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!
Echoes: Taking Your POCUS Game to the Next Level
Point of Care Ultrasound (POCUS) is becoming increasingly prevalent in Emergency Departments (EDs) for diagnostic, procedural, and management purposes. In this post, we will examine some less known, but extremely useful, indications for POCUS. For further information,...
Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial.
Journal Club Methodology Score: 4/5 Usefulness Score: 3/5 Sprigg N, et al. Lancet. 2018 May 26;391(10135):2107-2115 Question and Methods: Multicenter, double-blinded, randomized, placebo-controlled trial comparing if IV TXA vs placebo, given within 8h of spontaneous...
Mechanical CPR: Past, Current, and Future
Mechanical CPR is a technology whereby a machine performs chest compressions in place of a human provider. These devices are becoming increasingly prevalent in the prehospital and in-hospital arenas, and it is inevitable that healthcare providers will interact with...
Damage Control Resuscitation (DCR) – A Summary of the Joint Trauma System Clinical Practice Guideline
Hemorrhage is the leading cause of preventable death on the battlefield. Damage Control Resuscitation (DCR) works synergistically with Damage Control Surgery (DCS) and prioritizes non-surgical interventions that reduce morbidity and mortality due to trauma and...
Mass Gathering Medicine: The New Frontier
Mass gathering medicine (MGM) is an exciting niche field of emergency medicine focused on providing emergency medical care at large events. Mass gatherings, as the name implies, are events in which “large numbers of people assemble in public or private spaces to...
Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5 /5 Sperry JL, et al. N Engl J Med. 2018 Jul 26;379(4):315-326. Question and Methods: Determine the efficacy of prehospital plasma compared with standard-care resuscitation in injured patients at risk...
Sodium Bicarbonate: Supply Shortages and Medical Shortcomings
We’re familiar with sodium bicarbonate as a simple buffer solution, which has been utilized for a myriad of medical indications backed up by physiologic rationale and occasional moderate-quality evidence. It comes in two forms; vials (typically for infusions) and...
Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial
Journal Club Summary Methodology: 4/5 Usefulness: 3.5/5 Wang HE, et al. JAMA. 2018 Aug 28;320(8):769-778. Editorial: Pragmatic Airway Management in Out-of-Hospital Cardiac Arrest. Question and Methods: This multicenter pragmatic cluster-crossover randomized trial...
Identifying stroke mimics in the ED
In this post, we will aim to review the literature looking at identifying clinical and historical features that can help differentiate stroke mimics from strokes. We will also discuss the safety of the administration of IV tPA to misdiagnosed stroke mimics. This post...
Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiopulmonary Resuscitation on Neurological Outcome After Out-of-Hospital Cardiorespiratory Arrest: A Randomized Clinical Trial
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Jabre P, et al. JAMA. 2018 Feb 27;319(8):779-787. Question and Methods: This was a multicenter randomized trial comparing bag valve mask ventilation with endotracheal intubation performed by...