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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...

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,...

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...

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...

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....

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...

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...

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!

Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack

by emottawa | Dec 15, 2012

Journal Club Summary Landmark Series Methodology Score: 4/5 Usefulness Score: 4/5 Perry JJ, Sharma M, Sivilotti ML, Sutherland J, Symington C, Worster A, Émond M, Stotts G, Jin AY, Oczkowski WJ, Sahlas DJ, Murray HE, MacKey A, Verreault...

Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration

by emottawa | Nov 23, 2012

Journal Club Summary Methodology: 3.5/5 Usefulness: 4/5 Ramachandran SK, Cosnowski A, Shanks A, Turner CR. J Clin Anesth. 2010 May;22(3):164-8. PubMed Link This RCT of 30 obese adult male patients receiving either 5L of O2 via NP or no O2 during...

One-Hour Rule-out and Rule-in of Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin T.

by emottawa | Nov 15, 2012

Journal Club Summary Methodology: 2.5/5 Usefulness: 3.5/5 Reichlin T, Schindler C, Drexler B, et al. Arch Intern Med. 2012 Sep 10;172(16):1211-8. Abstract Link This study was a prospective, multicenter derivation and internal validation of a...

Emergency Cricothyroidotomy: A Randomized Crossover Trial Comparing Percutaneous Techniques: Classic Needle First Versus “Incision First”

by emottawa | Nov 6, 2012

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Kanji H, Thirsk W, Dong S, Szava-Kovats M, Villa-Roel C, Singh M, Rowe BH. Acad Emerg Med. 2012 Sep;19(9):E1061-E1067. Article Link This was a randomized crossover trial...

Accuracy of single-pass whole-body computed tomography for detection of injuries in patients with major blunt trauma

by emottawa | Oct 29, 2012

Journal Club Summary Methodology: 3/5 Usefulness: 3/5 Stengel D, Ottersbach C, Matthes G, Weigeldt M, Grundei S, Rademacher G, Tittel A, Mutze S, Ekkernkamp A, Frank M, Schmucker U, Seifert J. CMAJ. 2012 May 15;184(8):869-76. Article Link In...

Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis

by EMOttawa | Oct 23, 2012

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 De Backer D, Aldecoa C, Njimi H, Vincent JL. Crit Care Med. 2012 Mar;40(3):725-30. Article Link This meta-analysis of 6 trials found that in patients with septic shock, dopamine administration was...

Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction

by emottawa | Oct 15, 2012

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Smith SW, Khalil A, Henry TD, Rosas M, Chang RJ, Heller K, Scharrer E, Ghorashi M, Pearce LA. Ann Emerg Med. 2012 Jul;60(1):45-56.e2. Epub 2012 Apr 19. Pub Med Link This retrospective cohort study of...

Performance of 4 clinical decision rules in the diagnostic management of acute pulmonary embolism: a prospective cohort study

by emottawa | Oct 4, 2012

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 3/5 Douma RA, Mos IC, et al. Prometheus Study Group. Article Link This European study directly compared four clinical decision rules in combination with d-dimer testing to exclude PE without the need for...

Association Between helicopter vs Ground Emergency Medical Services and Survival for Adult with Major Trauma

by emottawa | Sep 24, 2012

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2.5/5 Galvagno SM Jr, Haut ER, Zafar SN, Millin MG, Efron DT, Koenig GJ Jr, Baker SP, Bowman SM, Pronovost PJ, Haider AH. JAMA 2012 Apr 18;307(15):1602-10. Article Link This...

The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis.

by emottawa | Sep 18, 2012

Journal Club Summary Landmark Series Quant EC, et. al 2009;339:b3354. Methods: 4/5 Usefulness: 4/5 Article Link This high quality meta-analysis demonstrated that the addition of antivirals to steroids did not result in any additional benefit in achieving at least...

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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.