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
All Categories
  • All Categories
  • REBEL Crit

Defibrillation Strategies for Refractory Ventricular Fibrillation

Background Information:  Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating …

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CardiovascularProcedures and SkillsResuscitation

Andexxa Vs 4F-PCC in ICH: An Ongoing Debate

BACKGROUND: Direct oral anticoagulants (DOACs) such as rivaroxaban [Xarelto] and apixaban [Eliquis] have become more prevalent in the aging population and are associated with intracranial bleeding at rates up to 4.2%. (Xian 2019) 4-Factor Prothrombin Complex Concentrates (4F-PCC), or K-Centra, …

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NeurologyTrauma

The LOVIT Trial: Orange Crushed

Background: Vitamin C dissociates to ascorbate at physiological pH and is not organically synthesized by the human body. Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. (Amrein 2018) A small, single-center, before-and-after study …

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Resuscitation

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

Background: Thromboelastography (TEG) is a reliable, comprehensive non-invasive hemostatic assay that measures the ability of whole blood to form a clot. TEG analyzes the interaction between platelets and the coagulation cascade. It provides highly descriptive, real-time information on clot formation, …

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Abdominal and Gastroinstestinal

Heads Up! There is No Association with Improved Outcomes for Head Up CPR: Why We Must Read Past the Abstract

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Over the years, we as a scientific community have worked extensively to find other interventions …

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CardiovascularResuscitation

The ADVOR Trial: Acetazolamide in Acute Decompensated Heart Failure

Background: Patients presenting with acute exacerbations of congestive heart failure are frequently treated with intravenous loop diuretics.  Despite being treated with loop diuretics, the problem is many are discharged from the hospital with residual clinical signs of volume overload despite …

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CardiovascularEndocrine, Metabolic, Fluid, and Electrolytes

The BOX Trial: BP & O2 Targets in Comatose Survivors of Cardiac Arrest

Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC.  While hypoxemia (SpO2 <90%) is clearly deleterious, it is unclear if hyperoxia is beneficial.  Recent studies on patients requiring critical care have demonstrated that hyperoxia is harmful and instead …

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CardiovascularResuscitationThoracic and Respiratory

COCA Trial Follow-Up: Calcium vs Placebo on Long-Term Outcomes of OHCA

Background: The Calcium for Out-of-Hospital Cardiac Arrest (COCA) trial was a randomized, placebo-controlled, double-blind trial of calcium compared to placebo in OHCA.  COCA found no improvement in sustained ROSC but, rather, a trend towards harm for their primary outcome. Additionally, …

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CardiovascularResuscitation

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

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