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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...

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...

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....

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,...

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...

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,...

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...

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!

Prospective multicenter evaluation of the pulmonary embolism rule-out criteria

by emottawa | Dec 1, 2014

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4.5/5 Kline JA, et al. J Thromb Haemost. 2008 May;6(5):772-80. Full Article In this prospective multicenter validation study, the PERC rule was found to have a sensitivity of 97.4% (CI...

2014 Canadian Guidelines for AF Management: Part 3: Unstable Patients with AF

by emottawa | Nov 24, 2014

We continue to discuss the latest recommendations for ED management of atrial fibrillation (AF) as presented in the newly published 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. The Guidelines PDF can...

Family presence during cardiopulmonary resuscitation

by emottawa | Nov 17, 2014

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3.5/5 Jabre P, et al. N Engl J Med. 2013 Mar 14;368(11):1008-18 Article Link This out of hospital, French randomized controlled trial found that when family members were given the option of viewing ongoing...

Safety and efficiency of a chest pain diagnostic algorithm with selective outpatient stress testing for emergency department patients with potential ischemic chest pain

by emottawa | Nov 12, 2014

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Scheuermeyer FX, Innes G, Grafstein E, Kiess M, Boychuk B, Yu E, Kalla D, Christenson J. Ann Emerg Med. 2012 Apr;59(4):256-264.e3. Abstract Link This prospective single-centre...

Hydrocortisone therapy for patients with septic shock

by emottawa | Nov 3, 2014

Journal Club Summary Landmark Series Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Sprung CL, et al. CORTICUS Study Group. N Engl J Med. 2008 Jan 10;358(2):111-24 Article Link This Multicenter, double-blind, parallel-group, placebo-controlled RCT...

A randomized trial of protocol-based care for early septic shock

by emottawa | Oct 27, 2014

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4/5 ProCESS Investigators N Engl J Med. 2014 May 1;370(18):1683-93. Abstract Link This large multicentre U.S. RCT of 1341 septic patients found no significant differences in mortality...

Lorazepam vs diazepam for pediatric status epilepticus: a randomized clinical trial

by emottawa | Oct 20, 2014

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2.5/5 Chamberlain JM, et al; Pediatric Emergency Care Applied Research Network (PECARN). JAMA.2014 Apr 23-30;311(16):1652-60. doi: 10.1001/jama.2014.2625. Full Article This double-blind, multi-center,...

2014 Canadian Guidelines for AF Management: Part 2: ED Algorithm and Risk Stratification for Stroke

by emottawa | Oct 14, 2014

2014 Canadian Guidelines for AF Management: Part 1: Introduction and CCS “CHADS-65” Algorithm

by emottawa | Oct 6, 2014

In this and subsequent postings we will discuss the latest recommendations for ED management of atrial fibrillation (AF) as presented in the newly published 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial...

Short-term vs Conventional Glucocorticoid Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease The REDUCE Randomized Clinical Trial

by emottawa | Sep 30, 2014

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Leuppi JD, et al. JAMA. 2013 Jun 5;309(21):2223-31. Article Link This multicenter, double blinded trial demonstrated non-inferiority of a 5-day course of 40mg prednisone versus a...

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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.