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!
Nailed it! A guide to Fingertip Injuries
A stable and functional fingertip is essential for sensation, fine motor skills, grip strength, and the overall durability and cosmetic appearance of the hand. Fingertips, often the first point of contact during daily activities, are particularly susceptible to...
Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest
Methodology: 4/5 Usefulness: 4/5 Vallentin MF, et al. N Engl J Med. 2024 Oct 31. doi: 10.1056/NEJMoa2407616. Editorial: The Way to a Patient's Heart - Vascular Access in Cardiac Arrest Question and Methods: This RCT compared IO vs. IV vascular access in adults with...
These are the ‘Roids you are looking for – Steroids in the ED
In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of...
A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest
Methodology: 4/5 Usefulness: 3/5 Couper K, et al. N Engl J Med. 2024 Oct 31:10.1056/NEJMoa2407780. Question and Methods: This multi-center, open label randomized control trial aimed to assess 30-day survival in patients with out of hospital cardiac arrest (OOHCA) who...
Mastery of DVT PoCUS
Point-of-care ultrasound (PoCUS) for lower extremity deep vein thrombosis (DVT) remains a skill with significant variability in local practice. While some physicians perform DVT scans regularly, others rarely incorporate PoCUS into their workflow. Regardless of your...
Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatment of Acute Traumatic Pain: A Randomized Clinical Trial
Methodology: 4/5 Usefulness: 2/5 McMullan JT, et al. Ann Emerg Med. 2024 Oct;84(4):363-373. doi: 10.1016/j.annemergmed.2024.04.018. Question and Methods: This out of hospital, placebo-controlled, blinded, parallel group RCT compared reduction in pain scores between...
Validation of the Hospital for Sick Children Algorithm for Discriminating Bacteremia From Contaminants in Children With a Preliminary Positive Blood Culture
Methodology: 3.5/5 Usefulness: 2/5 Gravel J, et al. Ann Emerg Med. 2024 Nov;84(5):490-499. doi: 10.1016/j.annemergmed.2024.05.005. Question and Methods: The authors aimed to validate the Sick Kids algorithm for distinguishing bacteremia from contaminants in pediatric...
Fever NYD? Maybe PoCUS can provide some FoCUS
A 59-year-old man presented to a community Emergency Department with a one-month history of subjective fevers and dyspnea. Due to COVID-19 restrictions, he had only consulted a physician via telephone, during which he was prescribed two courses of antibiotics for...
Quantitative End-Tidal CO2 – the New Scoop
Quantitative End-Tidal CO2 (ETCO2) was in vogue for a while, and seemingly some centres adopted it as standard of care, while others found that it did not make a significant clinical impact so it fell out of style and left to 'practitioner preference'. With increasing...
Derivation of the Falls Decision Rule to exclude intracranial bleeding without head CT in older adults who have fallen
Methodology: 3.5/5 Usefulness: 3.5/5 CMAJ. 2023 Dec 3;195(47):E1614-E1621. de Wit K, et al. doi: 10.1503/cmaj.230634. Question and Methods: The Falls Decision Rule was derived to identify older adults with fall who do not require CT to rule out intracranial bleeding,...