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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

Another Study on Peripheral Vasopressors

Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock.  Historically the administration of vasopressors was restricted to central venous catheters (CVC) due to concerns for local tissue injury …

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Resuscitation

The NICO Trial: NIV in Comatose Patients with Acute Poisoning

Background:  Patients with decreased level of consciousness due to alcohol, drugs, or medications commonly present to the ED. These patients can be at risk of vomiting and aspiration and often prompts clinicians to pursue definitive airway management to avoid pneumonia …

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ResuscitationToxicology

Clinical Conundrums: Do We Need to Order a CT for Every Patient with Renal Colic?

Bottom Line Up Top: In selective patients presenting with flank pain, we can diagnose renal colic without a CT scan. There is also a subset of patients that would benefit from IV contrast enhanced CT scanning. Clinical Scenario: A 35-year-old …

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Renal and Genitourinary

Non-Invasive Blood Pressure Monitoring in Critically Ill Adults?

Background: Patients with shock frequently present with hypotension.  Many of these patients are started on vasopressor and inopressor medications to assist in efforts to normalize blood pressure to help improve organ perfusion. In shocky patients, arterial lines are often used …

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CardiovascularResuscitation

REBEL Core Cast 117.0 – Infections of Pregnancy

Take Home Points Infections are a leading cause of maternal mortality worldwide. Prompt recognition is critical in management. Most infectious processes will require admission and close observation for improvement or decompensation.

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Obstetrics and Gynecology

The Needle Vs. The Knife for Spontaneous Pneumothorax: A Closer Look at the EXPRED Study

Background:  The optimal management of primary, spontaneous pneumothorax (sPTX) remains an area of active debate. The British Thoracic Society recommends the least invasive approach possible. In contrast, the American College of Chest Physicians favors first-line chest tube drainage for any …

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Thoracic and Respiratory

The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

Background: Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. Tenecteplase, a modified version of …

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Neurology

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Background: Massive pulmonary embolism  defined as sustained hypotension (SBP <90mmHg)  has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) [1]. However, full-dose thrombolytic therapy (Alteplase 100mg (IV) is  associated …

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CardiovascularResuscitationThoracic and Respiratory

Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. It can be used to distinguish between various conditions, including chronic obstructive pulmonary disease (COPD) exacerbation, acute heart failure (AHF), pleural effusion, pulmonary edema, pericardial …

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Procedures and SkillsThoracic and Respiratory

REBEL Core Cast 116.0 – Achilles Tendon Rupture

Take Home Points Achilles tendon rupture is a clinical diagnosis. The Thompson Test should be applied in all suspected cases. Remember to brace or splint a rupture, even if suspected, in the resting equinus position for optimal healing and prevention …

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Orthopedics

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