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Rebellion in EM 2019: Suboxone for Opioid Addiction via Salil Bhandari, MD

Background: The role of the ED physician in helping stop the opioid epidemic is three-fold: safe prescribing practices, beginning suboxone administration in the ED as part of an ED/Community Suboxone program, and providing Narcan prescriptions to at risk patients. Most ...

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Toxicology

Spontaneous Bacterial Peritonitis (SBP)

Definition: Acute infection of the ascitic fluid in a patient with liver disease without another source of infection Epidemiology: (Runyon 1988, Runyon 1988, Borzio 2001) Incidence 10-25% risk of at least one episode per year 20% risk in those with ascites ...

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Abdominal and Gastrointestinal

Post Contrast Acute Kidney Injury (PC-AKI): We Don’t Need Another Retrospective Observational Study

Background: Computed tomography pulmonary angiography (CTPA) is the current gold standard for diagnosing acute pulmonary embolism in the ED.  It has a high sensitivity, and specificity, is readily available, and can establish analternative diagnoses.  One issue with CTPA is that ...

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Renal and Genitourinary

REBEL Core Cast 25.0 – Osteomyelitis

Take Home Points  Osteomyelitis is an infection in any part of a bone. It has a varied presentation including acute and chronic forms. Patients can present septic, or rather well appearing. Patients may present with fever, chills, musculoskeletal pain, erythema, ...

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Infectious Disease

REBEL Crit Cast Episode 1.0 – Overview of Targeted Temperature Management (TTM) Post Cardiac Arrest

Therapeutic Hypothermia (also called targeted temperature management (TTM)) is a deliberate reduction of the core body temperature to 32 – 34°C, in patients who suffer cardiac arrest with return of spontaneous circulation, but also don’t regain consciousness.  In REBEL Crit ...

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Resuscitation

The CURASMUR Trial: Roc Rocks & Sux Sucks?

Background: Rapid sequence intubation (RSI) is the most widely utilized approach for patients requiring emergency tracheal intubation.  RSI typically requires the use of a induction agent followed by the use of a neuromuscular blocking agent (NMBA) to improve the overall ...

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Procedures and Skills

Should Bed Up Head Elevated (BUHE) be the New Standard Position for RSI in the ED?

Background: Although the standard positioning for intubation is supine in the sniffing position, there has been recent literature in the past decade that elevating the head of the bed to 25 to 30 degrees may be a preferable setup for ...

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Procedures and Skills

REBEL Cast Ep73: Are Peripheral Vasopressors Safe?

Background: Traditionally, vasopressors have been given through central venous catheters (CVCs) in the critically ill.However, the time it takes to place a CVC is time a patient could potentially remain hypotensive. Early initiation of vasopressors may be associated with reduced ...

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Resuscitation

The Q Word Superstition

Background: One of my favorite ED superstitions is that if someone says the word “quiet,” all hell is going to break loose. Many believe this superstition and as the ED inevitably gets busier as the day goes on, the person ...

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REBEL Crit Cast Ep 0.0 – The Intro

REBEL EM-ers: Salim & I would like to introduce the launch of a new REBEL EM project. We are adding a podcast focused on a wide variety of resuscitation and critical care topics in both Adult & Pediatric Medicine to ...

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