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,...

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....

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...

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...

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...

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...

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...

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...

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,...

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...
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! 

Gallbladder Case 2

Case 2 34 year old female presenting with vomiting and abdominal pain for 3 days. She has required antiemetic therapy in the ED, and on your assessment she has a POSITIVE sonographic Murphy's sign.                    ...

Gallbladder Case 4

Case 4 A 34-year-old male presents with nausea, vomiting and diarrhea for the past 24 hours. He has required antiemetics and fluids in the ED. On your sonographic assessment, you note that the patient did NOT have a sonographic Murphy's sign.      ...

Gallbladder Case 8

Case 8 A 54-year-old female with a history of liver cirrhosis presents with vomiting requiring antiemetics at triage. On your sonographic assessment, you note that the patient did NOT have a sonographic Murphy's.               [WATU...

Gallbladder Case 1

Case 1 54 year old female presents with nausea and vomiting for the past 48 hours. She is asymptomatic in the Emergency Department. On your assessment, you note that the patient DID NOT have a sonographic murphy's sign.              ...

Gallbladder Case 5

Case 5 A 64-year-old male presents with nausea for the past two weeks, but is asymptomatic in the ED. On your sonographic assessment, you note that the patient did NOT have a sonographic Murphy's sign.             [WATU...

Gallbladder Case 3

Case 3 A 54-year-old male presents with nausea and vomiting for 8 hours. He has had recurrent symptoms fo the past 3 months, but is currently asymptomatic in the ED. On your sonographic assessment you note that the patient did not have a positive sonographic Murphy's....

Gallbladder Case 7

Case 7 A 34-year-old female presents with vomiting and epigastric pain for the past week, requiring antiemetic therapy at triage. On your sonographic assessment you note that she does NOT have a sonographic Murphy's.              ...

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

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...

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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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