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Mechanical Ventilation Basics

by Cameron Leafloor | January 25, 2024 | Airway, Anesthesiology, cardiac arrest, Critical Care, Featured, Recently Featured, Respirology | 0 Comments

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience,...

Delirium revisited

by Simranjeet Singh | October 31, 2024 | Featured, Geriatrics, Grand Round Summaries, Infectious Disease, Recently Featured | 0 Comments

Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever,...

Functional Neurologic Disorders

by Maria Berliant | April 11, 2024 | Featured, Grand Round Summaries, Neurology, psychiatry, Recently Featured | 0 Comments

Note: This grand rounds presentation and summary had contributions from Dr. Anne-Marie Abe, a neuropsychiatrist specializing in functional neurological disorders in Ottawa. Patients living with functional neurologic disorders (FND) have been deeply stigmatized...

Posterior Circulation Strokes

by Kathleen O'Connell | March 14, 2024 | Critical Care, Featured, Grand Round Summaries, Neurology, Recently Featured, Resuscitation | 1 Comment

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more...

Lung Protective Ventilation

by Cameron Leafloor | February 1, 2024 | Anesthesiology, cardiac arrest, Critical Care, Featured, Recently Featured, Respirology | 1 Comment

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we've learned. If you haven't read part...

Invasive Group A Strep (iGAS).. It’s Backkkk (Part 1)

by Max Zworth | July 11, 2024 | cardiac arrest, Critical Care, Dermatology, Grand Round Summaries, Infectious Disease, Recently Featured | 0 Comments

In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. We prepared the ED for the patient’s arrival....

Stable Vaginal Bleeding in Pregnancy

by Caitlin Hutchings | November 21, 2024 | Featured, OBGYN, Recently Featured | 0 Comments

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...

These are the ‘Roids you are looking for – Steroids in the ED

by Naman Arora | January 9, 2025 | Critical Care, Endocrinology, Featured, Grand Round Summaries, Infectious Disease, Recently Featured | 0 Comments

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...

Nailed it! A guide to Fingertip Injuries

by Caroline Gregory | January 16, 2025 | Featured, Grand Round Summaries, Orthopedics, Recently Featured, Trauma | 0 Comments

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...

By the Hammer of Thora: Pleural Effusions in the ED (part 1)

by Alie Wudwud | August 15, 2024 | Anesthesiology, Cardiothoracic Surgery, Critical Care, Featured, Grand Round Summaries, Infectious Disease, Recently Featured, Respirology, Resuscitation | 0 Comments

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and unclear. This is largely due to the lack of guidelines around pleural effusions in the ED. In this post, I’ve tried to highlight some key information about an approach to...

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!

Meningitis in the ED Patient

by Nick Prudhomme, Richard Hoang | Apr 19, 2018

Meningitis is defined as the inflammation of the membranes of the brain and/or spinal cord. The incidence of bacterial meningitis is in the range of 5-10 cases per 100,000 patients per year1. Despite modern medical therapy, it is associated with a case fatality rate...

Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial

by Hans Rosenberg | Apr 16, 2018

Journal Club Summary Alam N, et al. Lancet Respir Med. 2018 Jan;6(1):40-50. Question and Methods: The authors of this nation-wide open-label RCT studied the mortality effect of pre-hospital antibiotics on febrile patients with one other non-laboratory SIRS criteria...

Management Controversies in Traumatic Cardiac Arrest

by Nick Costain, Robert Suttie | Apr 12, 2018

The management of traumatic cardiac arrest differs significantly from the management of medical cardiac arrest, however the management is often lumped together. In this weeks Grand Rounds summary Dr. Nicholas Costain takes us through some controversies in the...

Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome.

by Hans Rosenberg | Apr 9, 2018

Journal Club Summary Methodology: 3.5/5 Usefulness: 3/5 Peacock WF, et al. JAMA Cardiol. 2017 Dec 13 EDITORIAL: The Wait for High-Sensitivity Troponin Is Over-Proceed Cautiously Korley FK. JAMA Cardiol. 2017 Dec 13 Question and Methods: This prospective,...

ED Crowding: Is it Getting Cramped in Here?

by Matthew Lipinski, Richard Hoang | Apr 5, 2018

In this post, we take a deep dive into the ever-present issue of ED crowding, going beyond the basic input-throughput-output model and focusing on institutional and provincial strategies for managing patient flow and overcrowding. We will cover the following...

Ottawa’s Clerkship Guide to Emergency Medicine

by Shahbaz Syed | Mar 29, 2018

A Multicenter, Randomized Trial of Ramped Position vs Sniffing Position During Endotracheal Intubation of Critically Ill Adults

by Hans Rosenberg | Mar 26, 2018

Methodology Score: 3.5/5 Usefulness Score: 3/5 Semler MW, et al. Chest. 2017 Oct;152(4):712-722. Editorial: Should the Ramped Position Be "Sniffed at" in the ICU? Scott JA, et al. Chest. 2017 Oct;152(4):693-694. Question and Methods: Multicenter,...

Improving Morbidity and Mortality Rounds – the “OM3”

by Edmond Kwok | Mar 22, 2018

In the post, Dr. Edmund Kwok presents the Ottawa Morbidity and Mortality Model (OM3), and provides users with an helpful guide on how to implement change to effectively improve M&M rounds at any institution. OM3 Guide In modern medicine, the concept of keeping...

Prehospital Advanced Cardiac Life Support for Out-of-hospital Cardiac Arrest: A Cohort Study.

by Hans Rosenberg | Mar 19, 2018

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Cournoyer A, et al. Acad Emerg Med. 2017 Sep;24(9):1100-1109. Question and Methods: Retrospective observational cohort study to evaluate if the addition ACLS to BLS during EMS management for...

Low Back Pain – a management guide

by Shahbaz Syed, Halli Pedlow | Mar 15, 2018

A primer on this article: it is intended for use by healthcare professionals and patients. Many of the insights on therapy and non-medical management for patients with low back pain are provided by our guest author Halli Pedlow, a Registered Physiotherapist, with a...

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