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!
Scapholunate instability (the Mayfield Classification)
Do you often get the components of scapholunate instability mixed up? Do you find this a tough one to teach to residents? Dr. Hendin has you covered - here she provides an great graphic to fully explain the Mayfield classification (scapholunate instability).
Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study
Methodology Score: 3.5/5 Usefulness Score: 4/5 Babl FE, et al. Lancet. 2017 Jun 17;389(10087):2393-2402. Question and Methods: This prospective observational study sought to externally validate and subsequently compare the relative performance of the PECARN, CATCH,...
GCS Remastered: Recent Updates to the Glasgow Coma Scale (GCS-P)
Most clinicians are familiar with and utilize the Glasgow Coma Scale (GCS) on a daily basis, but many are not aware of the updates and additions to the score that were made in 2014 and 2018, respectively. Clarifications in the wording of the scale attempt to increase...
Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Chu DK, et al. Lancet. 2018 Apr 28;391(10131):1693-1705. Question & Methods: The authors wanted to summarize the best available evidence of RCTs to guide rational use of O2 therapy. Findings: Their review of...
Pre-Hospital Updates 2018
In this post, we will review several recent updates related to pre-hospital medicine. Specifically, we will: Review the role of tranexamic acid (TXA) in pre-hospital trauma Discuss the use of ketamine in Excited Delirium Examine the new Ottawa ROSC bypass protocol and...
Immobilization in external rotation combined with abduction reduces the risk of recurrence after primary anterior shoulder dislocation
Methodology: 3.5/5 Usefulness: 2.5/5 Heidari K. et al. J Shoulder Elbow Surg. 2014 Jun;23(6):759-66. Journal Club Bottom Line Question & Methods: Can abduction and external rotation (AbER) immobilization after primary anterior shoulder dislocation reduce rates of...
Transplant Medicine in the ED
Patients who receive solid organ or stem cell transplants are complex, but we see them frequently in the Emergency Department! This review summarizes the physiology of transplant and a few of the key issues to be aware of in these patients. Transplant by the numbers...
Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes: The ADvISED Prospective Multicenter Study
Methodology Score: 3/5 Usefulness Score: 3/5 Nazerian P, et al. Circulation. 2018 Jan 16;137(3):250-258. Editorial - Biomarker-Assisted Diagnosis of Acute Aortic Dissection. Question: The ADvISED trial was an International Multicenter prospective observational study...
Navigating a Digital Sea: Considerations for the Emergency Medicine Physician in an Era of Electronic Health Information
There is no denying that the evolution of technology will continue to alter our practice of Emergency Medicine; a prime example of this has come with the transition to electronic health information within our clinical environments. In seeking to better understand the...
Adjunctive Glucocorticoid Therapy in Patients with Septic Shock
Methodology Score: 4/5 Usefulness Score: 3/5 Venkatesh B, et al. N Engl J Med. 2018 Jan 19. Journal Club Bottom Line Question/Methods: This was a international, pragmatic, double-blind, randomized, controlled trial comparing hydrocortisone as continuous infusion to...