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!
Gallbladder Case 6
Case 6 An 34-year-old female presents with vomiting for the past two weeks, and required analgesia for RUQ pain at triage. On your assessment, you note that the patient DOES have a positive sonographic Murphy's sign.
Borderline Personality Disorder – Part 2
This post is a continuation of Borderline Personality Disorder - Part 1. In this second post, Dr. Beamish discusses the management of BPD in the emergency department and shares some valuable resources. Borderline Personality Disorder - Part 2 Case 2 A 22 year old...
Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial.
Methodology Score: 3/5 Usefulness Score: 3/5 Cooper DJ, et al. JAMA. 2018;320(21):2211-2220. doi:10.1001/jama.2018.17075 Question/Methods: This study was done to determine the effectiveness of early prophylactic hypothermia compared with normothermic management of...
Borderline Personality Disorder – Part 1
Borderline Personality Disorder (BPD) is a personality disorder that describes the emotional dysregulation, impulsivity, recurrent self-harm and suicidal behaviour experienced by many individuals. People suffering from this personality disorder frequently live chaotic...
Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomized, placebo-controlled trial
Methodology: 3.5/5 Usefulness: 3.5/5 The CRASH-3 trial collaborators. The Lancet. 2019 Oct 14. Online First Editorial: CRASH-3: a win for patients with traumatic brain injury Question and Methods: Multi-centre, randomized, placebo-controlled trial looking at whether...
Breaking the Glass – Elder Abuse
An 84-year-old male presented to the ED after a fall. The patient is confused but he talks about the fire truck ride with the “lights”. He knows the city and the month, but doesn’t know why he’s here. On exam, he has long hair, a full beard, sunken cheeks, and...
Three week versus six week immobilisation for stable Weber B type ankle fractures: randomised, multicentre, non-inferiority clinical trial
Methodology: 4/5 Usefulness: 3.5/5 Kortekangas T, et al. BMJ. 2019 Jan 23;364:k5432 Question and Methods: This is a pragmatic, randomized, controlled trial to determine if 3 weeks of immobilization (in cast or orthosis) is non-inferior to usual treatment (6 weeks cast...
E-cigarette and Vaping Associated Lung Injury (EVALI)
You may have seen the headlines; E-cigarette and Vaping Associated Lung Injury (EVALI) represent a new disease process that is potentially life-threatening. Emergency Physicians will inevitably be exposed to EVALI as front line health care providers. Here, we will...
We Need to Talk: Communicating with patients
During your medical training, how many times did someone watch you talk to a real patient? What about explaining their diagnosis? Or how to take their medications? Have you had a conversation with a patient and felt that you weren’t “speaking the same language”? Good...
The Bottom Line 2: Anorectal abscess & Fournier’s Gangrene
This post is a continuation of a previous post about anorectal issues in the ED. Here, we will discuss anorectal abscess, surrounding complications, and necrotizing infections. Anorectal Abscess Anorectal abscesses are thought to occur from the plugging of anal...