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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

REBEL Core Cast 21.0 – ECG in Syncope

  REBEL Core Cast 21.0 – ECG in Syncope Click here for Direct Download of Podcast

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Cardiovascular

PrePARE: Effect of Fluid Bolus on CV Collapse During RSI

Background: Peri-intubation cardiovascular collapse (shock, cardiac arrest or death) is an all too common complication of airway management in critically ill patients seen in up to 25% of patients (Jaber 2010, Umobong 2018). The causes for collapse are numerous and ...

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Resuscitation

Are Antibiotics for Sepsis in One Hour Feasible in the ED?

Background: Despite minimal high-quality supporting evidence (Seymour 2017, Liu 2017, Ferrer 2014, Sterling 2015), regulatory bodies have pushed for benchmark times for administration of antibiotics in patients with sepsis. While most clinicians would agree that in patients with septic shock ...

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Infectious Disease

REBEL EM/EEM 2020 Fellowship Competition

APPLY NOW: REBEL EM’s 2020 Infographic Competition for Essentials of Emergency Medicine Education Fellowship Program The Essentials of Emergency Medicine (EEM) conference is in May 2020, but the opportunities to attend start NOW. This conference is one of the largest live EM educational ...

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Rebellion in EM 2019: 3 Things That Have Changed the Way I Intubate

Background: Despite decades of experience with endotracheal intubation, we continue to find approaches to improving the process of how we intubate. In this talk at Rebellion in EM 2019, Rob J. Bryant, MD gave a 14 minute 12 second talk ...

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Procedures and Skills

REBEL Core Cast 20.0 – Takotsubo’s Cardiomyopathy

Take Home Points   Stress cardiomyopathy looks like ACS/STEMI, with patient presenting with chest pain, dyspnea or maybe syncope. It looks like ACS and should be treated as such until you prove to yourself it’s not. Classic patient is an older ...

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Cardiovascular
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