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!
Alcohol Abstinence in Drinkers with Atrial Fibrillation
Methodology: 5/5 Usefulness: 3.5/5 Voskoboinik A, et al. N Engl J Med. 2020 Jan 2;382(1):20-28. Editorial: A Sober Reality? Alcohol, Abstinence, and Atrial Fibrillation. Question/Methods: Among adults who consume ≥10 drinks/week with symptomatic paroxysmal or...
Hypothermia: Keeping your cool when it gets cold
Hypothermia results in slightly over one hundred deaths per year in Canada; typically as a result of primary hypothermia, frostbite and other cold exposure injuries (Toronto Public Health, 2014). In the United States, this is estimated at 1500 deaths annually...
Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus
Methodology Score: 4/5 Usefulness Score: 3.5/5 Kapur J et al. N Engl J Med. 2019 Nov 28;381(22):2103-2113. Question and Methods: A multicenter, randomized, blinded, comparative-effectiveness trial to determine the efficacy and safety of fosphenytoin, valproic acid...
Pneumonia: Getting In-Sync with the Guidelines
Community-acquired pneumonia is the leading infectious cause of death in Canada, and combined with influenza is the 7th most common cause of death overall. Diagnosis The 3 main pillars leading to the diagnosis of pneumonia are as follow: Evidence of infection (fever,...
Subdissociative‐dose Ketamine Is Effective for Treating Acute Exacerbations of Chronic Pain
Methodology: 2/5 Usefulness: 2.5 /5 Lumanauw DD, et al. Acad Emerg Med. 2019 Sep;26(9):1044-1051. doi: 10.1111/acem.13755. Epub 2019 Apr 29. Question and Methods: A randomized placebo-controlled trial to determine if sub-dissociative dose Ketamine (SDDK) is effective...
Community Paramedicine: Behind the Scenes
What is Community Paramedicine? The international round table on community paramedicine provides the following definition: “…a model of care whereby paramedics apply their training and skills in non-traditional community-based environments outside of the usual...
Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With Community-Acquired Bacterial Pneumonia: The LEAP 2 Randomized Clinical Trial
Methodology: 4/5 Usefulness: 2/5 Alexander E., et al. JAMA. 2019 Sep 27. doi: 10.1001/jama.2019.15468. Editorial: Lefamulin-A New Antibiotic for Community-Acquired Pneumonia. Question and Methods: LEAP-2 was a phase 3, double-blinded RCT to determine non-inferiority...
Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability
Methodology Score: 4/5 Usefulness Score: 4.5/5 Kearon C, et al. N Engl J Med. 2019 Nov 28;381(22):2125-2134 Question and Methods: the authors sought to demonstrate safety using a d-dimer cut-off of 1000ng/mL for low pre-test probability patients & a cut-off of...
Point-of-Care Ultrasound diagnosis of Endocarditis
A healthy patient presents to the Emergency Department (ED) where you are working one night. He complains of a four-day history of progressively worsening fatigue, constant and diffuse headache, neck stiffness, fever, chills and night sweats. There was no associated...
Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock: A Randomized Clinical Trial
Methodology: 4/5 Usefulness: 2/5 Sims CA, et al. JAMA Surg. 2019 Aug 28. Question and Methods: Single-centre, double-blind, randomized control trial to determine whether low-dose vasopressin decreases the need for blood product transfusion in trauma patients with...