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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...

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...

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...

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...

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,...

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...

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,...

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....

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!

Ability of emergency ultrasonography to detect pediatric skull fractures: a prospective, observational study

by emottawa | Jul 29, 2013

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Parri N, Crosby BJ, Glass C, Mannelli F, Sforzi I, Schiavone R, Ban KM. J Emerg Med. 2013 Jan;44(1):135-41. Article Link This single center prospective study of 55...

Epinephrine and Dexamethasone in Children with Bronchiolitis

by emottawa | Jul 22, 2013

() Journal Club Summary Landmark Series Methodology Score: 4.5/5 Usefulness Score: 4/5 Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S, Bhatt M, Joubert G, Black KJ, Turner T, Whitehouse S, Klassen TP; Pediatric Emergency Research Canada...

Meta-analysis: nonsteroidal anti-inflammatory drugs in Biliary Colic

by emottawa | Apr 29, 2013

Journal Club Summary Methodology: 4/5 Usefulness: 2/5 Colli A, Conte D, Valle SD, Sciola V, Fraquelli M. Aliment Pharmacol Ther. 2012 Jun;35(12):1370-8 Abstract Link This meta-analysis of 11 RCTs found that in patients with biliary colic, NSAIDs had a higher...

Azithromycin and the Risk of Cardiovascular Death

by emottawa | Apr 25, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 1.5/5 Ray WA, Murray KT, Hall K, Arbogast PG, Stein CM. N Engl J Med. 2012 May 17;366(20):1881-90 Article Link This retrospective cohort study found that there was a slight increased risk of cardiovascular...

Predictive accuracy of ST depression during rapid atrial fibrillation on the presence of obstructive coronary artery disease

by emottawa | Apr 15, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 3/5 Pradhan R, Chaudhary A, Donato AA. Am J Emerg Med. 2012 Sep;30(7):1042-7 Abstract Link This was a retrospective cohort study of 127 patients that found no association between ST depression during rapid...

Prognostic value of plasma lactate levels among patients with acute pulmonary embolism: the thrombo-embolism lactate outcome study

by emottawa | Apr 8, 2013

Journal Club Summary Prognostic value of plasma lactate levels among patients with acute pulmonary embolism: the thrombo-embolism lactate outcome study Methodology: 3/5 Usefulness: 2/5 Vanni S, Viviani G, Baioni M, Pepe G, Nazerian P, Socci F, Bartolucci M,...

Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis

by EMOttawa | Apr 4, 2013

Journal Club Summary Methodology: 3.5/5 Usefulness: 4/5 Hüpfl M, Selig HF, Nagele P. Lancet. 2010 Nov 6;376(9752):1552-7. Article Link This meta-analysis evaluated if dispatcher-assisted chest compression-only CPR was superior to standard CPR for citizen...

Ticagrelor versus clopidogrel in patients with acute coronary syndromes

by EMOttawa | Mar 26, 2013

Journal Club Summary Landmark Series Methodology: 4.5/5 Usefulness: 4.5/5 Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, Horrow J, Husted S, James S, Katus H, Mahaffey KW, Scirica BM, Skene A, Steg PG, Storey RF, Harrington RA; PLATO...

Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial

by emottawa | Mar 19, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 1/5 McMillan AM, Landorf KB, Gilheany MF, Bird AR, Morrow AD, Menz HB. BMJ. 2012 May 22;344:e3260. Article Link This double-blind RCT found that there was a reduction in a 100-point pain score at 4...

Low-Dose Abdominal CT for Evaluating Suspected Appendicitis

by emottawa | Mar 12, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 3/5 Kim K, Kim YH, Kim SY, Kim S, Lee YJ, Kim KP, Lee HS, Ahn S, Kim T, Hwang SS, Song KJ, Kang SB, Kim DW, Park SH, Lee KH. N Engl J Med. 2012 Apr 26;366(17):1596-605 Article Link This...

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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.