Author: Salim Rezaie

STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact.  In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer.  In these cases, …

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The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

Background: Cardiogenic shock develops in up to 10% of patients with acute myocardial infarction (AMI) and carries a 30 day mortality rate around 50%. Revascularization of the culprit lesion remains one of the few established treatments though there are numerous …

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REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation.  The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing …

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Procedures and SkillsTrauma

The PALACE Trial: Direct Oral PCN Challenge in Patients with Low-Risk PCN Allergy?

Background: Many patients report a vague history of penicillin allergy. The vast majority of these self-reported allergies are untrue (< 5%) .  Literature including patients with penicillin allergies also show longer, more complicated hospital courses. Standard practice for identifying errant allergy …

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Allergy and Immunology

The ARAMIS Trial: DAPT vs Alteplase in Minor Nondisabling Acute Ischemic Stroke

Background: Current stroke guidelines recommend IV alteplase for patients with acute ischemic stroke presenting within 4.5hrs of symptom onset based on the NINDS and ECASS III publications. Both NINDS and ECASS III excluded patients with mild stroke symptoms but failed …

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