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!
Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study
Methodology: 3.5/5 Usefulness: 3.5/5 Ann Intern Med. 2019 Oct 15;171(8):547-554. Cheng MP, et al. Question and Methods: Multi-center diagnostic study that investigated the sensitivity of post-antimicrobial blood cultures compared to pre-antimicrobial blood cultures in...
Performance Mindset: Expertise in Emergency Medicine
“The differences between expert performers and normal adults are not immutable, that is, due to genetically prescribed talent. Instead, these differences reflect a life-long period of deliberate effort to improve performance.” - K. Anders Ericsson What defines...
The D-Dimer Dilemma: It’s Use In Low-Risk PE
Pulmonary embolism is often a nebulous diagnosis with various nuances. COMMON: They affect 25-100 people per 100,000, or approximately 30,000 Canadians every year Potentially FATAL: 3rd most deadly cardiovascular disease, after Heart Attack and Stroke Associated with...
SRPC COVID-19 Virtual In-Situ Simulation Curriculum
One of our residents, Dr. Wilson Lam is part of a team looking to offer Rurals EDs across Canada as a way to complement and grow their rural emergency medicine practice by helping develop SIM programs for rural doctors and ED's. See the great video below and please...
Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial
Methodology: 4/5 Usefulness: 3.5/5 Baksaas-Aasen K, et al. Intensive Care Med. 2020 Oct 13. doi: 10.1007/s00134-020-06266-1. Question and Methods: Pragmatic, European, multi-center RCT comparing outcomes in trauma patients who received empiric massive transfusion...
A Crash Course on Competence Committees
A Competence Committee (CC) is a key component of Competence by Design (CBD), the Royal College of Physicians and Surgeons of Canada’s version of Competency-Based Medical Education. A CC is a sub-committee of the Residency Program Committee (RPC) that provides robust...
Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA.
Methodology: 2/5 Usefulness: 2/5 Johnston SC, et al. N Engl J Med. 2020 Jul 16;383(3):207-217. Question and Methods: Multicentre, double-blind RCT of ASA vs Ticagrelor-ASA among 11016 patients with high-risk TIA or minor stroke for prevention of stroke/death within 30...
Subarachnoid Hemorrhage in the ED- What a Headache!
The diagnosis of subarachnoid hemorrhage (SAH) carries with it remarkable morbidity and mortality. Case fatality rates approach 50% 1,2 Of those who survive, half will experience chronic disability and a significant reduction in health-related quality of...
Association of Checklist Use in Endotracheal Intubation With Clinically Important Outcomes: A Systematic Review and Meta-analysis.
Methodology: 3.5/5 Usefulness: 2/5 Turner JS, et al. JAMA Netw Open. 2020 Jul 1;3(7):e209278. Question and Methods: Systematic review and meta-analysis evaluating if checklist use during endotracheal intubation leads to improved patient outcomes. Findings: The authors...
“I’d like to work on my flow today”
You're starting your shift, and you're only moderately caffeinated. You meet your resident and they tell you that their goal for the shift is to "work on flow". You think, cool - let's see how many patients they see today. At least, that's how I thought about it the...