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The Needle Vs. The Knife for Spontaneous Pneumothorax: A Closer Look at the EXPRED Study

Background:  The optimal management of primary, spontaneous pneumothorax (sPTX) remains an area of active debate. The British Thoracic Society recommends the least invasive approach possible. In contrast, the American College of Chest Physicians favors first-line chest tube drainage for any …

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Thoracic and Respiratory

The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

Background: Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. Tenecteplase, a modified version of …

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Neurology

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Background: Massive pulmonary embolism  defined as sustained hypotension (SBP <90mmHg)  has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) [1]. However, full-dose thrombolytic therapy (Alteplase 100mg (IV) is  associated …

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CardiovascularResuscitationThoracic and Respiratory

Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. It can be used to distinguish between various conditions, including chronic obstructive pulmonary disease (COPD) exacerbation, acute heart failure (AHF), pleural effusion, pulmonary edema, pericardial …

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Procedures and SkillsThoracic and Respiratory

REBEL Core Cast 116.0 – Achilles Tendon Rupture

Take Home Points Achilles tendon rupture is a clinical diagnosis. The Thompson Test should be applied in all suspected cases. Remember to brace or splint a rupture, even if suspected, in the resting equinus position for optimal healing and prevention …

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Orthopedics

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