness: 3/5 Reuben A, et al. Ann Emerg Med. 2021 Feb 18:S0196-0644(20)31461-X. Question and Methods: This was a double-blind, randomized controlled trial comparing topical tranexamic acid to placebo in patients presenting to the ED with epistaxis...
Computer Based ECG Interpretation: It’s Use in the ED
ECG interpretation is a core and fundamental skill of emergency medicine. Emergency physicians are expected to provide expert ECG interpretation quickly in a busy emergency department environment and initiate emergent and life-saving interventions base on those...