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!
Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 Johnston SC, et al. N Engl J Med. 2018 Jul 19;379(3):215-225 Editorial: Antiplatelet Therapy after Ischemic Stroke or TIA. Question and Methods: This randomized, double-blind trial evaluated ASA +...
Health Journalism: Does it matter?
Why Should You Care About Health Journalism? Patients receive health information from many sources—and it’s often not from you, their doctor. The accuracy of the health information available varies widely. Critical health journalism can help set records straight, as...
Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kuppermann N, et al. N Engl J Med. 2018 Jun 14;378(24):2275-2287. Editorial: Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis. Question and Methods: 13 centre RCT with four arms to...
Focus on POCUS: Ultrasound in Delirium
For other POCUS focused cases please see our ultrasound archives Case The next chart you pick up is for an 87 year-old female brought in by EMS from her nursing home for agitation and vomiting. She is afebrile and her vital signs are normal. She has a past medical...
Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 5/5 Nath S, et al. Lancet. 2018 Mar 24;391(10126):1197-1204 Question and Methods: This meta-analysis sought to determine, in lumbar punctures, whether atraumatic or conventional (traumatic) spinal needles...
Procedural Sedation in the ED: Agents
In this two part series, we are delving into a few of the many controversies regarding procedural sedation and explore how to reduce resource utilization and ED length of stay. In PART 1, we discussed preprocedural fasting and concluded that adherence to fasting...
A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest.
Journal Club Summary: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al N Engl J Med. 2018 Jul 18. Editorial: Testing Epinephrine for Out-of-Hospital Cardiac Arrest. Callaway CW, et...
Fill ‘er up: Fluid Responsiveness in the ED
When we are caring for a septic patient in the ED, we know that aggressive care with early antibiotics and ensuring adequate preload saves lives. But what do we do when we aren’t sure if more fluid will help any longer? How can we finesse our fluid...
Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial
Journal Club Summary Methodology: 3.5/5 Usefulness: 3.5/5 Moore HB, et al. Lancet. 2018 Jul 28;392(10144):283-291. Editorial: No gains with plasma-first resuscitation in urban settings? Question and Methods: Use of prehospital plasma in patients with...
Procedural Sedation in the ED – Part 1: Preprocedural Fasting
Procedural sedation is commonly performed in the Emergency Department. It is a critical tool that helps facilitate unpleasant but often necessary procedures that our patients would otherwise not tolerate. However, procedural sedation is also an extraordinarily...