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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...

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...

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....

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...

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,...

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...

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...

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,...

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!

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...

Albumin replacement in patients with severe sepsis or septic shock

by emottawa | Sep 22, 2014

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Caironi P, Tognoni G, et al. the ALBIOS Study Investigators. N Engl J Med. 2014 Mar 18. Abstract Link This was an open-label RCT of 1,800 ICU patients with severe sepsis or septic...

Impact Factors for Emergency Medicine and Other Popular Journals

by emottawa | Sep 17, 2014

The impact factor (IF) of scientific journal reflects the average number of citations to recent articles published in the journal. It is used as a proxy for the relative importance of a journal, with journals with higher impact factors deemed to be more important...

Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies

by emottawa | Sep 15, 2014

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 2/5 Verhaegen J, Gallos ID, van Mello NM, Abdel-Aziz M, Takwoingi Y, Harb H, Deeks JJ, Mol BW, Coomarasamy A BMJ. 2012 Sep 27;345:e6077 Article Link This thorough and well performed...

Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial

by emottawa | Sep 8, 2014

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3.5/5 Aujesky D, et al. Lancet. 2011 Jul 2;378(9785):41-8. Abstract Link This open label, randomized, un-blinded, multi-centered trial compared inpatient vs. outpatient treatment of low-risk PE showed...

Fever Control Using External Cooling in Septic Shock: A Randomized Controlled Trial

by emottawa | Sep 1, 2014

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2/5 Schortgen F, et al. Am J Respir Crit Care Med. 2012 May 15;185(10):1088-95 Full Article This randomized, non-blinded trial found in an ICU population that external cooling in...

A Randomized Trial of Colchicine for Acute Pericarditis

by EMOttawa | Aug 26, 2014

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4.5/5 Imazio M, et al. ICAP Investigators. N Engl J Med. 2013 Oct 17;369(16):1522-8. Article Link This multicentre double-blind RCT found that a 3 month course of low-dose...

Sensitivity of Bedside Ultrasound and Supine Anteroposterior Chest Radiographs for the Identification of Pneumothorax After Blunt Trauma

by emottawa | Aug 18, 2014

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4/5 Wilkerson RG, Stone MB. Acad Emerg Med. 2010 Jan;17(1):11-7. Article Link   This evidence-based literature review of four prospective observational studies...

Red flags to screen for malignancy and fracture in patients with low back pain: systematic review

by emottawa | Aug 11, 2014

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Downie A, et al. BMJ 2013;347:f7095 Article Link This Cochrane review of the diagnostic accuracy of red flags for fracture or malignancy in patients with low back pain in multiple...

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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.