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The ARAMIS Trial: DAPT vs Alteplase in Minor Nondisabling Acute Ischemic Stroke

Background: Current stroke guidelines recommend IV alteplase for patients with acute ischemic stroke presenting within 4.5hrs of symptom onset based on the NINDS and ECASS III publications. Both NINDS and ECASS III excluded patients with mild stroke symptoms but failed ...

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Neurology

REBEL Core Cast 105.0 – Methylxanthine Toxicity

Take Home Points Methylxanthines are a drug class that includes caffeine, theophylline, and theobromine. The three main mechanisms that account for the clinical presentation of methylxanthine toxicity are: catecholamine release, adenosine antagonism, and phosphodiesterase inhibition. Beta agonism will lead to ...

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Toxicology

Peri-Intubation Hypotension – Dose Induction Dose Matter?

Background: Rapid Sequence Intubation (RSI) is a procedure fraught with potential complications including hypotension which, in turn, can result in cardiovascular collapse. While there are numerous potential causes of hypotension peri-RSI, induction medications represent an important, modifiable variable. Over the ...

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Procedures and Skills

Don’t Become Obsolete: The EM Physician’s Fight Against Procedural Decay

INTRODUCTION You’re moonlighting in a remote access hospital. EMS radios in for a burn patient and to anticipate a difficult airway. You can hear the tension in their voice. They’re rolling up now. The patient is horribly burned. She was ...

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Procedures and Skills

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession.  RSI inherently carries with it risks of complications such as post-intubation hypotension and cardiac arrest in the ...

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Procedures and SkillsResuscitationThoracic and Respiratory

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