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Petition to Retire the Surviving Sepsis Campaign Guidelines

Friends, Concern regarding the Surviving Sepsis Campaign (SSC) guidelines dates back to their inception.  Guideline development was sponsored by Eli Lilly and Edwards Life Sciences as part of a commercial marketing campaign (1).  Throughout its history, the SSC has a ...

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Infectious Disease

Chest Pain, "Negative" Stress Tests, POCUS, & ECG Equations

I was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain.  I remember ...

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Cardiovascular

Chest Pain, “Negative” Stress Tests, POCUS, & ECG Equations

I was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain.  I remember ...

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Cardiovascular

REBEL Cast Episode 49: Pediatric Pain Management Pearls with Sebrina Perkins

Background: There has been lots of research published in past years on how to minimize pain and anxiety in children brought to the ED.  Unfortunately, as we all know there is often a lag time from research publication to clinical ...

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Pediatrics

The BEST AF Trial: What is the Optimal Energy Selection for Cardioversion in Patients with Afib?

Background:There are two trains of thought in using transthoracic direct current cardioversion (DCCV) when it comes to converting atrial fibrillation.  The first is an escalating energy approach which allows cardioversion to occur at the lowest energy for each individual patient ...

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Cardiovascular

Stroke Workflow in 2018

With the publication of the DAWN and DEFUSE-3 trials came a new era in stroke management.  We have discussed the specific literature pertaining to endovascular therapy on REBEL EM before in our 2hour CME activity HERE.  Along with the two new publications ...

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Neurology

Bougie 1st Intubation in the ED?

Background: Successful first-pass endotracheal intubation is the desired outcome of all ER physicians as this can stave off hypoxemia and aspiration.  The bougie is one tool we have in our armamentarium that may be able to help with intubation. Many providers ...

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Procedures and Skills

The SIRS & qSOFA Confusion in Sepsis

Background: It is well established that the rapid identification of patients with sepsis is needed in order to initiate timely care to improve morbidity and mortality.  The systemic inflammatory response syndrome (SIRS) criteria have been used for some time for ...

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Infectious Disease

The SIRS & qSOFA Confusion in Sepsis

Background: It is well established that the rapid identification of patients with sepsis is needed in order to initiate timely care to improve morbidity and mortality.  The systemic inflammatory response syndrome (SIRS) criteria have been used for some time for ...

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Infectious Disease

REBEL Cast Ep 48: Octreotide and Somatostatin for Undifferentiated Upper Gastrointestinal Bleed

Recently I was asked to speak at the Texas College of Emergency Physicians (TCEP) conference April 2018.  The particulars of this session were, five, 10 minute lectures on new indications for old drugs.  My topic was the use of octreotide ...

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Abdominal and Gastrointestinal
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