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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

SENIOR-NSTEMI: Should Elderly Patients with NSTEMI Receive Invasive Care?

Background: Non-ST-elevation myocardial infarction (NSTEMI) is defined as acute coronary injury resulting in ischemia and myocardial infarction. The diagnosis is made based on clinical presentation and non-specific electrocardiogram (ECG) changes including ST-segment depression, T-wave inversions, or other nonspecific findings.1 Based …

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Cardiovascular

REBEL Cast Ep98: Intravenous Contrast and Long-Term Kidney Impairment

Background: It has long been thought that intravenous contrast can lead to acute kidney injury. Recent data, however, has called this dogmatic teaching into question.  Unfortunately, the data arguing against the association of contrast with AKI comes from observational trials …

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Renal and Genitourinary

Dogmalysis: GCS <8, Then Intubate?

In emergency medicine, the standard of care is to place an advanced airway for ventilatory or oxygenation failure, impending airway compromise, or inability to protect the airway. A patient with significant cognitive impairment may have depressed gag and/or cough reflexes, …

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Procedures and Skills

The Autotelic Emergency Physician

In the fall of 2014, while working overnight in the emergency department at a community hospital in NJ, a patient (let’s call him John) presented with ACE inhibitor angioedema. At first glance, his lips were swollen, but his tongue and …

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REBEL Core Cast 54.0 Wound Care I – Foreign Bodies

Take Home Points FBs are a very common complication of wounds. X-ray is poor at detecting foreign bodies US is a tremendous tool and be used dynamically at the bedside to assist w FB extraction Prophylactic antibiotics are not routinely …

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Trauma

Optimal Needle Position for Decompression of Tension Pneumothorax

Background: Tension Pneumothorax (TP) can occur as a potentially life-threatening complication of chest trauma. With the risk of respiratory and cardiac arrest, an immediate temporizing intervention for this condition is required by direct Needle Decompression (ND). In 2018, the Advanced Trauma …

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Procedures and Skills

REBEL Cast Book Club Episode 1 – The Coddling of the American Mind

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The MENDS2 Trial: Dexmedetomidine vs Propofol for Sedation

Background: In patients requiring mechanical ventilation, sedative medications are used for patient comfort and safety.  However, these medications can also lead to brain dysfunction (i.e. delirium or coma) and long-term cognitive impairment. Currently, the Society of Critical Are Medicine [2] …

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Thoracic and Respiratory

Gone in 120 Seconds!

By the time you finish reading this post, you could have completed most items on your daily to-do list. It’s surprising how many tasks can be completed in under 2 minutes once the next action is clarified.

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The VICTAS Trial: How Many More RCTs do we Need on the Metabolic Cocktail in Sepsis?

Background: Since the publication of the before and after Marik trial [1] published in 2016, there have been six randomized clinical trials trying to answer the question of the utility of the metabolic cocktail (Vitamin C, thiamine, and hydrocortisone) in …

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Infectious Disease

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