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...

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...

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...

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...

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,...

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...

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,...

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...
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! 

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Methodology: 4/5 Usefulness: 4/5 HALT-IT Trial Collaborators. Lancet. 2020 Jun 20;395(10241):1927-1936 Questions and Methods: This was an international, randomized, double-blind, placebo-controlled trial with the objective to quantify the effect of TXA on death due to...

ROTEM in Trauma: Blood is thicker with Wine – Part 2

ROTEM in Trauma: Blood is thicker with Wine – Part 2

In Part 2 of ROTEM for Trauma: Blood is Thicker with Wine – we will review the approach to interpreting ROTEM and how it can guide massive transfusion in the injured and bleeding patient. We will also touch on the practical considerations for starting a ROTEM program...

ROTEM in Trauma: Blood is thicker with Wine – Part 1

ROTEM in Trauma: Blood is thicker with Wine – Part 1

In this post, we’ll discuss viscoelastic hemostatic assays (VHAs), namely ROTEM (Rotational Thromboelastometry), and how we can use this tool to enhance the care of traumatically injured patients. This is the first in a two-part series. This part reviews the Evidence...

Point-of-Care Echocardiography

Point-of-Care Echocardiography

In non-emergency medicine literature, cardiac Point-of-Care Ultrasound is termed “focused cardiac ultrasound” or “FoCUS,” and has been the subject of national cardiology and intensive care guidelines. It is used by emergency medicine, trauma, internal medicine,...

The STI Cheat sheet

The STI Cheat sheet

Here we present a STI 'cheat sheet' to commonly encountered STIs - their etiology, workup and treatment. The following recommendations are based on the Canadian PHAC guidelines. We will not cover the important aspect of taking a sexual history, but an excellent...

An approach to acute diarrhea

An approach to acute diarrhea

Does diarrhea run in your family? Ok, that one's bad, we apologize. There is significant practice variation when it comes to acute diarrheal illness - fortunately, there are some recommendations to help guide our practices, and in particular, when we should be sending...

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World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.

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Mission Statement

World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.

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