REBEL Cast brings REBEL EM posts to life in audio form. We open with a clinical scenario and a focused clinical question, then critically appraise the study—key results, strengths, limitations, and what it means at the bedside. Every episode ends with actionable take-home points.
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Take Home Points Lithium toxicity comes in a three flavors: acute, chronic and acute on chronic. Each form will have a different presentation as well as management. Lithium levels are often unreliable in terms of guiding management and must be ...
Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating ...
Take Home Points Perichondritis is an infection of the cartilage and connective tissue of the ear Perichondritis can be recognized clinically by erythema, swelling and tenderness of the auricle. The most common organism in perichondritis is P. aeruginosa and antibiotics ...
Take Home Points Methemoglobinemia can result from exposure to a number of different medications. The most common are dapsone and topical anesthetic agents (i.e. benzocaine) Consider the diagnosis in any patient with cyanosis and hypoxia that doesn’t respond to oxygen ...
Take Home Points Spontaneous Bacterial Peritonitis (SBP) is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis An ascites PMN count > 250 cells/mm3 is ...
Take Home Points Severe hypocalcemia can cause hypotension and QTc prolongation leading to Torsades de Pointes. Treat moderate to severe symptoms and any EKG changes with IV calcium salts Always search for and treat the underlying cause of hypocalcemia
Take Home Points Patients with severe hypercalcemia (> 14 mg/dL) are at risk for severe cardiac dysrhythmias and cardiac collapse Treatment centers on volume repletion with normal saline with consideration for the addition of loop diuretics AFTER volume reexpansion is ...
Background: Hypoxemia is a commonly encountered adverse event during rapid sequence intubation (RSI) in the ED. Critically ill patients in the ED often have a lack of physiologic reserve, decreased cardiac output, increased shunting, and reduced pulmonary reserves. Therefore, a ...
Background: Some of the feared complications of endotracheal intubation include hypotension, cardiac arrest, and death (cardiovascular collapse). These complications can result from numerous causes including medication-induced vasodilation and decreased venous return to the heart due to increased intrathoracic pressure from ...
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