REBELEM Blog

  • 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
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

Damping and Arterial Lines

Damping is the influence within a system that is a dissipation of energy during an oscillation.  In other words, think of damping like a shock absorber. Imagine a patient presenting with altered mental status.  All we know about the patient …

Read More
CardiovascularProcedures and SkillsResuscitation

The ED-AWARENESS Study: Awareness with Paralysis

‘He remembered waking up with someone pulling very hard on his injured leg, which caused severe pain. He thinks he was in the ED. The patient said this was the worst pain he had every had and it was unbearable, …

Read More
Procedures and SkillsResuscitationThoracic and Respiratory

Antibiotics in COPD Exacerbations – 2 days vs 7 days

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are commonly seen in the ED. AECOPD is characterized by a change in the patient’s baseline dyspnea, cough or sputum purulence. While there are a number of causes for exacerbations, infectious …

Read More
Thoracic and Respiratory

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of resuscitation (weak recommendation, low-quality evidence). [2].  Additionally, the Surviving Sepsis Campaign Guidelines state there is insufficient evidence …

Read More
Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

REBEL Core Cast 83.0 – Post-LP Headache

Take Home Points Post dural-puncture headache affects up to 30% of patients after lumbar puncture. Suspect PDPH in all patients who recently underwent an LP or epidural anesthesia regardless of whether they meet the IHS criteria. The best way to …

Read More
NeurologyProcedures and Skills

REBEL Cast Ep110: The COVI-PRONE Trial – Awake Prone Positioning and COVID-19

Background: Early in the COVID-19 pandemic, clinicians were looking for practical, widely available, and low-cost interventions to help patients with hypoxemia.  One of those interventions was awake prone positioning.  Potential mechanisms of benefit in awake proning include more uniform distribution …

Read More
Infectious DiseaseThoracic and Respiratory

Tenecteplase vs Alteplase in Acute Ischemic Stroke

Background: At my shop we have changed wholesale to the use of tenecteplase over alteplase for acute ischemic stroke meeting criteria for thrombolytic therapy.  This was based on a systematic review and meta-analysis of 6 RCTs and 2 observational trials …

Read More
Neurology

EPIC Trial: Electrode Positioning in Cardioverting Atrial Fibrillation

Background Information: Electrical cardioversion of atrial fibrillation is regularly performed by emergency physicians, intensivists, and cardiologists. Although many approaches to performing this procedure exist, the most common electrode placement is the anterior-lateral compared to the anterior-posterior positioning.1 The literature backing …

Read More
CardiovascularProcedures and SkillsResuscitation

Traumatic Hemothorax: Pigtail vs Chest Tube

Background: Optimal management of pneumothorax and hemothorax with chest thoracostomy has been widely debated over the last decade.  We no longer question the utility of pigtail catheters for pneumothorax and now ask whether a catheter has to be placed at …

Read More
Thoracic and RespiratoryTrauma

REBEL Core Cast 82.0 – Abdominal Aortic Aneurysm

Take Home Points Consider AAA in patients with acute onset of back or abdominal pain particularly in patients > 50 and in those with a history of hypertension Consider ruptured AAA in patients (especially those > 50 years of age) …

Read More
Cardiovascular

Sponsored