REBELEM Blog

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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

REBEL Core Cast 130.0 – Omphalitis

Take Home Points Early diagnosis: erythema and warmth of the skin surrounding the umbilicus isn’t normal. Get labs, start abx and get the patient admitted Consult peds surgery on all of these patients as progression to nec fast, while uncommon, ...

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Pediatrics

REBEL Core Cast 129.0 – Gastric Lavage

Take Home Points Orogastric lavage may still play an important role in treatment of the overdose patient.  Do not perform lavage if the ingestion has limited toxicity at any dose or the ingested dose is unlikely to cause significant toxicity. ...

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Toxicology

REBEL Core Cast 128.0 – Toxic Alcohols

Take Home Points Toxic alcohols generally refer to methanol and ethylene glycol as these substances pose significant metabolic derangement and end-organ damage. Patient who present shortly after ingestion will simply look inebriated – no different than ethanol intoxication. At this ...

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Toxicology

Clinical Conundrums: Should Ketamine be Preferred Over Etomidate in RSI?

Bottom Line Up Top: Based on the available evidence, we should strongly consider ketamine over etomidate as our default induction agent in critically ill patients. Clinical Scenario: A 48 year old man presents with fever, hypotension, hypoperfusion and hypoxemia. Workup ...

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Resuscitation

REBEL Core Cast 127.0 – Penetrating Neck Injuries

Take Home Points Anticipate anatomically challenging airways and consider early intubation prior to loss of airway anatomy. Skip the zones of the neck and focus on hard signs of vascular (Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, ...

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Trauma

Rosh Review My EMCert Monthly Question

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The Ducanto Catheter—It Sucks!

Background: Emergency intubations present a unique set of challenges, particularly when dealing with heavily contaminated airways. Anesthesiologist, Dr. James DuCanto, developed the DuCanto catheter to enhance airway management in these high-stakes situations. The commonly used 14 Fr Yankauer catheter, with ...

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Procedures and SkillsResuscitation

Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with COVID-19

Background: The clinical burden of severe COVID-19 triggered a pharmaceutical race to find effective, easily accessible, oral treatments that could decrease the morbidity and mortality associated with the disease. Nirmatrelvir is an oral antiviral agent that inhibits the SARS-CoV2 main ...

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Infectious Disease

Remote Consult Protocols for Retinal Artery Occlusion: A Visionary Approach in Emergency Care?

Background:  Retinal artery occlusion (RAO) is a time-sensitive ophthalmic emergency that demands rapid diagnosis and intervention. Administration of intravenous tissue plasminogen activator (IVtPA) within 4.5 hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported ...

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Head, Eye, Ear, Nose, and Throat

The PROTECTION Trial – A Randomized Trial of Intravenous Amino Acids for Kidney Protection

Background Information: Acute kidney injury (AKI) is one of the most frequent complications of cardiac surgery and the cause is complex. Renal hypoperfusion from decreased glomerular filtration rate after cardiopulmonary bypass is a major contributor.1 This in combination with exogenous ...

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CardiovascularRenal and GenitourinaryResuscitation

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