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!
Canadian Syncope Risk Score – an infographic
Recently, Dr. Venkatesh Thiruganasambandamoorthy et al published the Canadian Syncope Risk Score, for the assessment of adult patients with syncope. He has previously helped provide some insight into the decision rule, and we now present an infographic and memory aid...
Time to Treatment and Mortality during Mandated Emergency Care for Sepsis
Journal Club Summary Seymour CW, et al. Journal N Engl J Med. 2017 Jun 8;376(23):2235-2244. EDITORIAL: State Sepsis Mandates - A New Era for Regulation of Hospital Quality. Hershey TB, et al. N Engl J Med. 2017 May 21. Methodology Score: 3.5/5 Usefulness Score: 3/5...
Approach to the Physiologically Difficult Airway
Physiologically difficult airway: airway management in the critically ill patient, whose underlying physiology puts them at higher risk of cardiovascular collapse with intubation and conversion to positive pressure ventilation. This is important for in the Emergency...
Getting it ‘Right’: Pulmonary Hypertension in the ED
Describe the pathophysiology of Pulmonary Hypertension (PH), and how it can be dangerous Who to suspect and workup for PH in the ED Describe the POCUS findings in PH Describe the management of these patients and how to avoid causing harm Physiology Definition...
Under Pressure: Review of Management of Hypertension in Neurological Emergencies
Objectives: Explore the data for safety and efficacy of urgent blood pressure lowering in hemorrhagic stroke. Is there any benefit from management of elevated blood pressure in acute ischemic stroke that is not a candidate for tPA? What is the data for blood pressure...
Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4.5/5 D'Onofrio G, et al JAMA. 2015 Apr 28;313(16):1636-44. Full Article This single, urban center RCT including 329 patients showed that buprenorphine initiated in the ED was more likely to increase...
A Randomized Controlled Noninferiority Trial of Single Dose of Oral Dexamethasone Versus 5 Days of Oral Prednisone in Acute Adult Asthma
Journal Clubs Summary Methodology Score: 3/5 Usefulness Score: 3.5/5 Rehrer MW, et al. Ann Emerg Med. 2016 Nov;68(5):608-613. Abstract Link This single centre, randomized, triple-blinded, control trial did not demonstrate noninferiority of a single dose of...
The ABCDE’s of Quality Improvement
What is Quality Improvement (QI)? You have all heard the latest buzzword in healthcare: “quality improvement”, or QI. Yet many healthcare professionals still only have a vague idea of what that truly means, and likely an even poorer understanding of how it might apply...
Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study.
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Stanley AJ, et al. BMJ. 2017 Jan 4;356:i6432. Full Article Summary This multicentre, multinational study assessed the ability of five upper gastrointestinal bleeding scores to predict...
Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial.
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3.5/5 Nijssen EC, et al Lancet. 2017 Feb 20. [Epub ahead of print] Abstract Link This prospective, open-label, single centre, randomized trial of 660 patients found no hydration...
