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!
Minor Blunt Thoracic Trauma in the Emergency Department: Sensitivity and Specificity of Chest Ultralow-Dose Computed Tomography Compared With Conventional Radiography
Methodology: 2/5 Usefulness: 2.5/5 Macri F, Greffier J, Khasanova E, Claret PG, Bastide S, Larbi A, Bobbia X, Pereira FR, de la Coussaye JE, Beregi JP. Ann Emerg Med. 2019 Jun;73(6):665-670. Question and Methods: This 160-patient pilot study prospectively compared...
Diagnosis of Elevated Intracranial Pressure in Critically Ill Patients
In the Emergency Department (ED) and Intensive Care Unit (ICU), we often encounter patients with brain injury. This includes patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH), among others [1]. In the ED and...
A Bloody Mess: an Update on UGIB Management in the ED
Acute upper gastrointestinal bleeding (UGIB) is an all-too-frequent presentation that can scare the pants off of even the most seasoned Emergency Physician. Severity of presentation can vary greatly, from simple bleeds related to gastritis to exsanguinating variceal...
Abdominal Stab Wounds: A Decision Algorithm
If you work at a trauma center, then you're bound to see your fair share of abdominal stab wounds. Though civilian penetrating trauma has declined over recent decades and is less common than blunt trauma, penetrating trauma represents ~10% of all trauma evaluations in...
Optimizing the Early Resuscitation After Out of Hospital Cardiac Arrest
Dr. Reardon and colleagues identify key management priorities in optimizing the early resuscitation in patients after out of hospital cardiac arrest.
Inhalation Injuries and Toxic Industrial Chemicals
Patients with both burn and inhalation injuries have significantly increased morbidity and mortality compared to those with just burn injuries alone, as there are multiple toxic industrial chemicals that act on the respiratory tract. In this post, we review...
Blast Injuries: What you Need to Know!
Blast injuries resulting from explosions have the capacity to cause life-threatening multisystem injuries in multiple victims simultaneously. The biggest potential challenge in managing blast injuries is the creation of large numbers of simultaneous critically ill...
Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism
Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4.5 /5 van der Pol LM, et al. N Engl J Med. 2019 Mar 21;380(12):1139-1149 Question and Methods: Using a prospective cohort study of 510 pregnant women, the authors were trying to see whether an algorithm...
CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions
Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 3/5 Prins HJ, et al. Eur Respir J. 2019 May 23;53(5). Question and Methods: The CATCH Study was a multicentre, randomised, controlled open intervention clinical trial comparing CRP guided antibiotics for...
Resuscitative Thoracotomy in the Civilian and Military Environments
Emergency Resuscitative Thoracotomy (ERT) is a potentially lifesaving intervention. It is a true salvage procedure, without which survival is essentially zero, even in indicated scenarios. After reading this post, you'll be slightly more comfortable should you ever...