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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

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, …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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) …

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Cardiovascular

Impella Devices 101

Now that I am working up in the ICU, one of the devices that I am frequently coming across is the Impella device.  This is not something we get much training on downstairs in the ED.  Below is a summary …

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Cardiovascular

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