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RSI, Predictors of Cardiac Arrest Post-Intubation, and Critically Ill Adults

Background:Intubation is a commonly performed procedure in the ED and ICU. We have discussed the physiologically difficult intubation before on REBEL EM.  One of the tenants in managing these patients is “resuscitate before you intubate.”  Two publications in the past ...

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Resuscitation

REBEL Cast Episode 50 – Intoxicated Patients can Equal Badness

Background: Visits to the ED for alcohol intoxication can create quite the clinical conundrum both for acute medical and traumatic reasons.  Acutely intoxicated patients, just like young kids, don’t always have the ability to communicate due to sedation, agitation, or ...

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Toxicology

Dosing Sedatives Low and Paralytics High in Shock Patients Requiring RSI

Background: A series of tweets I sent out recently generated a visceral response from critical care clinicians the world over. I summarized my strategy of shock dose RSI as sedatives low and paralytics high (low dose ketamine, high dose rocuronium along with ...

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Resuscitation

Getting Things Done in a Hyperdistracted World

I have been accused by many of my colleagues and friends as being hypomanic.  They always wonder how I get so much done.  Do I function on 4 – 5 hours of sleep?  Is it the fact that I am ...

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Keeping Up in EM at Cook County Grand Rounds

Background: With hundreds of journals, and thousands of publications in any given month it is near impossible to sift through all the current medical literature and hope that you find the most pertinent articles that could impact practice. One of the key ...

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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
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