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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,...

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...

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

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...

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...

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...

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...

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!

Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial

by EMOttawa | Oct 26, 2015

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2/5 Motov S, Rockoff B, Cohen V, et al. Ann Emerg Med. 2015 Mar 26. pii: S0196-0644(15)00191-2. Abstract Link This prospective, RCT found sub-dissociative ketamine (0.3mg/kg) and...

Randomized assessment of rapid endovascular treatment of ischemic stroke

by emottawa | Oct 20, 2015

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Goyal M, Demchuk AM, Menon BK, et al. N Engl J Med. 2015 Mar 12;372(11):1019-30 Full Article This multi-centre open label RCT compared endovascular treatment +/- tPA vs. standard...

Emerging drugs of abuse!

by emottawa | Oct 16, 2015

This isn't your parent's marijuana, thats for sure. As we continue to develop as a species, individuals are continuously attempting to develop newer and greater drug highs. As a result, the toxicologic world is continuously expanding, and in Emergency Medicine...

Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.

by emottawa | Oct 12, 2015

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3.5/5 Holcomb JB, Tilley BC, Baraniuk S, et al. JAMA. 2015 Feb 3;313(5):471-82. Full Article This prospective multicenter randomized control trial found that there was no statistically...

Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: prospective cohort study

by emottawa | Oct 5, 2015

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4.5/5 Perry, Jeffrey J. et al. Full Article This prospective observational cohort study identified a cutoff as 2000 x 106/L RBC on the final CSF tube and no xanthochromia as a...

A Randomized Trial of Icatibant in ACE-Inhibitor–Induced Angioedema

by emottawa | Sep 28, 2015

Journal Club Summary Methodology Score: 1.5/5 Usefulness Score: 1/5 Baş M, Greve J, Stelter K, et al. N Engl J Med. 2015 Jan 29;372(5):418-25 Full Article This small phase 2, multicenter, double blind randomized trial of 30 ED patients found a...

Association of Pyuria and Clinical Characteristics With the Presence of Urinary Tract Infection Among Patients With Acute Nephrolithiasis

by emottawa | Sep 21, 2015

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Abrahamian FM, Krishnadasan A, Mower WR, et al. Ann Emerg Med. 2013 Nov;62(5):526-33. Abstract Link Pyuria alone cannot be used to determine if UTI is present in patients with...

Opioid Alternatives in Acute Severe Pain

by emottawa | Sep 17, 2015

The ED patient in acute severe pain can be a challenge to treat. Even when we prescribe opioids appropriately (which is less often than you think), patient contraindications, side effects, and a poor analgesic response may limit their use. There is lots of new...

Intensive blood pressure reduction in acute intracerebral haemorrhage: a meta-analysis

by emottawa | Sep 7, 2015

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3/5 Tsivgoulis G, Katsanos AH, Butcher KS, et al. Neurology. 2014 Oct 21;83(17):1523-9 Abstract Link This systematic review and meta-analysis of 4 RCTs found that mortality rates...

Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial.

by emottawa | Aug 31, 2015

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Blum CA, Nigro N Briel M, et al. Lancet. 2015 Jan 16. pii: S0140-6736(14)62447-8. Abstract Link This randomized, double-blinded, placebo-controlled trial demonstrated an improved time to ‘clinical...

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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.