12 Mar 2018

March 12, 2018

Written by REBEL Cast
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?
Medical Categories: Thoracic and Respiratory
0 Likes
26 Feb 2018

February 26, 2018

Written by REBEL Cast
Imagine you have a patient in respiratory failure sitting right in front of you. The patient has an increased work of breathing and obviously in distress.  Monitors are beeping, nurses are asking you what you want to do, and if you don’t do something, the patient is going to arrest and potentially die.  What is your framework for tackling these patients?  Well, I had a chance to sit down with Haney Mallemat and discuss his framework for managing respiratory failure and NIV.
Medical Categories: Thoracic and Respiratory
2 Likes
5 Feb 2018

February 5, 2018

Written by REBEL Cast, REBEL Prez

What’s Wrong With Lectures/Presentations Now?

  • Lecturing style has remained stagnant despite the fact that our understanding of how people learn has changed.
  • Most presentations make the supportive media (i.e. slides) the focus of the presentation without thought about the story or the delivery.
  • Lectures are too focused on the educator instead of focusing on the needs of the learner.
6 Likes
25 Jan 2018

January 25, 2018

Written by REBEL Cast

Background: Placement of vascular access for administration of resuscitation drugs and fluids is a common procedure in the management of out of hospital cardiac arrest (OHCA). While intravenous (IV) placement has been the standard approach for decades, intraosseous (IO) access is rapid and safe and may be the preferred approach due to fact that the bone marrow does not collapse during shock states as peripheral veins often do. Despite it’s advantages, there are concerns about IO placement because of the potential for drugs to pool in the marrow and not circulate. Prior studies have shown an association with tibial IO placement and decreased rate of ROSC though no association with worse neurologic outcomes (Feinstein 2017).

Medical Categories: Procedures and Skills, Resuscitation
0 Likes
8 Jan 2018

January 8, 2018

Written by REBEL Cast
Background: In the United States we are not only seeing an opioid epidemic but also a shortage of IV opioid agents. For both reasons, it is important to find non-opioid options for common pain complaints seen in the ED.  Changing prescribing practices is difficult but an important step in minimizing opioid usage.  Current research suggests that even short term opioid use can cause a predisposition to subsequent opioid dependence. In the spirit of doing no harm, we as a healthcare community should look to find other less harmful ways to decrease pain and suffering.  In this episode, we will review four randomized clinical trials published in the past year on pain control to see if there is evidence to support other non-opioid options.
Medical Categories: Trauma
0 Likes
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