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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

REBEL Core Cast 8.0 – The NEJM + Non-Inferiority Studies

Take Home Points on Non-Inferiority Studies Non-inferiority studies should be done when a new treatment (or diagnostic modality) requires less resources (cost or time), is easier for the patient or has a lower side-effect profile. Non-inferiority study design largely negates ...

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Extending the tPA Window to 4.5 – 9 Hours in Acute Ischemic Stroke (AIS)?

Background: No matter which side of the debate you sit on in regard to systemic thrombolysis in acute ischemic stroke (AIS), there is one truth: systems have undergone major changes to ensure tPA is offered to patients in the ≤4.5-hour window.  ...

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Neurology

Critical Care Controversies: The REBEL vs The SKEPTIC at #SMACC 2019

On the last day of the last SMACC conference, Dr. Ken Milne (The SGEM) and I had a cage match debating four critical care controversies. It was all done in good fun with both of us taking our opportunities to ...

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NeurologyProcedures and SkillsResuscitation

Pulse Checks in Cardiac Arrest Should be Dead

Background: In an older study published in Resuscitation 1998 , ED physicians, ICU physicians, and nurses tried to identify a carotid pulse in a healthy male volunteer with normal blood pressure. 43.1% of the health professionals required >5 seconds to detect the ...

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Resuscitation

Tranexamic Acid (TXA) for Everything that Bleeds?

Background: TXA is a synthetic lysine derivative that binds with the lysine site on plasminogen and inhibits fibrinolysis.  TXA is not a new drug. Studies from the late 1960s and early 1970s have shown reduced bleeding and need for transfusions in ...

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Hematology and Oncology

JC: Time to put the REBOA Balloon Away? Maybe, Maybe Not…

The management of the critically hemorrhaging trauma patient has seen a large amount of change over last decade, from bringing care far forward to the field to early use of blood products to civilian translation and application tourniquets to name a ...

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Trauma

PreVent: Bag-Mask Ventilation Prior to Intubation

Background: Rapid Sequence Intubation (RSI)  is a common procedure performed by both emergency clinicians and intensivists. Although the procedure is complex, the major pieces are pre-oxygenation, administration of a sedative agent in close proximity with a paralytic, laryngoscopy and placement of ...

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Resuscitation

REBEL Core Cast 7.0 – Oncologic Emergencies

Take Home Points on Oncologic Emergencies: Hyperviscosity Syndrome happens when elevated WBCs or severe hyperproteinemia cause high serum viscosity and micro-circulatory problems in patients with Waldenstrom’s macroglobulinemia, multiple myeloma or acute leukemia. Be suspicious of this syndrome in these patient’s when they present with the ...

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Hematology and Oncology

HiTEMP: Procalcitonin-Guided Antibiotic Therapy in the ED

Background: With CMS core measures requiring timely use of antibiotics in patients with fever and suspected sepsis, many patients receive antibiotics up front that may ultimately end up having another non-bacterial etiology as the cause of their fever.  On the one ...

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Infectious Disease

TRAPID-AMI: Predictive Symptoms of Acute Myocardial Infarction (AMI)

Background: Chest pain is a complaint commonly seen in the emergency department.  Getting a good history is an essential part of working up patients with chest pain, as the history may guide us to be concerned for the cause of life-threatening ...

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Cardiovascular
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