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!
Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial
Journal Club Summary Methodology: 4/5 Usefulness: 2.5/5 Meltzer AC, et al. JAMA Intern Med. 2018 Aug 1;178(8):1051-1057. Editorial: Medical Expulsive Therapy for Ureteral Stones - Stone Age Medicine. Methods: This multi-center RCT of emergency department patients...
Polypharmacy, Prescribing, & Deprescribing in the ED
Care of the Elderly is an ever-growing, important, and prevalent part of an Emergency Physician's repertoire of skills. With increasing numbers of elderly patients presenting to EDs across Canada, we look to discuss the issue of polypharmacy, prescribing, and...
Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Atkinson PR, et al. Ann Emerg Med. 2018 Oct;72(4):478-489 Question and Methods: This was the first multicenter, prospective, RCT examining the effect of POCUS on 30-day survival of undifferentiated...
Antibiotic prescription strategies and adverse outcome for uncomplicated lower respiratory tract infections: prospective cough complication cohort (3C) study
Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Little P, et al. BMJ. 2017 May 22;357:j2148. Editorial: Controlling antibiotic prescribing for lower respiratory tract infections Scott AM et al. BMJ. 2017 May 22;357:j2398. doi: 10.1136/bmj.j2398....
Spinal Epidural Abscess: Zebra in horse’s clothing
Spinal epidural abscess (SEA) is a challenging diagnosis to make in the Emergency Department (ED), with a diagnostic delay occurring in about 75% of patients.[1] To ultimately make a diagnosis of SEA, patients typically require an MRI, and so physicians may often have...
Concomitant Oral Anticoagulant and Nonsteroidal Anti-Inflammatory Drug Therapy in Patients With Atrial Fibrillation
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kent AP, et al. J Am Coll Cardiol. 2018 Jul 17;72(3):255-267 Question and Methods: This was a post hoc analysis of the RE-LY trial examining the risk of NSAID use in patients receiving oral anticoagulation (OAC)...
Focus on POCUS: Crackles and Hypotension
For other ultrasound cases see our POCUS archives Case Vignette 63-year-old male presents with a two-day history of groin pain and swelling. He has a history of hypertension and smoking. He takes an anti-hypertensive medication and an atypical antipsychotic for...
The Unwritten Rules of Mentorship
I've recently spent some time thinking about what it means to be a mentor. We're often thrust into this role - with very little training on how to actually do this. I've been fortunate enough to be surrounded by a plethora of excellent mentors and residents, and have...
Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 5/5 Nogueira RG, et al. N Engl J Med. 2018 Jan 4;378(1):11-21 Editorial: A New DAWN for Imaging-Based Selection in the Treatment of Acute Stroke. Questions and Methods: DAWN was an open-label multi-centre...
EMS Bootcamp – An introduction to pre-hospital medicine
As dedicated in-hospital emergency providers, few of us truly understand or get to experience the difficulties and unique challenges facing our pre-hospital colleagues. Beyond the EMS handover and transfer of patient care, we seldom interact with this large and...