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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,...

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...

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...

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...

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...

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....

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...

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...

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!

Development and validation of a prioritization rule for obtaining an immediate 12-lead electrocardiogram in the emergency department to identify ST-elevation myocardial infarction

by emottawa | Mar 4, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 3/5 Glickman SW, Shofer FS, Wu MC, Scholer MJ, Ndubuizu A, Peterson ED, Granger CB, Cairns CB, Glickman LT. Am Heart J. 2012 Mar;163(3):372-82 Abstract Link This retrospective derivation of an electrocardiogram...

Accuracy and Quality of Clinical Decision Rules for Syncope in the Emergency Department: A Systematic Review and Meta-analysis

by emottawa | Feb 27, 2013

Journal Club Summary Methodology: 4/5 Usefulness: 2.5/5 Serrano LA, Hess EP, Bellolio MF, Murad MH, Montori VM, Erwin PJ, Decker WW. Ann Emerg Med. 2010 Oct;56(4):362-373 Abstract Link This systematic review and meta-analysis of multiple clinical...

Randomized clinical trial of antibiotics in acute uncomplicated Diverticulitis

by emottawa | Feb 18, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 3/5 Chabok A, Påhlman L, Hjern F, Haapaniemi S, Smedh K; AVOD Study Group. Br J Surg. 2012 Apr;99(4):532-9 Article Link An open label multicenter RCT from Sweden comparing usual antibiotic treatment versus no...

Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial

by emottawa | Feb 12, 2013

Journal Club Summary Methodology: 4/5 Usefulness: 3/5 Andolfatto G, Abu-Laban RB, Zed PJ, Staniforth SM, Stackhouse S, Moadebi S, Willman E. Ann Emerg Med. 2012 Jun;59(6):504-12.e1-2. Abstract Link This double-blind, randomized trial found that Ketofol does not...

The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis

by emottawa | Feb 4, 2013

Journal Club Summary Methodology: 1/5 Usefulness: 3/5 Marik PE, Flemmer M, Harrison W. Crit Care Med. 2012 Aug;40(8):2479-85 Pub Med Link This systematic review and meta-analysis concluded that there is no significant difference in the rates of...

The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial

by emottawa | Jan 29, 2013

Journal Club Summary Methodology: 2.5/5 Usefulness: 2.5/5 IST-3 collaborative group, Sandercock P, Wardlaw JM, et al. Lancet. 2012 Jun 23;379(9834):2352-63. Article Link This international, multicenter, randomized, open-treatment trial was aimed at detecting...

CT angiography for safe discharge of patients with possible acute coronary syndromes

by emottawa | Jan 21, 2013

Journal Club Summary Methodology: 4/5 Usefulness: 2/5 Litt HI, Gatsonis C, Snyder B, Singh H, Miller CD, Entrikin DW, Leaming JM, Gavin LJ, Pacella CB, Hollander JE. New England Journal of Medicine, 2012 Apr 12;366(15):1393-403. Article Link This...

A randomized trial of tenecteplase versus alteplase for acute ischemic stroke

by emottawa | Jan 14, 2013

Journal Club Summary Methodology: 3/5 Usefulness: 3/5 Parsons M, Spratt N, Bivard A, Campbell B, Chung K, Miteff F, O'Brien B, Bladin C, McElduff P, Allen C, Bateman G, Donnan G, Davis S, Levi C. N Engl J Med. 2012 Mar 22;366(12):1099-107. Article...

Clinical decision rules for adults with minor head injury: a systematic review

by emottawa | Jan 9, 2013

Journal Club Summary Methodology: 3.5/5 Usefulness: 4/5 Harnan SE, Pickering A, Pandor A, Goodacre SW. J Trauma. 2011 Jul;71(1):245-51 PubMed Link This systematic review compared the diagnostic accuracies of clinical decision rules for adults...

Hydroxyethyl starch or saline for fluid resuscitation in intensive care

by EMOttawa | Dec 19, 2012

Journal Club Summary Methodology: 4/5 Usefulness: 3.5/5 Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, Glass P, Lipman J, Liu B, McArthur C, McGuinness S, Rajbhandari D, Taylor CB, Webb SA; CHEST Investigators; Australian and New Zealand Intensive Care...

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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.