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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...

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...

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...

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...

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...

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...

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...

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...

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,...

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!

Tips for Success in your Emergency Medicine Rotation

by Hans Rosenberg | Sep 5, 2016

Our wonderful medical students are preparing to start their first clinical rotations. With this in mind here are some of the top tips for success in your EM rotation 1) Be On Time – show up to your shifts on time, better yet 5 minutes early. That first impression...

High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study

by emottawa | Aug 22, 2016

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Shah, AS, et al. Lancet. 2015 Dec 19;386(10012):2481-8 Full Article Editorial:Myocardial infarction: rapid ruling out in the emergency room Cullen L, et al. Lancet. 2015 Dec...

Corticosteroid Therapy for Patients Hospitalized With Community- Acquired Pneumonia A Systematic Review and Meta-analysis

by emottawa | Aug 15, 2016

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3.5/5 Siemieniuk RA, et al. Ann Intern Med. 2015;163(7):519-528. Abstract Link This is a well-done systematic review & meta-analysis elucidating whether corticosteroid therapy...

Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis A Randomized Clinical Trial

by emottawa | Aug 8, 2016

Journal Club Methodology Score: 4.5/5 Usefulness Score: 4.5/5 Freedman, SB, et al. JAMA. 2016;315(18):1966-1974. Abstract Link This single centre, single blinded non-inferiority randomized controlled trial suggests that in children 6-60mo with...

ACHY BREAKY HEART: Risk Scores for Assessing Chest Pain in the ED

by emottawa | Aug 4, 2016

In order to help evaluate patients who present with chest pain many clinical chest pain scores have been developed. The aim of this post is to: Emergency Department (ED) physicians must assess and risk stratify patients presenting with chest pain nearly every shift....

Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy

by emottawa | Aug 1, 2016

Journal Club Summary Methodology: 2.2/5 Usefulness: 3/5 Laan DV,et al. Injury. 2016 Apr;47(4):797-804. Abstract Link This systematic review and meta-analysis has found that the 4th/5th intercostal space at the anterior axillary line has the lowest mean chest...

Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis

by emottawa | Jul 22, 2016

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2.7/5 Martindale JL, et al. Acad Emerg Med. 2016 Mar;23(3):223-42 Abstract Link In patients presenting to the ED with undifferentiated dyspnea and a moderate pre-test probability of...

#Reanimate16: What We Can Learn From Resuscitators Around the World?

by emottawa | Jul 15, 2016

Out-of-hospital cardiac arrest (OHCA) remains a major cause of mortality for which we rely on advanced cardiac life support (ACLS) guidelines to manage within the ED. However, when these guidelines fail, we are left with almost no additional options as lifesaving...

Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest

by emottawa | Jul 11, 2016

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Kudenchuk PJ, et al. N Engl J Med. 2016 May 5;374(18):1711-22. Abstract Link This double blind RCT conducted by the ROC enrolled >3000 patients with out of hospital shock refractory cardiac...

Are You Afraid of the Dark? Suboxone and Methadone in the ED

by emottawa | Jul 7, 2016

Although methadone and suboxone (buprenorphine/naloxone) have tremendous benefits in the management of opioid use disorder, unfamiliarity with these treatments can make any clinician uncomfortable and can lead to substandard care for these patients. This summary will...

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