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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

Clinical Conundrum: Should Acute Asthma Exacerbations Be Discharged From the ED With Combination Beta Agonist/Corticosteroid Inhalers?

Bottom Line Up Top: In patients with mild to moderate asthma exacerbations that are stable for discharge home, there is evidence to support discharging patients from the ED with combination Inhaled Corticosteroid/Long-Acting Beta Agonist (ICS-LABA) maintenance therapy. Clinical Scenario: A ...

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Thoracic and Respiratory

Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

Background: Sickle cell disease (SCD) affects an estimated 300,000 infants born worldwide each year and has a total estimated prevalence of 100,000 in the United States alone (Piel 2017). Within this population, over 90% of healthcare encounters are due to ...

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Hematology and OncologyResuscitation

REBEL Core Cast 133.0 – TMJ Dislocation

Take Home points: Atraumatic TMJ dislocations are typically anterior in nature and can be reduced by a variety of techniques in the ED Traumatic TMJ dislocations often involve mandible fractures and typically require open reduction and fixation in the operating ...

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Head, Eye, Ear, Nose, and Throat

Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

Bottom Line Up Top: There doesn’t appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. Only treat fever if it causes the patient distress. Clinical Scenario: A 45-year-old woman ...

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Infectious Disease

REBEL Core Cast 132.0 – Recent-Onset AFib

Take Home points: If the patient is low risk with CHA2DS2-VASc (men < 2, women < 3), cardioversion is safe up to 48 hours from onset. In higher risk patients, we should reserve cardioversion unless there is clear onset less ...

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Threading the Needle: Bougie-First Intubation

Background: In 2018, the BEAM Trial, a small single-center randomized clinical trial, conducted in the emergency department at Hennepin County Medical Center, demonstrated that bougie use significantly increased the first-attempt intubation success rate compared to the endotracheal tube with stylet ...

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Procedures and SkillsResuscitation

Rosh Review My EMCert Monthly Question

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REBEL Core Cast 131.0 – Traumatic Arthrotomy

Take Home points: Always suspect an open joint if there is a laceration, regardless of size, the lies over joint CT scan of the affected joint is widely considered to be the standard approach to evaluation but the saline load ...

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Trauma

Is Pip-Tazo Harming Sepsis Patients?

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. Literature ...

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Infectious Disease

Elbow Dislocations

Elbow Dislocation Definition:  Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology:  Incidence Second most common joint dislocation (after shoulder) in adults  Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ...

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Trauma

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