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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...

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...

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...

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...

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,...

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...

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!

Low-dose ketamine improves pain relief in patients receiving intravenous opioids for acute pain in the emergency department: results of a randomized, double-blind, clinical trial.

by EMOttawa | Mar 7, 2016

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3.5/5 Beaudoin FL, et al. Acad Emerg Med. 2014 Nov;21(11):1193-202 Full Article This pilot, double blind, placebo-controlled, randomized trial demonstrates that ketamine at...

To ‘Roid or not to ‘Roid: Steroids in the ED!

by emottawa | Mar 1, 2016

Steroids have been used in medicine for their immune-modulating effects for decades, but how much of their use is actually evidence based? Here we review the most recent literature for their use in four select presentations often seen in the Emergency...

Randomized Trial of Apneic Oxygenation during Endotracheal Intubation of the Critically Ill

by emottawa | Feb 29, 2016

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 3/5 Semler MW, et al. Am J Respir Crit Care Med. 2015 Oct 1. [Epub ahead of print] Abstract Link This randomized, open-label, pragmatic trial of 150 adults undergoing intubation in a medical...

High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure

by emottawa | Feb 16, 2016

Journal Club Summary: Methodology Score: 4/5 Usefulness Score: 4/5 Frat JP, et al. N Engl J Med. 2015 Jun 4;372(23):2185-96. Full Article Editorial: Saving lives with high-flow nasal oxygen Matthay MA. N Engl J Med. 2015 Jun 4;372(23):2225-6....

Novel Migraine Therapies!

by emottawa | Feb 15, 2016

For those of us who work in the Emergency Department, we are very well versed in migraine management. We see these patients frequently, and typically don't hesitate to utilize our typical maxeran/toradol/fluids combo, as it is typically very effective. But what if...

Spinal Immobilization: Just a pain in the neck?

by emottawa | Feb 11, 2016

The principles behind spinal immobilization, including the utilization of backboards and cervical collars was derived from expert opinion in the 1960's [1-3], and has never been subjected to a randomized controlled trial or high quality observational...

A Systematic Review and Meta-analysis of D-dimer as a Rule-out Test for Suspected Acute Aortic Dissection

by emottawa | Feb 8, 2016

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 !

by emottawa | Feb 4, 2016

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

by emottawa | Feb 1, 2016

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

by emottawa | Jan 25, 2016

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...

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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.