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!
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,...
Ultrasound Guided Peripheral IVs
What do you do when expert nurses tell you they can’t obtain IV access? Do you spend 20 minutes performing an invasive central line? Does your resident finally get two IO EPAs? Or do you save the day with a slick, ultrasound guided IV? Obtaining peripheral ultrasound...
Stable Vaginal Bleeding in Pregnancy
A common Emergency Department (ED) presentation, vaginal bleeding in pregnancy affects approximately 30% of pregnancies in the 1st trimester and 1-2% in the 2nd trimester. About half of these result in pregnancy loss. Here we will use cases to highlight an ED approach...
Blurred Lines: The Ethical Pitfalls of Urine Drug Screens
Urine drug (or toxicologic) screens are a fairly standard tool used in addictions, psychiatry and the Emergency Department (ED), often employed to detect substance use in patients presenting with altered mental status, trauma, psychiatric or abnormal behaviour. Yet,...
Inhalation Injuries: The Answers You’ve Been LUNGing For
Inhalational injuries are a critical yet often overlooked aspect of trauma care, with far-reaching consequences in emergency medicine. These injuries can arise from various sources, including thermal injuries from fires, recreational activities such as smoke exposure...