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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Background: Current trauma resuscitation prioritizes control of bleeding and uses massive transfusion protocols to prevent and treat coagulopathy. This is typically done in the form of massive transfusion protocols delivered in proportions that approach the composition of whole blood. Two ...
Back in April 2020, on REBEL Cast episode 79 we sat down to discuss COVID-19. Specifically, we focused on not intubating patients early and why ARDSnet may not be the best ventilator paradigm for patients with COVID-19. By popular demand, ...
Background: Intravenous alteplase is the current standard care for treatment of acute ischemic stroke (AIS) despite active debate on the research supporting its use. The window for its use has been restricted to <3h of symptom onset based on the ...
Take Home Points This is a resuscitative hysterotomy – focus is on saving the mother first. Delivering the fetus can improve venous return thus increasing chance to save mom Don’t focus on gestational age to make the decision – if ...
Take Home Points Be sure to consider mesenteric ischemia in any elderly patient with abdominal pain or lower gastrointestinal (GI) complaints. Remember, the presentation can be tricky to find and they may have a reassuring abdominal exam. Ask about artherosclerotic ...
Background Information: Central venous catheterization is a common procedure performed in the ICU for the purposes of drug administration and resuscitation. The subclavian vein is the more preferred access site given its fixed puncture location, ease for nursing access and low ...
Background Information: Ultrasound guided peripheral and central venous access has become more common while simultaneously decreasing complications and increasing first pass success. Landmark guided palpation has historically been considered the standard of care when placing arterial lines, however the use ...
Background: The well-established, standard treatment for acute appendicitis is surgical appendectomy. However, recent research has challenged the dominance of the surgical approach in looking at antibiotics alone. The available literature on non-operative treatment of appendicitis (NOTA) has important limitations: exclusion ...
Take Home Points Watch for continued bleeding in excess of 500 ml or bleeding that is “more than normal.” Call it postpartum hemorrhage and start resuscitation Call your obstetric and/or surgical consultants early as operative intervention is often required Replace ...
Background: ICU discharge is often delayed due to intravenous vasopressor requirements to maintain clinically indicated blood pressure goals. In some patients without impairment of tissue oxygenation, the use of oral agents could facilitate weaning from IV vasopressors and lead to ...
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