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…
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!
Background: Sepsis can induce numerous physiologic derangements. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. septic shock). Judicious fluid resuscitation is indicated in patients with signs of …
Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. These patients can have a vasodilated vascular bed and the initial use of fluids is hypothesized to …
Background: Clinically significant pneumothoraces in patients on mechanical ventilation can be dangerous as positive pressure ventilation can cause an increase in intrapleural pressure and trigger tension physiology. Occult pneumothoraces are those not suspected clinically or not evident on plain radiographs …
Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. The TOMAHAWK (Desch 2021), COACT (Abella 2019), and …
Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Traditionally patients were managed on the ventilator with lung volumes of 10 – 15 ml/kg. However, that practice is long-outdated and patients …
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Though consensus has been reached for first-line treatment of ventricular rate control1 with beta blockers (BB) and non-dihydropyridine …
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 …
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, …
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 …
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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