Archive

Author: Anand Swaminathan

REBEL Core Cast 129.0 – Gastric Lavage

Take Home Points Orogastric lavage may still play an important role in treatment of the overdose patient.  Do not perform lavage if the ingestion has limited toxicity at any dose or the ingested dose is unlikely to cause significant toxicity. ...

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Toxicology

REBEL Core Cast 128.0 – Toxic Alcohols

Take Home Points Toxic alcohols generally refer to methanol and ethylene glycol as these substances pose significant metabolic derangement and end-organ damage. Patient who present shortly after ingestion will simply look inebriated – no different than ethanol intoxication. At this ...

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Toxicology

Clinical Conundrums: Should Ketamine be Preferred Over Etomidate in RSI?

Bottom Line Up Top: Based on the available evidence, we should strongly consider ketamine over etomidate as our default induction agent in critically ill patients. Clinical Scenario: A 48 year old man presents with fever, hypotension, hypoperfusion and hypoxemia. Workup ...

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Resuscitation

REBEL Core Cast 127.0 – Penetrating Neck Injuries

Take Home Points Anticipate anatomically challenging airways and consider early intubation prior to loss of airway anatomy. Skip the zones of the neck and focus on hard signs of vascular (Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, ...

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Trauma

Clinical Conundrums: Is an Arterial Lactate Necessary?

Bottom Line Up Top: A peripheral venous blood lactate can reliably be used instead of an arterial blood lactate as a marker of systemic tissue hypoperfusion and to measure response to treatment.  Clinical Scenario: A 63 year old woman with ...

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Endocrine, Metabolic, Fluid, and Electrolytes

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