We believe that critical care is not simply a location or a unit in a hospital, but the practice of providing care to those who need urgent support to treat or prevent a life-threatening illness. Whether you’re a paramedic, nurse, EM, IM, CCM doc, etc…

 

REBEL Crit

 

will help you critically appraise the literature so that you can deliver the highest quality, evidence based and compassionate care to your patients. REBELCrit not only review’s recent publications, but has many review article’s, on often complex topics, to help you, the busy provider, continue to provide the best care possible. Soon, REBELCrit will be launching a critical care podcast through our already popular REBELCast! REBELCrit strives to give you the most up to date and timely information so that you can be the best provider you can be and deliver the best care to your critically ill patients!

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  • REBEL Crit
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  • REBEL Crit

External Validation of Pittsburgh Cardiac Arrest Category (PCAC) Illness Severity Score

Background Information: Multiple illness severity scores have been developed for use after out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). Unfortunately, these rely on information that is not immediately available to providers in the early hours following return of …

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CardiovascularNeurologyResuscitation

The FIRST-ABC Step Up Trial: HFNC vs CPAP for Liberation of Respiratory Support in Children?

Background: Respiratory support is a common intervention in pediatric ICUs and can include HFNC and CPAP/BPAP to avoid invasive mechanical ventilation.  HFNC has become more popular due to its ease of use, perceived patient comfort, and the ability to discharge …

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PediatricsResuscitation

Damping and Arterial Lines

Damping is the influence within a system that is a dissipation of energy during an oscillation.  In other words, think of damping like a shock absorber. Imagine a patient presenting with altered mental status.  All we know about the patient …

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CardiovascularProcedures and SkillsResuscitation

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of resuscitation (weak recommendation, low-quality evidence). [2].  Additionally, the Surviving Sepsis Campaign Guidelines state there is insufficient evidence …

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

Impella Devices 101

Now that I am working up in the ICU, one of the devices that I am frequently coming across is the Impella device.  This is not something we get much training on downstairs in the ED.  Below is a summary …

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Cardiovascular

The Dirty Epi Drip and IV Flow Rates

Recently, I put out a video on the dirty epi drip (YouTube and TikTok) and in that video I discuss the use of this modality when in a pinch (i.e. can’t get push-dose pressors and/or a pump is not available …

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Resuscitation

Effect of Intra-Arrest Transport and eCPR on Neurologic Outcomes in Refractory OHCA

Background Information: Refractory out of hospital cardiac arrest (OHCA) is defined as prolonged cardiac arrest and cardiac arrest without return of spontaneous circulation (ROSC). In addition to an already morbid condition, the chances of these patients surviving drops below 5% …

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CardiovascularNeurologyResuscitation

Andexanet Alfa Vs. Four-Factor PCC: Is Andexanet Alfa Worth The Hype?

Background: Oral factor Xa inhibitors (FXi) have been associated with major and fatal bleeding events, including intracranial hemorrhage (ICH). In randomized controlled trials, both rivaroxaban and apixaban are associated with ICH at rates that range from 0.1 to 4% (Agnelli …

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Hematology and OncologyNeurologyTrauma

REBEL Crit Cast Ep6.0 – Mastering Mechanical Ventilation Part 1

Mechanical Ventilation is a modality commonly used in the critically ill, but many providers, may not have a strong understanding of the basics. Emergency Medicine and Critical Care Physicians need to have a firm grasp of the basic concepts of …

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Thoracic and Respiratory

REBEL Cast Ep106: The COCA Trial – Calcium in Cardiac Arrest

Background: The utility of pharmacological interventions for patients with OHCA are rather limited with no robust evidence that they improve outcomes.  Calcium, one of the pharmacological options has both inotropic and vasopressor effects. Additionally, calcium plays an important role in …

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Resuscitation

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