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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

Single Syringe Adenosine for SVT?

Background: The 2015 American Heart Association guidelines for Adult Advanced Cardiac Life Support recommend adenosine in non-hypotensive patients in regular narrow-complex supraventricular tachycardia (SVT).  Adenosine has a rapid onset and a half-life that is <10 seconds, which makes it an ...

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Cardiovascular

REBEL Core Cast 23.0 – Vaping Associated Pulmonary Injury

Take Home Points  Ask the patient if they vape! Worry about the sick looking patient and those seen recently CXR is nonspecific and CT might tell you what’s going on Start antibiotics and if you have strong suspicions of vaping ...

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Thoracic and Respiratory

AVERT-Shock: Vasopressin for Acute Hemorrhage?

You are working at a Level 1 Trauma Center; a 35-year-old female arrives via EMS from the scene of a motor vehicle accident. She was an unrestrained passenger, ejected 50 feet. She was hypotensive and hypoxic on scene with concern ...

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ResuscitationTrauma

SMART Trial Part 2: Secondary Analysis of Balanced Crystalloids vs Saline in Sepsis

Background: Saline (0.9% sodium chloride) has historically been one of the most common intravenous fluids administered in critically ill adults.  However, the supraphysiologic chloride concentration can cause hyperchloremia, metabolic acidosis, renal vasoconstriction and alter immune function.  There is nothing normal ...

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Endocrine, Metabolic, Fluid, and Electrolytes

LEAP 2: Lefamulin vs Moxifloxacin for CAP

Background: Recently there have been some observed trends in decreasing susceptibility among Strep pneumoniae isolates to antimicrobials used to treat community acquired pneumonia (CAP) (Resistance to oral penicillin and macrolides for Strep pneumoniae & macrolides and fluoroquinolones for Staph aureus).  ...

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Infectious Disease

REBEL Core Cast 22.0 – Decompensated Liver Disease

Take Home Points    End stage liver disease patients have fragile baseline physiology. Minor insults can have profound effects Always start with the basics – large bore IV lines SBP give 3rd generation cephalosporin + albumin in severe disease Upper ...

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Abdominal and Gastrointestinal

CITRIS-ALI: Vitamin C in Patients with Sepsis and Severe Acute Respiratory Failure

Background: In 2016, Paul Marik published a study in Chest demonstrating a decrease in hospital mortality of 32% for sepsis patients treated with vitamin C, thiamine and hydrocortisone.  The Marik protocol(as it has come to be known), entails IV ...

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Infectious Disease

ICU-ROX: Conservative vs Usual O2 Therapy During Mechanical Ventilation in the ICU

Background: The IOTA trial, was a systematic review and meta-analysis of 25 RCTs enrolling 16,000 patients with sepsis, critical illness, stroke, trauma, MI, cardiac arrest, and/or emergency surgery. In this review it was found that liberal use of O2 resulted ...

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Resuscitation

HYPERION: Targeted Temperature Management in Cardiac Arrest Patients with Non-Shockable Rhythms

Background Information: Therapeutic hypothermia is the use of targeted temperature management to reduce neurologic sequelae resulting from the severe ischemia-reperfusion injury that occurs during cardiac arrest primarily from shockable rhythms.1 Although a mainstay treatment in the Advanced Cardiac Life Support ...

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Resuscitation

SEPSIS-ACT: Selepressin in Septic Shock

Background: Septic shock is the most severe form of sepsis. It is characterized by vasodilation and increased capillary permeability leading to hypotension and tissue hypoxia.  The initial treatment of septic shock includes early identification, intravenous fluids when necessary, appropriate broad-spectrum ...

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Infectious Disease
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