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!
Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Chu DK, et al. Lancet. 2018 Apr 28;391(10131):1693-1705. Question & Methods: The authors wanted to summarize the best available evidence of RCTs to guide rational use of O2 therapy. Findings: Their review of...
Pre-Hospital Updates 2018
In this post, we will review several recent updates related to pre-hospital medicine. Specifically, we will: Review the role of tranexamic acid (TXA) in pre-hospital trauma Discuss the use of ketamine in Excited Delirium Examine the new Ottawa ROSC bypass protocol and...
Immobilization in external rotation combined with abduction reduces the risk of recurrence after primary anterior shoulder dislocation
Methodology: 3.5/5 Usefulness: 2.5/5 Heidari K. et al. J Shoulder Elbow Surg. 2014 Jun;23(6):759-66. Journal Club Bottom Line Question & Methods: Can abduction and external rotation (AbER) immobilization after primary anterior shoulder dislocation reduce rates of...
Transplant Medicine in the ED
Patients who receive solid organ or stem cell transplants are complex, but we see them frequently in the Emergency Department! This review summarizes the physiology of transplant and a few of the key issues to be aware of in these patients. Transplant by the numbers...
Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes: The ADvISED Prospective Multicenter Study
Methodology Score: 3/5 Usefulness Score: 3/5 Nazerian P, et al. Circulation. 2018 Jan 16;137(3):250-258. Editorial - Biomarker-Assisted Diagnosis of Acute Aortic Dissection. Question: The ADvISED trial was an International Multicenter prospective observational study...
Navigating a Digital Sea: Considerations for the Emergency Medicine Physician in an Era of Electronic Health Information
There is no denying that the evolution of technology will continue to alter our practice of Emergency Medicine; a prime example of this has come with the transition to electronic health information within our clinical environments. In seeking to better understand the...
Adjunctive Glucocorticoid Therapy in Patients with Septic Shock
Methodology Score: 4/5 Usefulness Score: 3/5 Venkatesh B, et al. N Engl J Med. 2018 Jan 19. Journal Club Bottom Line Question/Methods: This was a international, pragmatic, double-blind, randomized, controlled trial comparing hydrocortisone as continuous infusion to...
Tricks of the Trach: Approach to Tracheostomy Patients in the Emergency Department
In this post, we will review the anatomy, essential history, and common presentations of tracheostomy patients in the ED, including obstruction, decannulation, bleeding, tracheal stenosis, and infection. Anatomy of a tracheostomy tube Outer cannula Sits directly in...
DEFUSE-3: Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging
Methodology: 3.5/5 Usefulness: 4/5 Albers GW, et al. N Engl J Med. 2018 Jan 24. Journal Club Bottom Line Question/Methods: This was a multicentre, prospective, randomized, open label, blinded outcome trial comparing thrombectomy + medical therapy vs medical therapy...
Sweating the Small Stuff: An Evidence-Based Urgent Care Potpourri
https://www.youtube.com/watch?v=wlF-IsZtGjo Urgent care presents a specific set of challenging clinical questions for the emergency physician. Often, seemingly mundane presentations will leave us questioning whether or not we have managed a case appropriately. Our...