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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...

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...

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...

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,...

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...

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,...

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!

A 2-Hour Diagnostic Protocol for Possible Cardiac Chest Pain in the Emergency Department

by emottawa | Jan 27, 2014

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3/5 Than M, Aldous S, Lord SJ, Goodacre S, Frampton CM, Troughton R, George P, Florkowski CM, Ardagh M, Smyth D, Jardine DL, Peacock WF, Young J, Hamilton G, Deely JM, Cullen L,...

Clinical Decision Rules to Rule Out Subarachnoid Hemorrhage for Acute Headache

by emottawa | Jan 20, 2014

Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4/5 Perry JJ, Stiell IG, Sivilotti ML, Bullard MJ, Hohl CM, Sutherland J, Émond M, Worster A, Lee JS, Mackey D, Pauls M, Lesiuk H, Symington C, Wells GA. JAMA....

Vasopressin, Steroids, and Epinephrine and Neurologically Favorable Survival After In-Hospital Cardiac Arrest A Randomized Clinical Trial

by emottawa | Jan 13, 2014

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 2.5/5 Mentzelopoulos SD, et al. JAMA. 2013;310(3):270-279. Article Link This randomized, multi-centered, double blind, placebo controlled trial compared vasopressin, steroids and...

Comparison of dopamine and norepinephrine in the treatment of shock.

by EMOttawa | Jan 6, 2014

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4/5 De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL; SOAP II Investigators. N Engl J Med. 2010 Mar...

Short-term vs Conventional Glucocorticoid Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: the REDUCE randomized clinical trial

by emottawa | Dec 23, 2013

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3.5/5 Leuppi JD, Schuetz P, Bingisser R, Bodmer M, Briel M, Drescher T, et al. JAMA. 2013 Jun 5;309(21):2223-31 Article Link This multicentre, Swiss-based RCT adds to the literature that...

How Do I Perform a Lumbar Puncture and Analyze the Results to Diagnose Bacterial Meningitis?

by emottawa | Dec 16, 2013

Journal Club Summary Landmark Article Series - UPDATE Methodology Score: 2.5/5 Usefulness Score: 4/5 Straus SE, Thorpe KE, Holroyd-Leduc J. JAMA. 2006 Oct 25;296(16):2012-22. Article Link This overview article from the JAMA Rational Clinical Exam...

A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospective observational validation study

by emottawa | Dec 9, 2013

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Than M, Cullen L, Reid CM, Lim SH, Aldous S, Ardagh MW, et al. Lancet. 2011 Mar 26;377(9771):1077-84. Abstract Link This prospective multicentre cohort study attempted to validate...

Intravenous Droperidol or Olanzapine as an Adjunct to Midazolam for the Acutely Agitated Patient: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

by emottawa | Dec 2, 2013

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Chan EW, Taylor DM, Knott JC, Phillips GA, Castle DJ, Kong DC. Ann Emerg Med. 2013 Jan;61(1):72-81 Abstract Link This randomized, double-blind, double dummy study comparing...

Validation of the Simplified Motor Score in the Out-of-Hospital Setting for the Prediction of Outcomes After Traumatic Brain Injury

by emottawa | Nov 25, 2013

Journal Club Summary Methodology score: 3/5 Usefulness score: 2/5 Thompson DO, Hurtado TR, Liao MM, Byyny RL, Gravitz C, Haukoos JS. Ann Emerg Med. 2011 Nov;58(5):417-25 Article Link This retrospective registry study demonstrated poor performance of either the...

Hydroxyethyl Starch 130/0.42 versus Ringer’s Acetate in Severe Sepsis

by EMOttawa | Nov 18, 2013

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4.5/5 Perner A, et al.; 6S Trial Group; Scandinavian Critical Care Trials Group. N Engl J Med. 2012 Jul 12;367(2):124-34 Article Link This multi-centre, double-blind,...

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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.