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!
Association of Pyuria and Clinical Characteristics With the Presence of Urinary Tract Infection Among Patients With Acute Nephrolithiasis
Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Abrahamian FM, Krishnadasan A, Mower WR, et al. Ann Emerg Med. 2013 Nov;62(5):526-33. Abstract Link Pyuria alone cannot be used to determine if UTI is present in patients with...
Opioid Alternatives in Acute Severe Pain
The ED patient in acute severe pain can be a challenge to treat. Even when we prescribe opioids appropriately (which is less often than you think), patient contraindications, side effects, and a poor analgesic response may limit their use. There is lots of new...
Intensive blood pressure reduction in acute intracerebral haemorrhage: a meta-analysis
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3/5 Tsivgoulis G, Katsanos AH, Butcher KS, et al. Neurology. 2014 Oct 21;83(17):1523-9 Abstract Link This systematic review and meta-analysis of 4 RCTs found that mortality rates...
Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial.
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Blum CA, Nigro N Briel M, et al. Lancet. 2015 Jan 16. pii: S0140-6736(14)62447-8. Abstract Link This randomized, double-blinded, placebo-controlled trial demonstrated an improved time to ‘clinical...
Platelets: who needs them?
Platelets: too much, too little, don't work. The approach to platelet emergencies is perhaps a little bit more complicated than that, so we attempt to breakdown a simplified approach to platelets in the Emergency Department (ED). Patients with various disease...
Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study
Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2/5 Nijman RG, et al. BMJ. 2013 Apr 2;346:f1706. Full Article This was a derivation, cross-validation, and external validation of a decision rule for the febrile pediatric patient to identify who is at...
Abdominal X-Rays: What’s the Point?
Undifferentiated abdominal pain; three words that give every Emergency Physician (EP) the shivers. Plain abdominal X-Ray’s (AXR) are a commonly ordered test in the Emergency Department (ED). Does the AXR play any role in the diagnostic workup of constipation? As CT...
Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial
Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2.5/5 Florin TA, Shaw KN, Kittick M, Yakscoe S, Zorc JJ. JAMA Pediatr. 2014Jul;168(7):664-70. Full Article This single-centre triple-blinded study compared nebulized 3% saline (hypertonic) to 0.9%...
Prehospital ticagrelor in ST-segment elevation myocardial infarction
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Montalescot G, van 't Hof AW, Lapostolle F, et al. for the ATLANTIC Investigators. N Engl J Med. 2014 Sep 11;371(11):1016-27. Full Article This corporate-sponsored international, multicenter, RCT...
Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 Orr SL, et al. Cephalalgia. 2014 May 29. http://www.ncbi.nlm.nih.gov/pubmed/24875925 This Canadian Headache Society guideline for ED management of acute migraine gave a strong...



