January 10, 2015

Welcome to the January 2015 REBELCast, where Swami and I are going to tackle a very important scenario that comes up in the daily practice of not only Emergency Medicine, but also in Medicine.  Today we are going to specifically tackle one topic: Topic: Is the use of cephalosporin antibiotics in patients with a history of penicillin class antibiotics safe?

September 2, 2014

Welcome to the September REBELCast 2014, where Matt, Swami, and I are going to tackle a couple more scenarios to help your clinical practice.  Today, we are going to specifically tackle two different topics: Topic #1: The use of Non-Invasive Positive Pressure Ventilation (NIPPV) in the Pre-Hospital Treatment of Patients with Severe Respiratory Distress Topic #2: Once Weekly Dalbavancin for Skin Infections

August 14, 2014

A 52 year old female with a past medical history of type II diabetes mellitus and tobacco abuse presents with a chief complaint of chest pain. According to the patient she had about 2 - 3 months of stuttering, substernal chest pain without any radiation.  She described the pain as pressure-like, with activity, but that it would typically resolve after a few minutes of rest.  Today she awoke with substernal chest pain that never resolved and continued in the emergency department.  She quantifies her pain as 7/10 and not relieved with 2L nasal cannula of oxygen, 325mg PO aspirin, and SL NTG x3. BP 127/89     HR 76     RR 20      O2 sat 100% on 2L NC     Temp 99.3 Awake, A&Ox3, appears uncomfortable Mild JVD on examination RRR w/o m/r/g CTA B 2+ pulses in her extremities, no edema ECG is shown (No prior ECG for comparison).....

August 4, 2014

Welcome to REBEL Cast August 2014, where Matt, Swami, and I are going to tackle a couple more scenarios to help your clinical practice. Today, we are going to specifically tackle two different topics: Topic #1: Significance of Isolated Vomiting in Pediatric Minor Head Trauma Topic #2: Early Detection of Systemic Inflammatory Response Syndrome (SIRS) in the Emergency Department

July 11, 2014

D-dimer has been shown to increase with age, which can cause a lower specificity (i.e. more false positive tests) in older patients. The result of this would be that older patients would often have more diagnostic imaging or downstream testing, but on the other hand, maybe a higher cut-off d-dimer value may lead to increased false negative cases (i.e. missed venothromboembolism) and make this strategy less safe. Recently, I wrote a post on age-adjusted d-dimer testing on REBEL EM, but since that post there was a new article that was published in Chest 2014. This post, will specifically focus on an update of age-adjusted d-dimer testing based on the above article.