EMOttawa - Emergency Medicine Ottawa

This is a post summarizing our best-rated JC articles and the ones I find are the most useful from the past academic year. Each of the articles is broken down into one to two lines as to how I have incorporated them in my practice. For a little longer summary just click on the links for the JC summaries.

1) Oral Prednisolone in the Treatment of Acute Gout: A Pragmatic, Multicenter, Double-Blind, Randomized Trial.Rainer TH, et al. 
Ann Intern Med. 2016 Feb 23. doi: 10.7326/M14-2070.
47 yo male with stable CKD presenting with gout of his first MTP joint. I’m concerned about using colchicine or NSAIDs, instead I prescribe Prednisone 30mg/day for 5 days. 

2) Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular CareNeumar RW, Shuster M, Callaway CW, et al.
Circulation. 2015 Nov 3;132(18 Suppl 2):S315-67
For all those unfortunate patients with in and out of hospital arrest. Too many changes to mention but ther…

Guest post by Dr. Venkatesh Thiruganasambandamoorthy.
Syncope is an commonly encountered problem in Emergency Medicine, with the potential for significant morbidity and mortality to patients. Unfortunately, to date, there have not been any reliable decision tools or instruments to help us in our assessment of the syncope patient.  This week, Venkatesh Thiruganasambandamoorthy and colleagues at the Ottawa Hospital have published an new Canadian Syncope Risk Score to identify patients at risk of serious adverse events, published in CMAJ.1 Here, Dr. Venk helps provides some further insight and potential utilization of the risk score, he may also be heard discussing this rule on the March edition of Canadian EMRAP.


BackgroundSyncope constitutes 1% of Emergency Department (ED) visits, and approximately 10% of these patients will have serious underlying conditions causing syncope (arrhythmia, MI, serious structural heart disease, pulmonary embolism, subarachnoid or severe hemorrhage). Alarmin…

After more than a decade of undergraduate and postgraduate education, you have finally finished residency! Your "watch has ended" and you are about to be a "real" doctor. Before absolute panic sets in here are some tips to make your transition to practice a little easier.

1) Financial - obtain insurance (life/disability/health/malpractice), and consider if incorporation is right for you.

2) Get your (eg. OHIP) billing number – your billing agents and your consultants will require it.

3) Buy yourself something nice – if it feels like you would have never bought it in residency and it seems like it costs way too much, that’s about the right amount of money to spend*.

4) Be nice to everyone at your new job – especially allied health staff, clerks, security staff, etc. Do not confuse you new level of authority with an excuse to be a jerk. First impressions last a lifetime.

5) It’s ok to get upset sometimes - it will happen, but do it very sparingly and avoid pub…

With the Choosing Wisely Canada campaign underway, Emergency Medicine recently published their list of "5 Things Physicians and Patients should question" in conjunction with the Canadian Association of Emergency Physicians. Here we'll list the 5 "things" for you to quickly reference and for the full list, explanations, and references please go to Choosing Wisely Canada: Emergency Medicine. Given this is a Canadian endeavour each of the recommendations includes it's Canadian Article and FOAMed references that you can go to if you want to learn more about each topic. Maybe we should have saved this post for July 1st!



1) Don’t order CT head scans in adults and children who have suffered minor head injuries (unless positive for a head injury clinical decision rule).Canadian References:
1) CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury
2) The Canadian CT Head Rule for patients with minor head injury
Canadian FOA…