Category: Uncategorized

Sympathetic Crashing Acute Pulmonary Edema: High-Dose Vs. Low-Dose Nitro

Background: Sympathetic Crashing Acute Pulmonary Edema (SCAPE) results from an increased systemic vascular resistance and activation of the Renin-Angiotensin-Aldosterone System (RAAS), which causes increased sodium/water reabsorption and worsening cardiac function. Additionally, sympathetic activation shifts fluid from splanchnic beds into the …

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ResuscitationThoracic and Respiratory

REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy

Take Home Points Management of severe beta-blocker and calcium-channel blocker toxicity should occur in a stepwise fashion: potential gastric decontamination, multiple lines of access, judicious fluids, calcium, glucagon, and vasopressors as needed. Initiation of high dose insulin therapy requires a …

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Should We Be Switching to Whole Blood Instead of Component Therapy in Hemorrhagic Shock?

Background: Hemorrhage remains as one of the biggest causes of death in trauma patients. Strategies such as permissive hypotension, massive transfusion protocols, avoidance of crystalloids, TXA, and definitive hemorrhage control help decrease mortality in these patients. Empiric component blood transfusion …

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Hematology and OncologyTrauma

REBEL Core Cast 123.0 – Posterior Epistaxis

Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit …

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Head, Eye, Ear, Nose, and Throat

The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). MVM exaggerates venous return to the heart …

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