Archive

Author: Anand Swaminathan

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

REBEL Core Cast 126.0 – Peds Hem Onc Emergencies

Take Home Points Early administration of antibiotics (within 60 min) in patients with fever and neutropenia is life saving. Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well. Avoid sedation ...

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Hematology and OncologyPediatrics

REBEL Core Cast 125.0 – Hyperkalemia

Take Home Points Always obtain an EKG in patients with ESRD upon presentation Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause If the patient with hyperkalemia is unstable or has significant EKG changes ...

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Endocrine, Metabolic, Fluid, and Electrolytes

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