REBEL Cast

is the blogs audio version. The podcast typically starts by setting a clinical stage with a pertinent clinical question, followed by a discussion of the paper with pertinent results, strengths, limitations, and further discussion. Finally, we end every podcast with clinical take home points from the papers being reviewed. If there are papers you think we should evaluate, email them to srrezaie@gmail.com.

July 28, 2021

Take Home Points

  • Infuse factor first, investigate later
  • Treat when bleeding is suspected, not confirmed. Have a low threshold!
  • It is better to over treat than undertreat. Give full dose when in doubt
    • Factor 8 = 50U/kg
    • Factor 9 = 100 U/kg
  • Beware of hidden bleeds (brain, retroperitoneal, deep muscles)
  • If patient has inhibitors, or no factor available you may use
    • Activated PCC (FEIBA) = 80 -100U/kg
    • Recombinant factor 7a = 90 mcg/kg

July 14, 2021

Take Home Points

1. Debriefing is critical. Studies show numerous benefits in terms of team communication and staff ability to regroup.
2. Start by gathering your team, thanking them for their work and noting that nothing could have changed the patient's ultimate outcome.
3. Summarize the events so everyone is on the same page and then prompt people to offer thoughts by asking "what went well? what could have gone better?"
4. Remember to end on a positive note to get everyone refocused and energized.

June 30, 2021

Take Home Points

- Unexplained tachycardia (or any abnormal vital sign) warrants investigation.
- Pain, induration, "woody" feel of any muscle group should raise suspicion of infection in that muscle group that has spread hematogenously especially in those with predisposing factors (e.g HIV, trauma, IVDA)
- Early pyomyositis will not necessarily have abscess formation
- Treatment consists of IV antibiotics, possible drainage or surgery for source control.

June 16, 2021

Take Home Points
  • Neck movement (both extension and flexion) has the ability to cause cord damage.
  • Using hyperangulated blade in video laryngoscopy improves chances for glottic visualization in patients with a c-collar in place.
  • Ultimately, hypoxemia kills – Intubate the patient with what you have available, as there has not been shown to be a definitively superior technique.