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!
By the Hammer of Thora: Pleural Effusions in the ED (part 1)
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...
Rotating Around the Cuff of Shoulder Injuries
Shoulder injuries are a common yet complex presentation in emergency medicine, presenting a unique challenge due to the intricate anatomy and diverse range of potential pathologies, where imaging may not always be helpful. In this post, we will explore the various...
Is Shift Work Shortening your Life?
Social media headlines and evolving literature have highlighted the abysmal life expectancy of emergency room doctors. For example, Dr. Ken Milne, the creator behind The Skeptics Guide to Emergency Medicine, recently shared this post on sobering life-expectancy data...
Invasive Group A Strep (iGAS).. It’s Backkkkk (Part 2)
In case you missed it, in part 1 of this series, Dr. Zworth discussed the increasing prevalence of invasive Group A Strep (iGAS), the mounting public health concern, recognition, and diagnosis. In this post, we focus on management, the treatment of (strep)...
Invasive Group A Strep (iGAS).. It’s Backkkk (Part 1)
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....
Drugs: the problem, the solution, the interactions!
We all know medications can help us feel better and stay healthy but as we are all familiar, sometimes drug interactions can be overlooked and cause significant adverse health outcomes. Drug interactions are common clinical problems that can occur in several different...
Spinal Immobilization: a Twisted Tale
For decades, "spinal immobilization", or spinal motion restriction (SMR) using backboards and cervical collars has been a "cornerstone of EMS protocols, aimed at minimizing secondary spinal cord injuries during trauma patient management. Originating in the 1960s, this...
Comparing the efficacy of intravenous morphine versus ibuprofen or the combination of ibuprofen and acetaminophen in patients with closed limb fractures: a randomized clinical trial
Methodology: 3.5/5 Usefulness: 2/5 Nasr Isfahani M, et al. BMC Emerg Med. 2024 Jan 25;24(1):15. Question and Methods: This triple blinded RCT of 158 patients with isolated closed limb fractures assessed pain scores at 1-hour following the administration of...
A Rolling Stone Without a Home: Bouveret Syndrome on PoCUS
This case report demonstrates the utility of point-of-care ultrasound (POCUS) to identify complicated gallbladder disease. In this case, the patient presented with abdominal pain and a known history of cholelithiasis. POCUS demonstrated signs of small bowel...
Ketamine Compared With Morphine for Out-of-Hospital Analgesia for Patients With Traumatic Pain: A Randomized Clinical Trial
Methodology: 3/5 Usefulness: 1.5/5 Le Cornec C, e al. JAMA Netw Open. 2024 Jan 2;7(1):e2352844. Question and Methods: This was a multicenter, single-blind, noninferiority RCT, to assess the noninferiority of intravenous ketamine vs intravenous morphine for pain...