REBEL EM has primarily been a clinical blog focusing on critical appraisal of research, but now we are proud to introduce

REBEL Core

, an initiative to improve discussion of core content in emergency medicine/critical care. Free Open Access Medical Education (FOAMed) has long been dedicated to discussing current literature to shorten knowledge translation. However, if all you use is FOAMed, then you will have “swiss cheese knowledge”, due to the lack of having foundational knowledge. The entire breadth of emergency medicine is not currently covered by FOAMed with a disproportionate representation of critical care topics (i.e. ECG, Ultrasound, Resuscitation, Procedures). REBEL Core will continue to discuss the foundational knowledge necessary in all aspects of emergency care.
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  • REBEL Core
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  • REBEL Core

REBEL Core Cast 91.0 – Testicular Torsion

Take Home Points Consider the diagnosis of testicular torsion in all patients with acute testicular pain Testicular torsion is a surgical emergency that requires immediate urologic consultation to increase the rate of tissue salvage. History, physical examination and ultrasound are …

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Renal and Genitourinary

REBEL Core Cast 90.0 – Methemoglobinemia

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 …

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Toxicology

REBEL Core Cast 89.0 – Spontaneous Bacterial Peritonitis

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 …

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Abdominal and Gastroinstestinal

REBEL Core Cast 88.0 – Hypocalcemia

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

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Endocrine, Metabolic, Fluid, and Electrolytes

REBEL Core Cast 87.0 – Hypercalcemia

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 …

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Endocrine, Metabolic, Fluid, and Electrolytes

REBEL Core Cast 86.0 – Hand Nerve Blocks

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Procedures and Skills

REBEL Core Cast 85.0 – Superficial Venous Thrombosis

Take Home Points SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation.  The rate of concurrent DVT and PE in patients with SVT is 25% and 5%, respectively. 

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REBEL Core Cast 84.0 – AVNRT

Take Home Points AVNRT is a common tachydysrhythmia that results from a reentrant loop within the AV node. Unstable patients with AVNRT should be considered for immediate synchronized electrical cardioversion. Stable patients with AVNRT can have a trial of vagal …

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Cardiovascular

REBEL Core Cast 83.0 – Post-LP Headache

Take Home Points Post dural-puncture headache affects up to 30% of patients after lumbar puncture. Suspect PDPH in all patients who recently underwent an LP or epidural anesthesia regardless of whether they meet the IHS criteria. The best way to …

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NeurologyProcedures and Skills

REBEL Core Cast 82.0 – Abdominal Aortic Aneurysm

Take Home Points Consider AAA in patients with acute onset of back or abdominal pain particularly in patients > 50 and in those with a history of hypertension Consider ruptured AAA in patients (especially those > 50 years of age) …

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Cardiovascular

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