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- Abdominal and Gastrointestinal
- 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
- Human Behavior
- Infectious Disease
- Neurology
- Obstetrics and Gynecology
- Orthopedics
- Pediatrics
- Procedures and Skills
- Psychiatry/Behavioral Health
- Renal and Genitourinary
- Resuscitation
- Team Performance
- Thoracic and Respiratory
- Toxicology
- Trauma
Pre-Hospital Antibiotics in Sepsis?
Background: Sepsis remains one of the leading causes of morbidity and mortality. It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Time to antibiotic therapy (from triage, not from onset of infection) has ...
Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?
Bottom Line Up Top: In patients with infectious processes that are stable for discharge home, there is no role for giving a first dose of antibiotics IV in the ED. Clinical Scenario: A 45-year-old woman with hypertension presents with a ...
REBEL Core Cast 115.0 – Cardiogenic Shock
Take Home Points: Know clinical (cold extremities, oliguria, confusion, dizziness, narrow pulse pressure) and laboratory markers (metabolic acidosis, elevated creatinine, lactic acidosis) of hypoperfusion. An elevated lactate is a danger sign and requires explanation. Norepinephrine is a great first line ...
REBEL Core Cast 114.0 – Carbon Monoxide Toxicity
Take Home Points: Carbon monoxide is a colorless, odorless, and tasteless gas that results from incomplete combustion of any carbon containing product. Exposure often occur unintentionally from indoor use of gas powered generators, camp stoves, or faulty home heaters. The ...
Don’t Believe the Headline: Ultrasound vs CXR in Traumatic Pneumothorax Diagnosis
Background: The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. Though the initial ...
Clinical Conundrums: How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis?
How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis? Bottom Line Up Top: After prompt recognition and appropriate treatment with IM epinephrine, the risk of biphasic reactions are exceedingly low. There is no set observation time to monitor ...
Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management
Background: In medicine, guidelines are valuable tools that help guide care. However, they are not rigid rules that must be strictly followed. Clinicians often find themselves grappling with the challenge of balancing the demands of meeting Center for Medicaid & ...
REBEL Core Cast 113.0 – ACS Therapies and Management
Take Home Points: All STEMIs should be loaded with dual antiplatelet therapy. Prasugrel (Effient) is avoided as there is an increase in bleeding complications if the patient requires a CABG. NSTEMI cases can be challenging to manage. Consult Cardiology early ...
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