May 7, 2018

Background: Visits to the ED for alcohol intoxication can create quite the clinical conundrum both for acute medical and traumatic reasons.  Acutely intoxicated patients, just like young kids, don’t always have the ability to communicate due to sedation, agitation, or some other critical medical/traumatic process that is ongoing.  This makes getting a complete history or depending on the physical exam unreliable at best.

April 26, 2018

Background: There has been lots of research published in past years on how to minimize pain and anxiety in children brought to the ED.  Unfortunately, as we all know there is often a lag time from research publication to clinical application.  It has been my experience that health care professionals tend to provide inconsistent and inadequate pain control for children.  In this episode of REBEL Cast we are going to interview Sebrina Perkins, a pediatric emergency medicine physician working for the Greater San Antonio Emergency Physicians (GSEP) group, on pediatric pain management pearls.

April 13, 2018

Recently I was asked to speak at the Texas College of Emergency Physicians (TCEP) conference April 2018.  The particulars of this session were, five, 10 minute lectures on new indications for old drugs.  My topic was the use of octreotide and somatostatin for undifferentiated upper gastrointestinal bleeding.  This is a particular topic I have been getting more and more requests for, but didn’t really know the evidence behind why I was doing it.  Does it help my patients or just another expensive medication, that takes up an IV with no clear patient oriented outcome?

March 26, 2018

Background: Welcome back to REBEL Cast episode 47.  In this issue we are going to talk about some recent trials published in the past year that have gotten some love in the FOAMed world.  We have been meaning to discuss these trials, but just simply didn't have the time until now.  What trials are we reviewing?
  • The age of PRBCs in transfusion
  • The usefulness of lidocaine in renal colic
  • The utility of oxygen therapy in Stroke

March 12, 2018

In Episode 46a we discussed respiratory failure and NIV.  In episode 46b we are going move on to the patient where you have tried NIV and your patient just doesn’t seem to be improving.  You decide to intubate your patient and connect them to the ventilator.  Now the ventilator starts beeping and your patient begins to decompensate.  What are the steps you use to assess the problem and fix it?