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All Categories
  • All Categories
  • Abdominal and Gastroinstestinal
  • Allergy and Immunology
  • Cardiovascular
  • 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

TTM2: Hypothermia vs Normothermia for Out-of-Hospital Cardiac Arrest

Background Information: Hypothermia was first introduced in 2002 by two studies, Bernard et al and The Hypothermia After Cardiac Arrest (HACA) trial.1,2 The latter, although a small trial, showed improved neurologic outcomes at six months when patients were cooled to …

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CardiovascularNeurologyResuscitation

GRACE Guidelines: A Pragmatic Approach to Recurrent Low-Risk Chest Pain

In the United States, a patient with chest pain presents to the emergency department (ED) every 5 seconds. By the time you finish reading this post, 60 patients will have sought treatment for chest pain. In 2017, chest pain was …

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Cardiovascular

The REALITY Trial: Restrictive vs Liberal Blood Transfusion in Patients with AMI and Anemia

Background: Transfusion thresholds for anemia have large variations in clinical practice.  This is especially true in patients with acute myocardial infarction (AMI).  Part of the reason for this is the lack of high-quality data.  There was a large, randomized trial …

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Cardiovascular

REBEL Core Cast 61.0 – Debriefing

Take Home Points 1. Debriefing is critical. Studies show numerous benefits in terms of team communication and staff ability to regroup. 2. Start by gathering your team, thanking them for their work and noting that nothing could have changed the …

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I Love Me Some High-Dose NTG and NIV for SCAPE

Background: Hypertensive acute heart failure is a subgroup of acute congestive heart failure (CHF) patients.  Physiologically there is increased afterload and decreased venous capacitance both leading to fluid shifts resulting in pulmonary vascular congestion.  Sympathetic crashing acute pulmonary edema (SCAPE) …

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Cardiovascular

External Validation of the Canadian Syncope Risk Score

Background Information: The Canadian Syncope Risk Score (CSRS) is one of several clinical decision tools used in the emergency department (ED) following a syncopal episode. (Figure 1) It was derived from one of the largest datasets currently available and its …

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Cardiovascular

The KetaBAN Trial: Nebulized Ketamine for Analgesia in the ED

Background: Intravenous sub-dissociative dosed ketamine has gained an expanded role in the management of a variety of acute painful conditions in the ED (REBEL EM).  When IV access is not readily available or unobtainable, sub-dissociative dosed ketamine can be given …

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Procedures and Skills

Thromboembolic Events After Cardioversion of Acute Atrial Fibrillation and Flutter: Should we Anticoagulate?

Background: Atrial fibrillation and atrial flutter are two of the most common dysrhythmias seen in the emergency department (ED). Rarely does a shift go by that you don’t see one or the other. For decades, there has been a debate …

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CardiovascularNeurology

REBEL Core Cast 60.0 – Pyomyositis

Take Home Points – Unexplained tachycardia (or any abnormal vital sign) warrants investigation. – Pain, induration, “woody” feel of any muscle group should raise suspicion of infection in that muscle group that has spread hematogenously especially in those with predisposing …

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Chest Pain and Chemotherapy: 5-FU Induced Coronary Vasospasm

58 y/o female with colorectal cancer recently started on continuous 5-FU chemotherapy presents to the ED with chest pain, shortness of breath, and diaphoresis.  The symptoms wax and wane with no specific exacerbating factors.  She has no other past medical …

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Cardiovascular

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