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All Categories
  • All Categories
  • Abdominal and Gastroinstestinal
  • 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
  • Infectious Disease
  • Neurology
  • Obstetrics and Gynecology
  • Orthopedics
  • Pediatrics
  • Procedures and Skills
  • Pyschobehavioral
  • Renal and Genitourinary
  • Resuscitation
  • Thoracic and Respiratory
  • Toxicology
  • Trauma

Gun Laws and Mass Shootings: A Call to Action

Background: Rob Elementary. Columbine. Sandy Hook. Pulse Night Club. Tops Grocery Store. Irvine Taiwanese Presbyterian Church. Virginia Beach. The Tree of Life Synagogue. Santa Fe High School. The New York City Subway. The Las Vegas Harvest Music Festival. Aurora Movie …

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Ethical and Legal

The FIRST-ABC Step Up Trial: HFNC vs CPAP for Liberation of Respiratory Support in Children?

Background: Respiratory support is a common intervention in pediatric ICUs and can include HFNC and CPAP/BPAP to avoid invasive mechanical ventilation.  HFNC has become more popular due to its ease of use, perceived patient comfort, and the ability to discharge …

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PediatricsResuscitation

REBEL Core Cast 84.0 – AVNRT

Take Home Points AVNRT is a common tachydysrhythmia that results from a reentrant loop within the AV node. Unstable patients with AVNRT should be considered for immediate synchronized electrical cardioversion. Stable patients with AVNRT can have a trial of vagal …

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Cardiovascular

Damping and Arterial Lines

Damping is the influence within a system that is a dissipation of energy during an oscillation.  In other words, think of damping like a shock absorber. Imagine a patient presenting with altered mental status.  All we know about the patient …

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CardiovascularProcedures and SkillsResuscitation

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

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