REBELEM Blog

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). Recent evidence has challenged the routine use of aggressive hydration as unnecessary. There are also potential harms …

Background: Thromboelastography (TEG) is a reliable, comprehensive non-invasive hemostatic assay that measures the ability of whole blood to form a clot. TEG analyzes the interaction between platelets and the coagulation cascade. It provides highly descriptive, real-time information on clot formation, …

Background: Medical equipment that gives clinicians vital signs or other objective information must be reliable across populations as this data drives medical decisions. Many of these tools were not developed or validated in a racially diverse group of patients.  We …

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Over the years, we as a scientific community have worked extensively to find other interventions …

Background: Patients presenting with acute exacerbations of congestive heart failure are frequently treated with intravenous loop diuretics.  Despite being treated with loop diuretics, the problem is many are discharged from the hospital with residual clinical signs of volume overload despite …

Background: Coronary artery disease can result in hibernating myocardium (chronic myocardial contractile dysfunction) due to ischemia.  The theory is that there is reduced coronary blood flow and increased myocardial demand resulting in impaired contractility. Whether reversal of myocardial hibernation by …

Background: Hypoxemia is a commonly encountered adverse event during rapid sequence intubation (RSI) in the ED.  Critically ill patients in the ED often have a lack of physiologic reserve, decreased cardiac output, increased shunting, and reduced pulmonary reserves.  Therefore, a …

Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC.  While hypoxemia (SpO2 <90%) is clearly deleterious, it is unclear if hyperoxia is beneficial.  Recent studies on patients requiring critical care have demonstrated that hyperoxia is harmful and instead …

Background: The Calcium for Out-of-Hospital Cardiac Arrest (COCA) trial was a randomized, placebo-controlled, double-blind trial of calcium compared to placebo in OHCA.  COCA found no improvement in sustained ROSC but, rather, a trend towards harm for their primary outcome. Additionally, …