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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...

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...

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...

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...

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,...

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...

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...

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...

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!

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...

2014 Top Articles – by Drs. Stella Yiu and Jeff Freeman

by emottawa | Feb 13, 2015

Below is a fantastic list of the most relevant articles from 2014, some are practice changing, some will make you think and others remind you not to do things in the ED that don't help our patients. The list below was presented by Drs. Stella Yiu (@Stella_Yiu) and...

High versus Low Blood-Pressure Target in Patients with Septic Shock

by emottawa | Feb 9, 2015

Journal Club Summary Methodology Score: 4.5 Usefulness Score: 4.5 Asfar P, Meziani F, Hamel JF, Grelon F, Megarbane B, Anguel N, et al. for the SEPSISPAM Investigators. N Engl J Med. 2014 Apr 24;370(17):1583-93 Full Article This multi-centre,...

Antibiotic prophylaxis for mammalian bites

by emottawa | Feb 2, 2015

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Medeiros IM, Saconato H Cochrane Database Syst Rev2001:(2) Abstract Link This Cochrane Review by Medeiros and Saconato attempted to review the evidence surrounding prophylactic...

Does this patient with shoulder pain have rotator cuff disease?: The Rational Clinical Examination systematic review

by emottawa | Jan 26, 2015

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Hermans J, et al. JAMA. 2013 Aug 28;310(8):837-47. Abstract Link This systematic review of studies comparing clinical tests for rotator cuff disease with a diagnostic reference...

Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest The LINC Randomized Trial

by emottawa | Jan 19, 2015

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 2.5/5 Rubertsson S, Lindgren E, Smekal D, Östlund O, Silfverstolpe J, Lichtveld RA, Boomars R, Ahlstedt B, Skoog G, Kastberg R, Halliwell D, Box M, Herlitz J, Karlsten R. JAMA. 2014...

Ondansetron and the Risk of Cardiac Arrhythmias: A Systematic Review and Postmarketing Analysis

by emottawa | Jan 12, 2015

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2/5 Freedman SB, Uleryk E, Rumantir M, Finkelstein Y. Ann Emerg Med. 2014 Jul;64(1):19-25.e6. Article Link This retrospective review of adverse drug reaction (ADR) registries and...

Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage: A meta-analysis

by emottawa | Jan 5, 2015

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 3/5 Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, Kumbhani DJ, Mukherjee D, Jaff MR, Giri J. JAMA. 2014 Jun 18;311(23):2414-21. Article Link This...

Does This Adult Patient Have Septic Arthritis?

by emottawa | Dec 22, 2014

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 Margaretten ME, Kohlwes J, Moore D, Bent S. JAMA. 2007 Apr 4;297(13):1478-88. Abstract Link This 2007 systematic review found that (aside from specific clinical scenarios),...

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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.