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.
Have a paper we should review? Email: rebelemteam@gmail.com.
Listen:
Take Home Points Ask about the red flags: cancer, fever, IVDA, FND, point tenderness, saddle/perianal anesthesia, trauma, urinary retention, bowel incontinence, weight loss Most don’t need XR’s – set this expectation and advise against bed rest Consider XR’s: h/o cancer, ...
Take Home Points Get a upreg on any childbearing age female with vaginal bleeding – this is an ectopic pregnancy until proven otherwise Confirm vaginal vs rectal bleeding – it can be hard for patients to tell, especially the elderly ...
Take Home Points Get a upreg on every female patient of child bearing age with lower abdominal pain – this is an ectopic pregnancy until proven otherwise Always consider ovarian/testicular pathology for lower abdominal pain Always have a chaperone when ...
Take Home Points Diffuse abdominal pain can be anything – keep a broad differential and work from there Old patient and flank pain = aortic catastrophe – aortic dissections and aneurysms can knock off flow to the kidneys Appendicitis and ...
Take Home Points Patients don’t necessarily know what’s important – ask lots of questions, find out if they’ve been taking a ton of NSAID’s or Tylenol for their pain and now they have an ulcer or hepatitis Keep a broad ...
Take Home Points Go in thinking sick vs not sick – this can take time to develop and that’s ok, this skill will come as you see more patients If you’re thinking about getting a scan or u/s – just ...
Take Home Points Think about causes – is it the head, the belly, or something else leading to the vomiting Get a upreg on all females of childbearing age Peritoneal signs – look for rebound/guarding, consider surgery consult prior to ...
Take Home Points Take chest pain seriously – ACS and PE patients don’t always appear ill – look for the silent killer cases Remember 4-2-1 approach to chest pain = 4 chambers, 2 lungs, 1 esophagus EKG’s – get an old ...
Take Home Points Wheezing can be absent when severe – be wary of the silent chest = impending respiratory failure Not everything that wheezes is asthma! Beware of mimics – COPD, CHF, anaphylaxis, stridor Consider dexamethasone in those with poor ...
Take Home Points Keep a wide differential Think of the airway, lungs, heart, blood, kidneys, acid/base, brain Use Wells & PERC consecutively to stratify those who you think may have a PE Silent chest is asthma patients is a harbinger ...
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