Archive for category: Clinical

REBELCast Bootcamp Edition

15 Jun
June 15, 2015

Welcome back to a special edition, or should I say “bootcamp edition” of REBELCast. We have started to do something new by inviting guests onto the show to discuss papers in the literature they find interesting. This month I had the pleasure of working with Steve Carroll, an emergency room physician in my neck of […]

Morphine Kills in Acute Decompensated Heart Failure

08 Jun
June 8, 2015

Background: Intravenous morphine use has been reported in nearly one of seven patients hospitalized with acute decompensated heart failure (ADHF). I have anecdotally, even seen physicians giving morphine as a “first-line” agent: Nitroglycerine, Non-Invasive Positive Pressure Ventilation (NIPPV), and Morphine. There is surprisingly little evidence supporting routine use of morphine in ADHF, and no major […]

Low Risk Chest Pain and Clinically Relevant Adverse Cardiac Events (CRACE)

04 Jun
June 4, 2015

Background: In 2010, 5.4% of all emergency department (ED) visits in the United States were for chest pain. Admission or observation of such patients cost about $11 billion dollars in the United States in 2006. The majority of these admissions are commonly determined to be non-cardiac in etiology. Many physicians and patients believe that a […]

REBELCast: The Crashing Asthmatic

01 Jun
June 1, 2015

Acute severe asthma, formerly called status asthmaticus, is defined as severe asthma unresponsive to repeated courses of beta-agonist therapy or subcutaneous epinephrine. It is a medical emergency that requires immediate recognition and treatment. Recently, Anand Swaminathan (Twitter: @EMSwami) gave a lecture to the residents at the University of Texas Health Science Center at San Antonio (UTHSCSA) […]

Mythbuster: Administration of Vasopressors Through Peripheral Intravenous Access

28 May
May 28, 2015

Background: Vasopressors are frequently used in critically ill patients with hemodynamic instability both in the emergency department (ED) as well as intensive care units (ICUs). Typically, vasopressors are given through central venous catheters (CVCs) as opposed to peripheral intravenous (PIV) access due to the concerns about adverse events (i.e. tissue ischemia/necrosis) associated with extravasation through […]

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