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- Head, Eye, Ear, Nose, and Throat
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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 ...
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 ...
REBEL Cast Ep126: Should We Not Be Recommending Small Adult BVMs in OHCA?
Background: The holy grail of outcomes in OHCA is survival with good neurologic outcome. The only interventions proven to increase this outcome are high quality CPR and defibrillation in shockable rhythms. Ventilation is also an important component of resuscitation in ...
DanGer Shock Trial: Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock
Background: STEMI can be complicated by cardiogenic shock and this complication is associated with a high morbidity and mortality rate. Decreased cardiac output results in inadequate perfusion and subsequent end-organ damage. Mechanical circulatory support can improve perfusion and, in theory, ...
REBEL Core Cast 121.0 – Acute Sinusitis
Take Home Points Acute rhinosinusitis is a clinical diagnosis The vast majority of acute rhinosinusitis cases are viral in nature and do not require antibiotics Consider the use of antibiotics in select groups with severe disease or worsening symptoms after ...
Don’t Forget About the IO in the Critically Ill Patient
Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and critical care physicians have tried many ways to establish IV access in ...
The ACORN Trial: Battle of the Gorilla-Cillins (Cefepime vs Piperacillin-Tazobactam)
Background: Acutely ill adults presenting to the hospital with suspected infection commonly receive empiric, broad-spectrum antibiotics as part of their initial management including coverage of both MRSA and pseudomonas species. MRSA coverage includes the use of vancomycin while anti-pseudomonal coverage ...
Clinical Conundrums: Should I Provide Patients with Pharyngitis a Dose of Corticosteroids
Bottom Line Up Top: Steroids provide modest improvement in time to resolution and degree of resolution of symptoms in pharyngitis. They should be considered in patients presenting to the ED after weighing potential benefits and risks. Clinical Scenario: A 22-year-old ...
How Much O2 Is Right in COVID?
Background: Hypoxemic respiratory failure is a frequent complicating feature of severe COVID-19 infection. Early in the pandemic, extensive efforts were made to identify the best approach to oxygenation in this group of patients. Best practices settled on aggressive use of ...