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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,...

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...

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...

Mechanical Ventilation Basics

by Cameron Leafloor | January 25, 2024 | Airway, Anesthesiology, cardiac arrest, Critical Care, Featured, Recently Featured, Respirology | 0 Comments

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,...

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...

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...

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...

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. We prepared the ED for the patient’s arrival....

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...

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...

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!

Post intubation analgesia and sedation in the ED

by emottawa | Jan 6, 2016

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

by emottawa | Jan 4, 2016

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.

by emottawa | Dec 21, 2015

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,...

Alcohol: Beyond the “Breakfast Plan”

by emottawa | Dec 18, 2015

Acute alcohol intoxication and alcoholism are two separate and unique entities that we see regularly in the emergency department. As ER physicians, our role for the acutely intoxicated patient should focus on ruling out life threatening disease and ensuring their...

Therapeutic hypothermia after out-of-hospital cardiac arrest in children

by emottawa | Dec 14, 2015

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Moler FW, Silverstein FS, Holubkov R, et al. N Engl J Med. 2015 May 14;372(20):1898-908. Full Article This prospective, multi-center RCT found no significant difference in...

Skin and Soft Tissue Infections in the ED

by emottawa | Dec 11, 2015

Cellulitis and erysipelas – collectively referred to as skin and soft tissue infections (SSTIs) – are a seemingly simple entity to manage. Yet the burden of SSTIs and the complexity of this disease process may surprise you! From 1997 to...

Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial.

by emottawa | Dec 7, 2015

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4.5/5 Appelboam A, Reuben A, Mann C, et al. Lancet. 2015 Aug 24. pii: S0140-6736(15)61485-4. Full Article The REVERT trial, a pragmatic, multicenter RCT evaluating the efficacy of a...

Prospective validation of a 1-hour algorithm to rule-out and rule-in acute myocardial infarction using a high-sensitivity cardiac troponin T assay

by emottawa | Nov 30, 2015

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Reichlin T, Twerenbold R, Wildi K, et al. CMAJ May 19, 2015 187:E243-E252; Full Article This multicenter study aiming to prospectively validate a 1 hour algorithm using a high sensitivity...

Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial

by emottawa | Nov 23, 2015

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4.5/5 Pecard R, Starr K, MacLennan G, Lam T, et al. Published Online May 19, 2015 http://dx.doi.org/10.1016/S0140-6736(15)60933-3 Full Article This high quality multicenter, randomized,...

Improving attendance at post-emergency department follow-up via automated text message appointment reminders: a randomized controlled trial

by emottawa | Nov 17, 2015

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3/5 Arora S, Burner E, Terp S, Nok Lam C, Nercisian A, Bhatt V, Menchine M. Acad Emerg Med. 2015 Jan;22(1):31-7. Full Article In this single-center, open label RCT of 374 patients, a per-protocol...

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World-Class Emergency Medicine: To provide outstanding compassionate emergency care through practice-changing research and innovative medical education. For more about our department, visit us at EMOttawa.