We are excited to introduce the Fifth edition of The Ottawa Handbook of Emergency Medicine. Your bedside guide for approaches to various Emergency Medicine presentations.
Highlights of the Fifth edition include the addition of: general surgery emergencies, pediatric orthopedic presentations, and updates in pediatric fever + more!
Don’t Sweat It! Heat Related Illness
Global temperatures are increasing and are projected to continue warming. The rates of warming across out planet are not uniform. In Canada, the loss of snow and sea ice reduces the reflectivity of the surface leading to increased absorption of solar radiation and a...
Reduction of urea test ordering in the emergency department: multicomponent intervention including education, electronic ordering, and data feedback
Methodology: 2.5/5 Usefulness: 2/5 Mathura P, et al. CJEM. 2022 Sep;24(6):636-640. Editorial: When evidence-based medicine and quality improvement collide. Question and Methods: Can we decrease physician ordering of the BUN (blood urea nitrogen) test, using an...
Don’t go Breaking my Heart: 2022 Heart Failure Guidelines
Patients with heart failure are often newly diagnosed in the Emergency Department, or are the presenting location for those with decompensated heart failure. This is why it is important for ER Physicians to remain updated on the latest AHA/ACC/HFSA guidelines for the...
Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial
Methodology: 4/5 Usefulness: 3.5/5 Bouzat P, et al. JAMA. 2023 Mar 21:e234080. doi: 10.1001/jama.2023.4080. Question and Methods: This double-blind, randomized, placebo-controlled superiority trial aimed to assess whether 4F-PCC decreases 24hr blood product...
Quality initiative to improve emergency department sepsis bundle compliance through utilisation of an electronic health record tool
Methodology: 2/5 Usefulness: 3/5 Warstadt NM, et al. BMJ Open Qual. 2022 Jan;11(1):e001624. Questions and Methods: Using a cohort and QI approach, to demonstrate the effectiveness of a multidisciplinary educational intervention and EHR tool to increase sepsis bundle...
Psychology and Science of Waiting
Preamble: This Grand Rounds was inspired in part by a conversation I had with Dr. Andrew Petrosoniak during my time at St. Michael’s Hospital where we discussed the growing concern of excessive ED wait times and the limited concerted effort on addressing the waiting...
Safely reducing abdominal/pelvic computed tomography imaging in pediatric trauma: a quality improvement initiative
Methodology: 4.5/5 Usefulness: 5/5 Beno S, al. CJEM. 2022 Aug;24(5):535-543. Editorial: Reducing overuse of CT imaging in pediatric trauma: a model example of the Model for Improvement. Question and Methods: The aim of this QI project was to reduce unnecessary CT...
CAEP 2023 in review!
Well, the CAEP 2023 (#CAEP23) (Canadian Associated of Emergency Physicians) conference is officially over. We've head back to our respective homes and departments, and by now the melancholy has fully kicked in. It was the first time, in a while, that the CAEP...
Topical NSAIDs for Acute Pain Management
I was early in my PGY-1 year when I first witnessed an adverse effect from oral nonsteroidal anti-inflammatory drugs (NSAIDs). It was a busy morning with long patient wait times, and I picked up the chart of a 19-year-old female presenting with abdominal pain. She...
A Comparison of Prehospital Pediatric Analgesic Use of Ketamine and Opioids
Methodology: 3/5 Usefulness: 3/5 Frawley, John et al. “A Comparison of Prehospital Pediatric Analgesic Use of Ketamine and Opioids.” Prehospital emergency care, 1-5. 8 Mar. 2023, doi:10.1080/10903127.2023.2183295 Question and methods: This study sought...