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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,...

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...

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....

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...

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...

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...

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...

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...

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,...

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...

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!

Sublingual buprenorphine in acute pain management: a double-blind randomized clinical trial

by emottawa | Jul 3, 2012

Journal Club Summary Methodology: 3.5/5 Usefulness: 2/5 Jalili M, Fathi M, Moradi-Lakeh M, Zehtabchi S. Ann Emerg Med. 2012 Apr;59(4):276-80. PubMed Link This double blind, double dummy RCT compared sublingual Buprenorphine (0.4 mg) to IV Morphine (5 mg) for...

Four sensitive screening tools to detect cognitive dysfunction in geriatric emergency department patients: brief alzheimer’s screen, short blessed test, Ottawa 3DY and the caregiver-completed AD8

by emottawa | Jun 27, 2012

Journal Club Summary Methodology: 3.5 Usefulness: 3.5 Carpenter CR, Bassett ER, Fischer GM, Shirshekan J, Galvin JE, Morris JC.   Acad Emerg Med 2011 April 18(4): 374-384.  Article Link  Trained research assistants administered cognitive dysfunction screening...

Induction of prehospital therapeutic hypothermia after resuscitation from nonventricular fibrillation cardiac arrest

by emottawa | Jun 19, 2012

Journal Club Summary Methodology: 2/5 Usefulness: 2/5 Bernard SA, Smith K, Cameron P, Masci K, Taylor DM, Cooper DJ, Kelly AM, Silvester W; Rapid Infusion of Cold Hartmanns Investigators. Crit Care Med. 2012 Mar;40(3):747-53. Pubmed Link This study looked at the...

Validation and Refinement of a Rule to Predict Emergency Intervention in Adult Trauma Patients

by emottawa | Jun 11, 2012

Journal Club Summary Methodology: 1.5/5 Usefulness: 2/5 Haukoos JS, Byyny RL, Erickson C, Paulson S, Hopkins E, Sasson C, Bender B, Gravitz CS, Vogel JA, Colwell CB, Moore EE. Ann Emerg Med. 2011 Aug;58(2):164-71. Article Link This retrospective validation of two...

Does This Patient Have a Severe Upper Gastrointestinal Bleed?

by emottawa | Jun 5, 2012

Journal Club Summary Methodology: 2.5/5 Usefulness: 2.5/5 Srygley FD, Gerardo CJ, Tran T, Fisher DA. JAMA. 2012 Mar 14;307(10):1072-9 Article Link This recent installment of JAMA’s Rational Clinical Examination series found that a history or physical exam...

Association Between Arterial Hyperoxia Following Resuscitation From Cardiac Arrest and In-Hospital Mortality

by EMOttawa | Jun 3, 2012

Journal Club Summary Methodology: 3/5 Usefulness: 4/5 Kilgannon JH, Jones AE, Shapiro NI, Angelos MG, Milcarek B, Hunter K, Parrillo JE, Trzeciak S; Emergency Medicine Shock Research Network (EMShockNet) Investigators. JAMA 2010 Jun 2;303(21):2165-71. Article...

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