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All Categories
  • All Categories
  • Abdominal and Gastroinstestinal
  • Allergy and Immunology
  • Cardiovascular
  • Dermatology
  • 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 91.0 – Testicular Torsion

Take Home Points Consider the diagnosis of testicular torsion in all patients with acute testicular pain Testicular torsion is a surgical emergency that requires immediate urologic consultation to increase the rate of tissue salvage. History, physical examination and ultrasound are …

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Renal and Genitourinary

Andexxa Vs 4F-PCC in ICH: An Ongoing Debate

BACKGROUND: Direct oral anticoagulants (DOACs) such as rivaroxaban [Xarelto] and apixaban [Eliquis] have become more prevalent in the aging population and are associated with intracranial bleeding at rates up to 4.2%. (Xian 2019) 4-Factor Prothrombin Complex Concentrates (4F-PCC), or K-Centra, …

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NeurologyTrauma

REBEL Core Cast 90.0 – Methemoglobinemia

Take Home Points Methemoglobinemia can result from exposure to a number of different medications. The most common are dapsone and topical anesthetic agents (i.e. benzocaine) Consider the diagnosis in any patient with cyanosis and hypoxia that doesn’t respond to oxygen …

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Toxicology

Etomidate Vs. Ketamine: A Systematic Review and Meta-Analysis

Background: Rapid sequence intubation (RSI) induction agent selection remains a heavily debated matter. Etomidate causes adrenal suppression in critically ill patients triggering a groundswell of support in favor of ketamine. (Albert 2011, Jabre 2009) However, the existing literature comparing etomidate …

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Resuscitation

REBEL Core Cast 89.0 – Spontaneous Bacterial Peritonitis

Take Home Points Spontaneous Bacterial Peritonitis (SBP) is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis An ascites PMN count > 250 cells/mm3 is …

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Abdominal and Gastroinstestinal

The LOVIT Trial: Orange Crushed

Background: Vitamin C dissociates to ascorbate at physiological pH and is not organically synthesized by the human body. Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. (Amrein 2018) A small, single-center, before-and-after study …

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Resuscitation

REBEL Core Cast 88.0 – Hypocalcemia

Take Home Points Severe hypocalcemia can cause hypotension and QTc prolongation leading to Torsades de Pointes.  Treat moderate to severe symptoms and any EKG changes with IV calcium salts Always search for and treat the underlying cause of hypocalcemia

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Endocrine, Metabolic, Fluid, and Electrolytes

REBEL Core Cast 87.0 – Hypercalcemia

Take Home Points Patients with severe hypercalcemia (> 14 mg/dL) are at risk for severe cardiac dysrhythmias and cardiac collapse Treatment centers on volume repletion with normal saline with consideration for the addition of loop diuretics AFTER volume reexpansion is …

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Endocrine, Metabolic, Fluid, and Electrolytes

Less is More . . . Again: Speed of IV Fluid Administration in Pancreatitis (WATERFALL Trial)

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). Recent evidence has challenged the routine use of aggressive hydration as unnecessary. There are also potential harms …

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Abdominal and Gastroinstestinal

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

Background: Thromboelastography (TEG) is a reliable, comprehensive non-invasive hemostatic assay that measures the ability of whole blood to form a clot. TEG analyzes the interaction between platelets and the coagulation cascade. It provides highly descriptive, real-time information on clot formation, …

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Abdominal and Gastroinstestinal

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