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!
Another stroke update! (Last one! For now..)
Ischemic stroke and Transient Ischemic Attack have been a vigorously studied subject, particularly in the past few years. With numerous updates and recommendations, we will provide an updated guide for Emergency Physicians in regards to ischemic stroke...
Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial.
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al. Lancet. 2015 Mar 14;385(9972):947-55 Full Article This was a cluster-randomized, pragmatic trial looking at mechanical CPR with the LUCAS-2 device versus...
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.
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!
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
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
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!
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?
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
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 !
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...
