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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...

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,...

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,...

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...

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. Watch the entire Grand Rounds here...

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...

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...

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...

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!

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...

Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage.

by EMOttawa | Sep 12, 2012

Journal Club Summary Landmark Series Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN, et al. N Engl J Med. 2008 May 15;358(20):21 27–37. Article Link This industry sponsored, international multicentre RCT involved 841 patients with acute ICH and found...

Hydrocortisone therapy for patients with septic shock.

by EMOttawa | Sep 3, 2012

Journal Club Summary Landmark Series Sprung CL, Annane D, Keh D, Moreno R, Singer M, Freivogel K, et al. N Engl J Med. 2008 Jan.10;358(2):111–24. Article Link This European multicentre RCT compared hydrocortisone to placebo for 499 ICU patients with septic shock and...

Does this adult patient have septic arthritis?

by emottawa | Aug 31, 2012

Journal Club Summary Landmark Series Margaretten ME, Kohlwes J, Moore D, Bent S. JAMA. 2007Apr.4;297(13):1478–88. Article Link This systematic overview from the excellent JAMA series reviewed the relatively weak evidence regarding assessment of patients with...

Randomized, Controlled Trial of Acetaminophen, Ibuprofen, and Codeine for Acute Pain Relief in Children With Musculoskeletal Trauma.

by EMOttawa | Aug 22, 2012

Journal Club Summary Landmark Series Clark E, Plint AC, Correll R, Gaboury I, Passi B. A Pediatrics. 20 07Mar.1;119(3):460–7. Article Link This high quality RCT by local investigators rigorously compared acetaminophen, ibuprofen and codeine analgesics among...

How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis?

by EMOttawa | Aug 14, 2012

Journal Club Summary Landmark Series Straus SE, Thorpe KE, Holroyd-Leduc J. JAMA. 2006Oct.25;296(16):2012–22. PubMed Link This systematic literature review and meta-analysis in the Rational Clinical Examination series found a non-significant trend towards less...

Safety and Efficacy of Hydromorphone as an Analgesic Alternative to Morphine in Acute Pain: A Randomized Clinical Trial

by emottawa | Aug 7, 2012

Journal Club Summary Landmark Series Andrew K Chang, Polly E Bijur, Robert H Meyer, Mark K Kenny, Clemencia Solorzano, and E John Gallagher PubMed Link This U.S. randomized trial in ED adults with severe pain found similar effectiveness for intravenous...

Laryngeal View During Laryngoscopy: A Randomized Trial Comparing Cricoid Pressure, Backward-Upward-Rightward Pressure, and Bimanual Laryngoscopy

by EMOttawa | Jul 31, 2012

Journal Club Summary Landmark Series Levitan RM, Kinkle WC, Levin WJ, Everett WW. Ann Emerg Med. 2006 Jun.;47(6):548–55. PubMed Link This U.S. study evaluated manipulation techniques for direct laryngoscopy during endotracheal intubation in 1,530 comparisons performed...

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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.