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All Categories
  • All Categories
  • Abdominal and Gastrointestinal
  • 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
  • Human Behavior
  • Infectious Disease
  • Neurology
  • Obstetrics and Gynecology
  • Orthopedics
  • Pediatrics
  • Procedures and Skills
  • Psychiatry/Behavioral Health
  • Renal and Genitourinary
  • Resuscitation
  • Team Performance
  • Thoracic and Respiratory
  • Toxicology
  • Trauma

The RECOVERY Trial: Dexamethasone for COVID-19?

Background: We have been in need of a sign of hope in the fight against SARS-CoV-2 as it runs from city to city overwhelming health systems.  The majority of patients will be either asymptomatic or have only mild disease.  These ...

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Infectious Disease

Auricular Hematoma Management

Ear, nose, and throat (ENT) complaints are commonly seen in the emergency department. When you hear “ENT emergencies,” you probably think about epistaxis, sinusitis, and possibly foreign body removal (either from the ear or nose). While not as common, auricular ...

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Head, Eye, Ear, Nose, and Throat

REBEL Cast Ep84: Here We Go Again with Time is Brain

Background: Here we go again with another “Time is Brain,” acute ischemic stroke study.  The authors start out by saying that earlier administration of intravenous tPA in acute ischemic stroke is associated with reduced mortality by the time of hospital ...

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Neurology

Factor Xa Inhibitor Related ICH & PCCs

Background: Factor Xa inhibitors have gained more use over the past several years due to the ease of administration and easier monitoring. However, bleeding, namely intracranial hemorrhage (ICH) is still a risk and the lack of a proven antidote is ...

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Hematology and Oncology

Fluid Administration in End-Stage Renal Disease for Severe Sepsis and Septic Shock by Shyam Murali, MD

Background: In end-stage renal disease (ESRD) patients on hemodialysis (HD), infection is the second most common cause of mortality after cardiovascular disease (Sarnik 2000). Because of the systemic inflammation and increased capillary permeability, septic patients are at significant risk for fluid ...

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

Hydroxychloroquine is Ineffective for Post-Exposure Prophylaxis

Background: Despite the initial excitement around the use of chloroquine (CQ) and hydroxychloroquine (HCQ), there is mounting evidence that neither drug is effective in COVID-19 treatment. Laboratory studies have shown antiviral and immunomodulatory properties in vitro but these have not ...

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Infectious Disease

Convalescent Plasma Therapy for COVID-19: Hopeful Signals of Improvement

Background: Convalescent plasma therapy is not a new or novel therapeutic option.  It involves taking the plasma from patients who have recovered from an illness and using it to treat patients who currently have the same illness. This approach has ...

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Infectious Disease

Peripheral Pressors: 6 Pearls to Not F*#k Up the Arm

Traditionally, vasopressor infusions have been done through central venous catheters (CVCs) due to the hypothetical risk of extravasation injury to extremities when given through peripheral IVs.  The documented risk of extravasation from peripheral pressors is 3 – 6% . Hypothetically, ...

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Procedures and Skills

COVID-19: Remdesivir RCT #3 (5d vs 10d)

Background: We have covered the two previous RCTs on remdesivir on REBEL EM (RCT #1 and RCT #2). In the first trial by Wang et al , there was no statically significant improvement in clinical outcomes, but, there were trends ...

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Infectious Disease

The FISH RCT: Surgical vs Non-Surgical Management of Displaced Humeral Shaft Fractures

Background: Humeral shaft fractures are commonly seen in the Emergency Department and emergency management is relatively straightforward: assess for other trauma, assess for radial nerve injury, analgesia, sling or functional bracing and follow up with orthopedics. However, there are debates ...

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Orthopedics
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