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Nailed it! A guide to Fingertip Injuries

by Caroline Gregory | January 16, 2025 | Featured, Grand Round Summaries, Orthopedics, Recently Featured, Trauma | 0 Comments

A stable and functional fingertip is essential for sensation, fine motor skills, grip strength, and the overall durability and cosmetic appearance of the hand. Fingertips, often the first point of contact during daily activities, are particularly susceptible to...

Functional Neurologic Disorders

by Maria Berliant | April 11, 2024 | Featured, Grand Round Summaries, Neurology, psychiatry, Recently Featured | 0 Comments

Note: This grand rounds presentation and summary had contributions from Dr. Anne-Marie Abe, a neuropsychiatrist specializing in functional neurological disorders in Ottawa. Patients living with functional neurologic disorders (FND) have been deeply stigmatized...

Stable Vaginal Bleeding in Pregnancy

by Caitlin Hutchings | November 21, 2024 | Featured, OBGYN, Recently Featured | 0 Comments

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...

Mechanical Ventilation Basics

by Cameron Leafloor | January 25, 2024 | Airway, Anesthesiology, cardiac arrest, Critical Care, Featured, Recently Featured, Respirology | 1 Comment

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience,...

Posterior Circulation Strokes

by Kathleen O'Connell | March 14, 2024 | Critical Care, Featured, Grand Round Summaries, Neurology, Recently Featured, Resuscitation | 1 Comment

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more...

Lung Protective Ventilation

by Cameron Leafloor | February 1, 2024 | Anesthesiology, cardiac arrest, Critical Care, Featured, Recently Featured, Respirology | 1 Comment

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we've learned. If you haven't read part...

Invasive Group A Strep (iGAS).. It’s Backkkk (Part 1)

by Max Zworth | July 11, 2024 | cardiac arrest, Critical Care, Dermatology, Grand Round Summaries, Infectious Disease, Recently Featured | 0 Comments

In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. Watch the entire Grand Rounds here...

These are the ‘Roids you are looking for – Steroids in the ED

by Naman Arora | January 9, 2025 | Critical Care, Endocrinology, Featured, Grand Round Summaries, Infectious Disease, Recently Featured | 0 Comments

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of...

Delirium revisited

by Simranjeet Singh | October 31, 2024 | Featured, Geriatrics, Grand Round Summaries, Infectious Disease, Recently Featured | 0 Comments

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,...

By the Hammer of Thora: Pleural Effusions in the ED (part 1)

by Alie Wudwud | August 15, 2024 | Anesthesiology, Cardiothoracic Surgery, Critical Care, Featured, Grand Round Summaries, Infectious Disease, Recently Featured, Respirology, Resuscitation | 0 Comments

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and unclear. This is largely due to the lack of guidelines around pleural effusions in the ED. In this post, I’ve tried to highlight some key information about an approach to...

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!

Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED

by emottawa | Nov 14, 2016

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 2/5 Zemek R, et al. JAMA. 2016 Mar 8;315(10):1014-25. Full Article Editorial: Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms. Babcock L, et al....

What We Know About Lyme Disease.

by emottawa | Nov 11, 2016

Relative to its incidence and prevalence, Lyme disease has gathered a tremendous amount of attention, particularly in the last decade or so. This can be attributed, in part, to the perceived difficulty in properly diagnosing and treating the disease. However,...

Direct versus Video Laryngoscopy: Are they just as good?

by emottawa | Nov 10, 2016

Did we get your attention? Good! This is one of the areas in Acute and Critical Care Medicine which is highly controversial. This post is a desire to explore the topic after this very interesting article below came out. I hope to get some feedback but please keep it...

Double-Blind Prospective Randomized Controlled Trial of Dopamine Versus Epinephrine as First-Line Vasoactive Drugs in Pediatric Septic Shock

by emottawa | Nov 7, 2016

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3/5 Ventura AMC, et al. Crit Care Med. 2015 Nov;43(11):2292-302 Abstract Link This well designed RCT demonstrated that in fluid refractory pediatric septic shock, dopamine is...

Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial

by emottawa | Oct 31, 2016

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2.5/5 Seirink JC et al. Lancet. 2016 Aug 13;388(10045):673-83. Abstract Link This is a multicenter randomized control trial of over a thousand trauma patients at five Level 1 trauma centres in western...

Ah, that feels better! The Use of Nerve Blocks in the ED.

by emottawa | Oct 25, 2016

The ability to administer peripheral nerve blocks in the ED has the potential to provide fast and direct analgesia with less systemic side effects compared to parenteral medications. When administered by an experienced provider, studies have shown that peripheral...

Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multi group, randomized control trial

by emottawa | Oct 24, 2016

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 3.5/5 Pathan SA, et al. Lancet. 2016 May 14;387(10032):1999-2007 Abstract Link Editorial: Non-steroidalanti-inflammatory drugs for renal colic Knoedler JJ, et al....

Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack

by emottawa | Oct 11, 2016

Journal Club Summary Methodology Score: 5/5 Usefulness Score: 3.5/5 Johnston SC, et al. N Engl J Med. 2016 Jul 7;375(1):35-43. Full Article This large international double-blind double-dummy RCT across 33 countries and including 13,199 patients...

Randomized comparison of intravenous procainamide vs. intravenous amiodarone for the acute treatment of tolerated wide QRS tachycardia: the PROCAMIO study

by emottawa | Oct 3, 2016

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 3/5 Ortiz M, et al. Eur Heart J. 2016 Jun 28. pii: ehw230. [Epub ahead of print] Full Article This RCT of patients with tolerated wide complex tachycardia found that IV Procainamide...