REBEL Review 61: Intracranial Hemorrhage

Created March 30, 2014 | Trauma | DOWNLOAD

REBEL Review 60: CVA Syndromes

Created March 29, 2014 | Neurology | DOWNLOAD

March 27, 2014

Diabetic ketoacidosis (DKA) is a common endocrine emergency encountered in the emergency department.  DKA associated mortality is relatively low in adults, but in children with type 1 diabetes, the elderly, and adults with concomitant illnesses have a mortality rate is > 5% [cite source="pubmed"]19564476[/cite].  Guidelines for the management of hyperglycemic crisis in adults provide recommendations for intravenous fluid administration, correction of electrolyte abnormalities, insulin and bicarbonate therapy.  While the recommendations made in the American Diabetes Association (ADA) consensus statement are intended to be evidence based, there are two recommendations which have less than optimal supporting evidence which results in controversy in the emergency department: 1. Use of regular insulin boluses of 0.1 units/kg and 2. patients with a pH < 6.9 should receive sodium bicarbonate therapy.  Today we will attempt to answer the question, is there any benefit to an initial insulin bolus in DKA?

REBEL Review 59: Hemolytic Anemia

Created March 26, 2014 | Hematology and Oncology | DOWNLOAD

March 24, 2014

Preoxygenation and apneic oxygenation are key in emergency airway management, prevention of desaturation, and very important to patient safety.  One of the best papers I have ever read on this was written by Scott D. Weingart (@emcrit) and Richard M. Levitan (@airwaycam) in the Annals of Emergency Medicine in March 2012. This article reviewed techniques in preoxygenation and peri-intubation oxygenation in adult patients requiring tracheal intubation.