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All Categories
  • All Categories
  • Abdominal and Gastroinstestinal
  • Allergy and Immunology
  • Cardiovascular
  • Dermatology
  • EMS and Disaster
  • Endocrine, Metabolic, Fluid, and Electrolytes
  • Environmental
  • Ethical and Legal
  • Head, Eye, Ear, Nose, and Throat
  • Hematology and Oncology
  • Infectious Disease
  • Neurology
  • Obstetrics and Gynecology
  • Orthopedics
  • Pediatrics
  • Procedures and Skills
  • Pyschobehavioral
  • Renal and Genitourinary
  • Resuscitation
  • Thoracic and Respiratory
  • Toxicology
  • Trauma

Navigating Nerve Blocks: US-Guided Nerve Blocks Vs. Sub-Dissociative Ketamine

Background: Ultrasound-guided nerve blocks have become appealing for pain management in the emergency department (ED). The adoption and expansion of ultrasound, coupled with the precise delivery route and low complication rates, facilitated the transition of nerve blocks from the operating room …

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Procedures and Skills

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

Rosh Review My EMCert Monthly Question

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Thoracic and Respiratory

BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED

Background: Non-invasive positive pressure ventilation (NIPPV) is an effective treatment modality for patients with both hypoxemic or hypercapnic respiratory failure and has been shown to decrease the need for intubation [2].  Continuous positive airway pressure (CPAP) provides a constant positive …

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Thoracic and Respiratory

The PREOXI Trial: Pre-Oxygenation with NIV vs Facemask

Background: Tracheal intubation is frequently performed in critically ill patients.  Hypoxemia is one of the major adverse events that can occur during intubation and it increases the risk of morbidity and mortality. Preoxygenation before induction of anesthesia increases the amount …

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ResuscitationThoracic and Respiratory

Should End-Tidal Capnometry (ETC) During ED Procedural Sedation/Analgesia (PSA) Not Be Standard Care?

Background: Procedural sedation and analgesia (PSA) is a frequently employed in the emergency department (ED) to facilitate painful procedures. Some of the potential untoward effects of PSA include cardio-respiratory depression and/or airway compromise.  Standard practice in many parts of the …

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Procedures and Skills

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

Sympathetic Crashing Acute Pulmonary Edema: High-Dose Vs. Low-Dose Nitro

Background: Sympathetic Crashing Acute Pulmonary Edema (SCAPE) results from an increased systemic vascular resistance and activation of the Renin-Angiotensin-Aldosterone System (RAAS), which causes increased sodium/water reabsorption and worsening cardiac function. Additionally, sympathetic activation shifts fluid from splanchnic beds into the …

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ResuscitationThoracic and Respiratory

REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy

Take Home Points Management of severe beta-blocker and calcium-channel blocker toxicity should occur in a stepwise fashion: potential gastric decontamination, multiple lines of access, judicious fluids, calcium, glucagon, and vasopressors as needed. Initiation of high dose insulin therapy requires a …

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Toxicology

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