July 1, 2014

Welcome to REBEL Cast Episode 1, where Matt, Swami, and I are going to tackle a couple of scenarios to help your clinical practice.  Today, we are going to specifically tackle two different topics:
  • Topic #1: Clinically Important Biphasic Anaphylaxis
  • Topic #2: Total Lymphocyte Count (TLC) as a Surrogate Marker for CD4 Counts

June 19, 2014

For those who haven't checked out the site already R.E.B.E.L. EM stands for Rational Evidence Based Evaluation of Literature in Emergency Medicine. (Edit: name changed 2/2016) The blog was launched in October 2013, and continues to grow every month, and with that growth we are excited to announce the introduction of REBEL Cast. 

June 11, 2014

  Please welcome a new development in critical care publishing with the launch of a new open access critical care journal: CRITICAL CARE HORIZONS!!!  This will be a fresh, new, original voice in the critical care literature, offering thought provoking, cutting-edge commentary, opinion papers, plus state-of-the art review articles.

June 9, 2014

  89 year old male with PMH of hypertension, stage 3 chronic kidney disease with chief complaint of shortness of breath. Several days ago patient had a laminectomy for radicular pain. He was doing fine post-operatively and began to develop gradual shortness of breath.  He had no complaints of chest pain, nausea/vomiting, fevers, diaphoresis, but did have some weakness.  There were no prior ECGs for comparison. BP: 98/48 HR: 103 RR: 18 O2 on RA: 94% Temp: 38.6 JVD to the angle of the mandible Bibasilar Crackles Sinus Tachycardia Bilateral lower extremity pitting edema Labs: Na 125, K+ 4.2, Creatinine 2, BNP > 2500 ECG from triage is shown...

May 29, 2014

The first left ventricular assist device (LVAD) was performed in 1984 and since that time there is an increasingly growing population of patients with LVADs.  This means ED physicians will be seeing more and more of these patients in the ED and should have a basic understanding of how these devices work and have an adequate understanding of common complications and an approach to evaluate these patients. LVADs are typically used for end-stage heart failure for both a bridge to transplantion and for long-term quality of life improvement. Most of the information for this post comes from a great review article written by Chris Partyka et al in EMA 2014.
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