Medical Category: Thoracic and Respiratory

Intubation in Surgical Patients: VL vs DL

Background: Although most intubations are typically successful there is still a portion of patients that may require multiple intubation attempts.  Repeated intubation attempts could lead to respiratory and hemodynamic complications. We recently covered the DEVICE trial on REBEL EM which …

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Procedures and SkillsResuscitationThoracic and Respiratory

REBEL Cast Ep125: 1st 48 Hours of PE Management – How Good Is Unfractionated Heparin?

Background: The mainstay of treatment for symptomatic pulmonary embolism  (PE) is anticoagulation (AC).  Patients with higher-risk PE may require advanced interventions such as thrombolytic therapy, surgical thrombectomy, or even extracorporeal membrane oxygenation (ECMO). Because of its short half-life and availability …

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CardiovascularHematology and OncologyResuscitationThoracic and Respiratory

The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

Background:  Ventilator-associated pneumonia (VAP), or what the CDC recently renamed infection-related ventilator-associated complication (IVAC),  is defined as a nosocomial pneumonia occurring on day 3 of mechanical ventilation that was preceded by 2 days of stable or decreasing ventilator requirements.1, 2  …

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NeurologyThoracic and Respiratory

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

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