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!
Guidelines for Emergency Airway Management of COVID-19
Guiding Principles Suspected SARS-COV-2 patients showing signs of hypoxemic respiratory failure should be intubated proactively, as early as possible. Signs may include FiO2 requirement > 50%, clinical signs of respiratory fatigue despite supplemental oxygen, or...
Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes
Methodology Score: 4/5 Usefulness Score: 4/5 Schüpke S, et al N Engl J Med. 2019 Oct 17;381(16):1524-1534. Editorial: Ticagrelor or Prasugrel in Acute Coronary Syndromes - The Winner Takes It All? Question and Methods: This open-label multicenter trial was the first...
#StayHome (…but stay sane)
Some helpful tips on how to #StayHome but maintaining your sanity while practicing social distancing!
Bupropion – Picking our Poisons
What is Bupropion? Bupropion is an anti-depressant commonly prescribed for seasonal affective disorder, as a smoking cessation aid, and off-label in the management of major depressive disorder. You may know it by the trade names Wellbutrin, Zyban or Champix. While...
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial
Methodology: 4/5 Usefulness: 3/5 Fujii T, et al. JAMA. 2020 Jan 17. doi: 10.1001/jama.2019.22176. [Epub ahead of print] Editorial: Lack of Benefit of High-Dose Vitamin C, Thiamine, and Hydrocortisone Combination for Patients With Sepsis. Question and Methods:...
Managing Stress and Anxiety related to COVID-19
As Bob Dylan once said; “Times, they are a-changin'”. With respect to the novel coronavirus-19 (COVID-19), the situation in Canada and around the globe is changing rapidly and aggressively. As part of the first responder network, Emergency Departments (ED) and it’s...
Hypothermia Part 2: Prognostication and Protocols
Here we present part two on our series on hypothermia. For more on the assessment, resuscitation, and management of the hypothermic patient, see part one. Prognostication of cardiac arrest in hypothermia Indicators of cardiac arrest before cooling (Brown 2012) Major...
Alcohol Abstinence in Drinkers with Atrial Fibrillation
Methodology: 5/5 Usefulness: 3.5/5 Voskoboinik A, et al. N Engl J Med. 2020 Jan 2;382(1):20-28. Editorial: A Sober Reality? Alcohol, Abstinence, and Atrial Fibrillation. Question/Methods: Among adults who consume ≥10 drinks/week with symptomatic paroxysmal or...
Hypothermia: Keeping your cool when it gets cold
Hypothermia results in slightly over one hundred deaths per year in Canada; typically as a result of primary hypothermia, frostbite and other cold exposure injuries (Toronto Public Health, 2014). In the United States, this is estimated at 1500 deaths annually...
Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus
Methodology Score: 4/5 Usefulness Score: 3.5/5 Kapur J et al. N Engl J Med. 2019 Nov 28;381(22):2103-2113. Question and Methods: A multicenter, randomized, blinded, comparative-effectiveness trial to determine the efficacy and safety of fosphenytoin, valproic acid...