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!
High Sensitivity Cardiac Troponin Testing (hs-cTnT) in ACS
Case: You are the emergency physician taking care of a 45-year-old male who has a background history of hypertension and dyslipidemia for which he is on a ACEi and a statin. He presents with 2.5 hours of ongoing non-radiating chest discomfort while at work. His...
Trust the Process
“Trust the process” – a promise that our assistant Program Director (PD), Jen Leppard, makes on our first day of the EM year. I am new here, and I am nervous. But, as I walk into the ED, this feeling quickly vanishes, as I am reminded of what drew me to Ottawa in the...
Does N-Terminal Pro-B-Type Natriuretic Peptide Improve the Risk Stratification of Emergency Department Patients With Syncope?
Methodology: 4/5 Usefulness: 3/5 Thiruganasambandamoorthy V, et al. Ann Intern Med. 2020 May 19;172(10):648-655. Methods: Prospective cohort study to evaluate whether adding NT-proBNP to the CSRS improves prediction of 30-day SAEs. Findings: Adding NT-proBNP provided...
Approach to the ECG
Full PDF: ECG PDF
Multicenter Emergency Department Validation of the Canadian Syncope Risk Score
Methodology: 4.5/5 Usefulness: 4.5/5 Thiruganasambandamoorthy V, et al. JAMA Intern Med. 2020 Mar 23;180(5):1-8. Question and Methods: Prospective cohort validation to predict 30-day serious outcomes among ED patients with syncope Findings: 3819 patients had an...
Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review
Methodology: 1/5 Usefulness: 2/5 Riley CM, et al. JAMA. 2019 Feb 26;321(8):786-797. Question: Aimed to review and provide practical information regarding the diagnosis and long-term management of patients with COPD in the outpatient setting. Methods: This was a...
The Status on Status: Management of Status Epilepticus
Status epilepticus (SE) is considered one of the most common neurological emergencies with an estimated incidence of 20 cases/100,000 people worldwide. Just the facts The distribution is bimodal, peaking in patients <1 and >60 years old. In children, the cause...
Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial.
Methodology: 4.5/5 Usefulness: 4/5 Stiell IG, et al. Lancet. 2020 Feb 1;395(10221):339-349 Editorial: Atrial fibrillation cardioversion in the emergency department. Question and Methods: This partial factorial randomized trial aimed to determine which rhythm control...
What a headache: Updates on Migraine Management
Migraine headaches are not a benign disease - they have a significant impact on quality of life, ability to function, and pose a considerable economic and societal burden. Prevalence tends to peak during peoples' period of highest productivity. According to...
Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs
Methodology: 2.5/5 Usefulness: 3/5 Daley JI, et al. Acad Emerg Med 26 (11), 1211-1220 Nov 2019 Questions and methods: In patients with abnormal vital signs, what is the sensitivity of FOCUS for the diagnosis of PE? Prospective, multicenter, observational...