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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...

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....

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...

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...

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...

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...

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...

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!

Meta-analysis of Usefulness of D-dimer to Diagnose Acute Aortic Dissection

by emottawa | Nov 11, 2013

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3/5 Shimony A, Filion KB, Mottillo S, Dourian T, Eisenberg MJ. Am J Cardiol. 2011 Apr 15;107(8):1227-34 Abstract Link This meta-analysis of seven studies shows a pooled sensitivity...

Lactate Clearance vs Central Venous Oxygen Saturation as Goals of Early Sepsis Therapy: a Randomized Clinical Trial

by emottawa | Nov 4, 2013

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Jones AE, Shapiro NI, Trzeciak S, Arnold RC, Claremont HA, Kline JA; Emergency Medicine Shock Research Network (EMShockNet) Investigators. JAMA. 2010 Feb 24;303(8):739-46. Article...

Transfusion Strategies for Acute Upper Gastrointestinal Bleeding

by EMOttawa | Oct 28, 2013

Journal Club Summary Landmark Series Methodology Score: 3.5/5 Usefulness Score: 4/5 Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E,...

Oral Dimenhydrinate versus Placebo in Children with Gastroenteritis: a Randomized Controlled Trial

by emottawa | Oct 21, 2013

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2/5 Gouin S, Vo TT, Roy M, Lebel D, Gravel J. Pediatrics. 2012 Jun;129(6):1050-5. Article Link This randomized, double-blinded, placebo-controlled trial of 144 children in Montreal...

Diuretic Strategies in Patients with Acute Decompensated Heart Failure

by emottawa | Oct 14, 2013

Journal Club Summary Methodology: 3.5/5 Usefulness: 2/5 Felker GM, et al. NHLBI Heart Failure Clinical Research Network. N Engl J Med. 2011 Mar 3;364(9):797-805 Article Link This double-blind double-dummy RCT (N=308) found that there was no difference in the patient...

Subclinical cerebral edema in children with diabetic ketoacidosis randomized to 2 different rehydration protocols

by emottawa | Sep 9, 2013

Journal Club Summary Methodology Score: 2/5 Usefulness Score: 2/5 Glaser NS, Wootton-Gorges SL, Buonocore MH, Tancredi DJ, Marcin JP, Caltagirone R, Lee Y, Murphy C, Kuppermann N. Pediatrics. 2013 Jan;131(1):e73-80 Abstract Link This pilot randomized controlled...

Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence

by EMOttawa | Sep 3, 2013

Journal Club Summary Landmark Article Series Methodology Score: 4.5/5 Usefulness Score: 4.5/5 Colman I, Friedman BW, Brown MD, Innes GD, Grafstein E, Roberts TE, Rowe BH. BMJ. 2008 Jun 14;336(7657):1359-61 Article Link In this well performed meta-analysis, a...

Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction

by emottawa | Aug 26, 2013

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Armstrong PW, et al. STREAM Investigative Team. N Engl J Med. 2013 Apr 11;368(15):1379-87 Abstract Link This open-label, prospective, randomized, parallel, comparative, international...

Moderate Pulmonary Embolism Treated With Thrombolysis (from the “MOPETT” Trial)

by emottawa | Aug 19, 2013

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 1.5/5 Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M; “MOPETT” Investigators. Am J Cardiol. 2013 Jan 15;111(2):273-7 Article Link This single-center, open label, randomized control...

Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial.

by emottawa | Aug 5, 2013

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 4/5 Boutis K, Willan A, Babyn P, Goeree R, Howard A. CMAJ. 2010 Oct 5;182(14):1507-12. Article Link This non-blinded, single-center RCT (N=96) of children aged 5-12 with minimally...

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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.