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!
Sickle Cell in the ED: An Update
Sickle Cell Disease (SCD) is a complex medical entity, associated with significant morbidity and mortality. Patients with SCD suffer from acute and chronic pain, along with a seemingly endless list of additional complications (from hemolysis and sequestration, to...
Back to Basics: Revisiting Common EM Controversies
In this post, we will explore the current literature regarding common EM controversies, covering the nature and prevalence of penicillin allergies, the management of skin and soft tissue infections, and the role of NSAIDs for acute pain. Penicillin allergies in the ED...
Impact of two-step urine culture ordering in the emergency department: a time series analysis
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Stagg A, et al. BMJ Qual Saf. 2018 Feb;27(2):140-147. Question and Methods: This QI time-series analysis assessed the efficacy, safety and costs of a 2-step urine culture (UC)...
Selected Imaging Controversies in ED Trauma
Traumatic injuries are amongst the most common presentations for all emergency departments (ED). In 2010, there were over 1 million patients in Canada who visited the ED for trauma, result in an cost of almost 9 billion dollars.1 Yet, in spite of their frequency,...
An Analysis of Paralysis: Neuromuscular blocking agents in the Emergency Department
In this post, we will discuss the use of neuromuscular blocking agents (NMBAs) for intubation in the Emergency Department; we will focus on considerations in predicted difficult airways (RSI vs. awake intubation), Rocuronium vs. Succinylcholine, and the indications...
An Update: Rate Control in Atrial Fibrillation
In this post, we will discuss updates and controversies surrounding rate control in Afib, specifically we will: Review the new 2017 CAEP Afib best practices guidelines Review Tachycardia Induced Cardiomyopathy Review Afib and Type 2 ACS Discuss the identification and...
Diagnosis of Necrotising Soft Tissue Infection
Necrotising soft tissue infections are an significant cause of morbidity and mortality, so an timely diagnosis is critical for the Emergency Physician. Here we discuss the publication of a new systematic review and meta-analysis on this challenging diagnostic entity,...
Meningitis in the ED Patient
Meningitis is defined as the inflammation of the membranes of the brain and/or spinal cord. The incidence of bacterial meningitis is in the range of 5-10 cases per 100,000 patients per year1. Despite modern medical therapy, it is associated with a case fatality rate...
Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial
Journal Club Summary Alam N, et al. Lancet Respir Med. 2018 Jan;6(1):40-50. Question and Methods: The authors of this nation-wide open-label RCT studied the mortality effect of pre-hospital antibiotics on febrile patients with one other non-laboratory SIRS criteria...
Management Controversies in Traumatic Cardiac Arrest
The management of traumatic cardiac arrest differs significantly from the management of medical cardiac arrest, however the management is often lumped together. In this weeks Grand Rounds summary Dr. Nicholas Costain takes us through some controversies in the...