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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,...

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...

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...

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...

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...

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...

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...

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....

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...

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!

Entrustable Professional Activities: Making Sense of the Emergency Medicine Milestones.

by emottawa | May 22, 2015

Journal Club Summary Methodology: n/a (concept paper) Usefulness: 4/5 Beeson MS, Warrington S, Bradford-Saffles A, Hart D. J Emerg Med 2014;47(4):441–52. Abstract Link In this concept paper, the authors propose that Entrustable Professional Activities (EPAs) can be...

Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials.

by emottawa | May 19, 2015

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 Ruff CT, et al. Lancet. 2014 Mar 15;383(9921):955-62. Abstract Link This systematic review comparing New Oral Anticoagulants (NOACs) to warfarin for patients with atrial fibrillation found...

Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis

by emottawa | May 11, 2015

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4/5 Smith-Bindman R, et al. N Engl J Med. 2014 Sep 18;371(12):1100-10. Full Article This multicentre randomized trial of over 2700 patients with suspected nephrolithiasis...

Clinical and safety outcomes associated with treatment of acute venous thromboembolism: a systematic review and meta-analysis

by emottawa | May 4, 2015

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3.5/5 Castellucci LA, et al. JAMA. 2014 Sep 17;312(11):1122-35. Full Article This network meta-analysis comparing the efficacy and safety outcomes associated with 8 anticoagulation options...

Comparison of the “real-life” diagnostic value of two recently published electrocardiogram methods for the differential diagnosis of wide QRS complex tachycardias

by emottawa | Apr 27, 2015

Journal Club summary Methodology Score: 2/5 Usefulness Score: 2/5 Szelényi Z, et al. Acad Emerg Med. 2013 Nov;20(11):1121-30. Abstract Link This retrospective cohort study found that the Vereckei algorithm for differentiating between VT and SVT...

Antiemetic Use for Nausea and Vomiting in Adult Emergency Department Patients: Randomized Controlled Trial Comparing Ondansetron, Metoclopramide, and Placebo

by emottawa | Apr 20, 2015

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Egerton-Warburton D, Meek R, Mee MJ, Braitberg G. Ann Emerg Med. 2014 May 9. pii: S0196-0644(14)00223-6. Abstract Link This prospective placebo-controlled trial found that...

Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): a multicentre, double-blind, placebo-controlled, randomised trial.

by emottawa | Apr 13, 2015

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Imazio M, et al. Lancet. 2014 Jun 28;383(9936):2232-7. Abstract Link This randomized double-blind placebo-controlled trial of colchicine in addition to usual anti-inflammatory...

Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone–the STONE score: retrospective and prospective observational cohort studies.

by emottawa | Apr 6, 2015

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2/5 Moore CL, Bomann S, Daniels B, Luty S, Molinaro A, Singh D, Gross CP. BMJ. 2014 Mar 26;348:g2191. Full Article This study derived and validated an objective clinical prediction...

Goal-directed resuscitation for patients with early septic shock.

by emottawa | Apr 1, 2015

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 5/5 ARISE Investigators and the ANZICS Clinical Trials Group. N Engl J Med. 2014 Oct 16;371(16):1496-506 Abstract Link ARISE was a multicenter, international ED...

Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries

by emottawa | Feb 16, 2015

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Boutis K, et al. CMAJ. 2013 Oct 15;185(15):E731-8 Full Article This multicenter implementation study of a pediatric Low Risk Ankle Rule demonstrated an initial and sustained 20% decrease in...

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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.