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!
Spinal Epidural Abscess: Zebra in horse’s clothing
Spinal epidural abscess (SEA) is a challenging diagnosis to make in the Emergency Department (ED), with a diagnostic delay occurring in about 75% of patients.[1] To ultimately make a diagnosis of SEA, patients typically require an MRI, and so physicians may often have...
Concomitant Oral Anticoagulant and Nonsteroidal Anti-Inflammatory Drug Therapy in Patients With Atrial Fibrillation
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kent AP, et al. J Am Coll Cardiol. 2018 Jul 17;72(3):255-267 Question and Methods: This was a post hoc analysis of the RE-LY trial examining the risk of NSAID use in patients receiving oral anticoagulation (OAC)...
Focus on POCUS: Crackles and Hypotension
For other ultrasound cases see our POCUS archives Case Vignette 63-year-old male presents with a two-day history of groin pain and swelling. He has a history of hypertension and smoking. He takes an anti-hypertensive medication and an atypical antipsychotic for...
The Unwritten Rules of Mentorship
I've recently spent some time thinking about what it means to be a mentor. We're often thrust into this role - with very little training on how to actually do this. I've been fortunate enough to be surrounded by a plethora of excellent mentors and residents, and have...
Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 5/5 Nogueira RG, et al. N Engl J Med. 2018 Jan 4;378(1):11-21 Editorial: A New DAWN for Imaging-Based Selection in the Treatment of Acute Stroke. Questions and Methods: DAWN was an open-label multi-centre...
EMS Bootcamp – An introduction to pre-hospital medicine
As dedicated in-hospital emergency providers, few of us truly understand or get to experience the difficulties and unique challenges facing our pre-hospital colleagues. Beyond the EMS handover and transfer of patient care, we seldom interact with this large and...
Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 Johnston SC, et al. N Engl J Med. 2018 Jul 19;379(3):215-225 Editorial: Antiplatelet Therapy after Ischemic Stroke or TIA. Question and Methods: This randomized, double-blind trial evaluated ASA +...
Health Journalism: Does it matter?
Why Should You Care About Health Journalism? Patients receive health information from many sources—and it’s often not from you, their doctor. The accuracy of the health information available varies widely. Critical health journalism can help set records straight, as...
Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kuppermann N, et al. N Engl J Med. 2018 Jun 14;378(24):2275-2287. Editorial: Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis. Question and Methods: 13 centre RCT with four arms to...
Focus on POCUS: Ultrasound in Delirium
For other POCUS focused cases please see our ultrasound archives Case The next chart you pick up is for an 87 year-old female brought in by EMS from her nursing home for agitation and vomiting. She is afebrile and her vital signs are normal. She has a past medical...