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!
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...
PoCUS Pearl – Measuring Fetal Heart Rate
We often talk about PoCUS for first-trimester bleeding. Is there an IUP? NDIUP? IDK? Yet one of the most common questions patients ask is; “Can you see the heartbeat?” While measuring fetal heart rate is not always our top priority, I’m here to convince you of the...
Test characteristics of point-of-care ultrasonography in patients with acute kidney injury.
Methodology: 2.5/5 Usefulness: 3.5/5d Gaudreau-Simard M, et al. Ultrasound J. 2024 Feb 22;16(1):15. doi: 10.1186/s13089-023-00352-3. Question and Methods: The authors aimed to determine the test characteristics of point-of-care ultrasonography (POCUS) for detecting...
Tell me an Ultrasonic Love Story – PoCUS for the everyday user
Point-of-care ultrasound (POCUS) is often taught to answer binary questions, like, "Is there free fluid in the abdomen?" However, when we combine POCUS images with clinical documentation, we are telling a story — and every good story has a beginning, middle, and end....
Acetylcholine vs Dopamine “It’s Not You, It’s Me”
I wrote this piece because understanding diseases by framing them as high or low levels of dopamine, acetylcholine, glutamate, or GABA has significantly improved my grasp of their pathophysiology and treatment strategies. Too often, medicine is taught as isolated...