Critical care is the moment when time, physiology, and decisions collide—and the margin for error is thin. It’s not defined by an ICU bed; it’s defined by the need for emergent care to prevent or treat life-threatening illness.

REBEL Crit exists to help clinicians deliver the best possible care to the sickest patients. We critically appraise the latest literature, translate findings into bedside practice, and publish review articles on complex topics designed for busy providers. 

First do no Harm: Rethinking Our Approach to Intubation in Trauma

Airway management as the first priority has been the backbone of resuscitation for years. “Address A first, before moving to B and C,” is what we are taught and what we go on to teach successive generations of learners. For ...

Read More
Trauma

Critical Care Fundamentals: Basics of 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 of mechanical ventilation. Emergency Medicine and Critical Care Physicians need to have a firm grasp of the ...

Read More
Thoracic and Respiratory

DISCO Pilot Feasibility Study: Direct or Subacute Coronary Angiography in OHCA

Background: The clinical importance of immediate coronary angiography, with subsequent percutaneous coronary intervention (PCI) in OHCA patients without STEMI is a matter of debate.  We have already covered the COACT trial on REBEL EM, but this is a second study, the pilot ...

Read More
CardiovascularResuscitation

The HEAVEN Criteria Part 2 – Predicting Challenging Airways

Background: Predicting a challenging airway is important to assist in the most optimal approach to airway management during RSI.  Two such tools include the Mallampati and LEMON scores and were derived in the pre-operative setting. Major limitations of these scores include ...

Read More
Procedures and Skills

REBEL Cast Episode 66: The COACT Trial – Coronary Angiography After Cardiac Arrest without STEMI

Background: Post-ROSC care is a multifaceted endeavor that includes targeted temperature management (TTM), vital-organ support, and treatment of the underlying cause of arrest. One of the most common causes of cardiac arrest is acute coronary syndrome.  Current European and American guidelines ...

Read More
CardiovascularResuscitation

REBEL Cast Episode 65: Optimal Order of Drug Administration in Rapid Sequence Intubation

Background Information: The sequential administration of a sedative and neuromuscular blocking agent (NMBA) to facilitate the passage of an endotracheal tube is a common method of intubating in both the emergency department (ED) and intensive care unit (ICU). In fact, 85% ...

Read More
Procedures and SkillsResuscitationThoracic and Respiratory

How to Intubate the Critically Ill Like a Boss

Despite decades of experience with endotracheal intubation, we continue to find approaches to improving the process of how we intubate.  In today’s post we are not only going to talk about how to avoid post intubation cardiac arrest, but we ...

Read More
Procedures and SkillsResuscitation

Dispatcher-Assisted Cardiopulmonary Resuscitation (DA-CPR)

Background: The two biggest keys to successful survival with good neurological outcome in out-of-hospital cardiac arrest (OHCA) are high-quality CPR and early defibrillation. Dispatcher-assisted (DA) CPR is a novel concept to not only improve the rate of CPR being performed, but ...

Read More
Resuscitation

The Great Debate Between Balanced and Unbalanced Crystalloids Continues

Background: Although the debate over balanced (i.e. lactated ringers, PlasmaLyte) vs unbalanced (i.e. 0.9% saline) crystalloids has not been settled, fluid resuscitation continues to be a fundamental therapy given to critically ill patients.  0.9% saline is one of the most common ...

Read More
Endocrine, Metabolic, Fluid, and Electrolytes

If You’re Going to do the Thoracotomy…do a Clamshell

Every now and again someone raises the issue on social media about resuscitative thoracotomy.  What are the indications (we have the EAST guidelines for that), what are the risks (highlighted in this important recent paper), and of course, whether EM ...

Read More
Trauma
Showing Slide 1 of 11
Get new posts (free)

1 email per week. No spam.

Sponsored