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!
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...
Delirium revisited
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,...
Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants
Methodology: 4/5 Usefulness: 4/5 Geraghty LE, et al. N Engl J Med. 2024 May 30;390(20):1885-1894. doi: 10.1056/NEJMoa2402785. Question and Methods: Study aimed to determine if video laryngoscopy improves first-attempt intubation success in neonates compared to direct...
Is there a Precedence for Precedex in the ED?
Precedex (dexmedetomidine) is an alpha-2 adrenergic agonist increasingly used in critical care environments for sedation and anxiolysis. It offers a unique profile of sedation without respiratory depression, making it an attractive option in various clinical...
S’now Problem: Keep your Cool when Stimulants turn up the Speed
We remain amid an opioid crisis in Canada, with over 8000 deaths (or 22/day) in 2023. The harms of opioid use in society are devastating and cannot be understated – but so too are the harms from stimulant and other substance use. In 2023 there were 3479 apparent...
Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis
Methodology: 3/5 Usefulness: 4/5 Essat M, et al. Ann Emerg Med. 2024 Jun 18:S0196-0644(24)00260-9 Question and Methods: Using systematic review methodology, the authors aimed to determine sensitivity and specificity in the use of D-Dimer in the work-up for Acute...
PoCUS Pearl – Tibial Nerve Block
Ever tried injecting local anesthetic into the bottom of someone’s foot? If you have, you’ll understand the incredible pain and difficulty in trying to anesthetize this region. Fortunately, there’s a better way to anesthetize the plantar foot, and avoid getting kicked...