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!
A Systematic Review and Meta-analysis of D-dimer as a Rule-out Test for Suspected Acute Aortic Dissection
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3/5 Asha SE, Miers JW. Ann Emerg Med. 2015 Oct;66(4):368-78. Full Article This systematic review and meta-analysis aims to determine the diagnostic accuracy of D-dimer as a rule out...
Sepsis Myths: Bringing Sepsy back !
Fluids and antibiotics and lactate…. oh my! Sepsis management in the Emergency Department (ED) was revolutionized by the Rivers trial – a relatively small study showing a NNT of 6 with early goal directed therapy (EGDT). It heavily influenced the end-goals of...
Air Versus Oxygen in ST-Segment–Elevation Myocardial Infarction
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Stub D, Smith K, Bernard S, et al. Circulation. 2015 Jun 16;131(24):2143-50. Abstract Link Editorial: Oxygen for ST-Segment–Elevation Myocardial Infarction: Still Up in the Air...
Acetaminophen for Fever in Critically Ill Patients with Suspected Infection
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 2/5 Young P, Saxena M, Bellomo R, et al. N Engl J Med. 2015 Oct 5. Abstract Link This multicentre, ICU RCT received a methodology score of 4/5 and 2/5 for usefulness. They concluded...
What is Optimal Chest Compression Depth During Out-of-Hospital Cardiac Arrest Resuscitation of Adult Patients?
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Stiell IG, Brown SP, Nichol G, et al. Circulation. 2014 Nov 25;130(22):1962-70 Full Article This observational study found that an optimal CPR chest compression depth of 40 - 55...
LVAD’s 101 !
Have a crashing Left Ventricular Assist Device (LVAD) patient in your Emergency Department? Need some help? Want to challenge your residents? The following should help you in your bedside assessment and treatment of the critically ill LVAD patient. For a thorough...
A Trial of an Impedence Threshold Device in Out-of-Hospital Cardiac Arrest
Journal Club Summary Methodology Score: 5/5 Usefulness Score: 3/5 Aufderheide TP, Nichol G, Rae TD, et al. N Engl J Med. 2011 Sep 1;365(9):798-806 Full Article This large effectiveness trial sought to test whether standard CPR with an Impedance...
Post intubation analgesia and sedation in the ED
You deftly sweep the tongue aside, slide into the vallecula, lift the epiglottis, and have a great view of the cords. You smoothly pass the tube, secure it, and walk away – a superstar. Meanwhile your nurses wonder “what now?” as your patient begins to wake up pulls...
Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4/5 Neumar RW, Shuster M, Callaway CW, et al. Circulation. 2015 Nov 3;132(18 Suppl 2):S315-67 Full Article Supplement: The Evolution and Future of ACC/AHA Clinical Practice...
An Age-Adjusted D-dimer Threshold for Emergency Department Patients With Suspected Pulmonary Embolus: Accuracy and Clinical Implications.
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3/5 Sharp AL, Vinson DR, Alamshaw F, Handler J, Gould MK. Ann Emerg Med. 2015 Aug 27. pii: S0196-0644(15)00616-2. Abstract Link Retrospective study of 31,094 patients investigated for PE,...


