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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

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

Should We Be Switching to Whole Blood Instead of Component Therapy in Hemorrhagic Shock?

Background: Hemorrhage remains as one of the biggest causes of death in trauma patients. Strategies such as permissive hypotension, massive transfusion protocols, avoidance of crystalloids, TXA, and definitive hemorrhage control help decrease mortality in these patients. Empiric component blood transfusion …

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Hematology and OncologyTrauma

REBEL Core Cast 123.0 – Posterior Epistaxis

Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit …

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Head, Eye, Ear, Nose, and Throat

The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). MVM exaggerates venous return to the heart …

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Cardiovascular

ANNEXA-1: Andexanet Alfa Associated with Harm in DOAC Reversal

Background: In May of 2018, Andexanet alfa gained accelerated approval by the FDA for the reversal direct oral anticoagulants (DOACs) despite a lack of robust evidence for use. The 2022 AHA/ASA guidelines give the drug a level 2A recommendation and …

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Hematology and OncologyNeurology

Automated vs Manual Chest Compressions in Out-of-Hospital Cardiac Arrest

Background Information: Out of hospital cardiac arrest (OHCA) is a medical emergency that requires immediate intervention to increase the chance of survival. The global survival rate of OHCA patients who received CPR has increased in the past 40 years [1]. …

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CardiovascularResuscitationThoracic and Respiratory

Rosh Review My EMCert Monthly Question

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Head, Eye, Ear, Nose, and ThroatHematology and Oncology

Sub-Dissociative IV vs Nebulized Ketamine to Treat Pain

Background: IV subdissociative ketamine at a dose of 0.1 to 0.3mg/kg is increasingly being used as an opioid sparing option for short-term acute pain relief. Alternatively, nebulized ketamine can be used for this indication and may have a benefit as …

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OrthopedicsPediatricsProcedures and SkillsTrauma

REBEL Core Cast 122.0 – Neutropenic Fever

Take Home Points: There are many causes of neutropenia, chemotherapy being by far the most dangerous. Febrile neutropenia is a condition conveying high mortality. Early administration of antibiotics is the only factor known to reduce this mortality. For a patient …

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Infectious Disease

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