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- Environmental
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- Head, Eye, Ear, Nose, and Throat
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- Renal and Genitourinary
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- Trauma
BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED
Background: Non-invasive positive pressure ventilation (NIPPV) is an effective treatment modality for patients with both hypoxemic or hypercapnic respiratory failure and has been shown to decrease the need for intubation . Continuous positive airway pressure (CPAP) provides a constant positive ...
The PREOXI Trial: Pre-Oxygenation with NIV vs Facemask
Background: Tracheal intubation is frequently performed in critically ill patients. Hypoxemia is one of the major adverse events that can occur during intubation and it increases the risk of morbidity and mortality. Preoxygenation before induction of anesthesia increases the amount ...
Should End-Tidal Capnometry (ETC) During ED Procedural Sedation/Analgesia (PSA) Not Be Standard Care?
Background: Procedural sedation and analgesia (PSA) is a frequently employed in the emergency department (ED) to facilitate painful procedures. Some of the potential untoward effects of PSA include cardio-respiratory depression and/or airway compromise. Standard practice in many parts of the ...
REBEL Core Cast 125.0 – Hyperkalemia
Take Home Points Always obtain an EKG in patients with ESRD upon presentation Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause If the patient with hyperkalemia is unstable or has significant EKG changes ...
Sympathetic Crashing Acute Pulmonary Edema: High-Dose Vs. Low-Dose Nitro
Background: Sympathetic Crashing Acute Pulmonary Edema (SCAPE) results from an increased systemic vascular resistance and activation of the Renin-Angiotensin-Aldosterone System (RAAS), which causes increased sodium/water reabsorption and worsening cardiac function. Additionally, sympathetic activation shifts fluid from splanchnic beds into the ...
REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy
Take Home Points Management of severe beta-blocker and calcium-channel blocker toxicity should occur in a stepwise fashion: potential gastric decontamination, multiple lines of access, judicious fluids, calcium, glucagon, and vasopressors as needed. Initiation of high dose insulin therapy requires a ...
Should We Be Switching to Whole Blood Instead of Component Therapy in Hemorrhagic Shock?
Background: Hemorrhage remains as one of the biggest causes of death in trauma patients. Strategies such as permissive hypotension, massive transfusion protocols, avoidance of crystalloids, TXA, and definitive hemorrhage control help decrease mortality in these patients. Empiric component blood transfusion ...
REBEL Core Cast 123.0 – Posterior Epistaxis
Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit ...
The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?
Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). MVM exaggerates venous return to the heart ...