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. 

Beyond ACLS: Pre-Charging the Defibrillator

Post Written By: Sam Ghali (Twitter: @EM_RESUS) In cardiac arrest care there has been a lot of focus over the years on limiting interruptions in chest compressions during CPR. In fact, this concept has become a major focus of the ...

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Resuscitation

Sepsis 3.0

Background: Systemic Inflammatory Response Syndrome (SIRS) is something that has been beat into the heads of medical students, residents, fellows, and all physicians in general. However, the derivation of SIRS occurred in 1991, where the focus was on the then-prevailing ...

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Infectious Disease

Should we be Using Apneic Oxygenation (ApOx) in the ED?

Background: Tracheal intubation is a procedure that is often performed in the ED on patients in critical condition. Because of this, there is the potential for complications such as hypoxemia, hypotension, dysrhythmias, aspiration, and cardiac arrest. Apneic Oxygenation (ApOx) is ...

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Resuscitation

Cardiocerebral Resuscitation: Hands-Only CPR

One of the major reasons contributing to dismal survival rates in out-of-hospital cardiac arrest (OHCA) is the lack of bystander initiated cardiopulmonary resuscitation (CPR). Even though the majority of OHCA is witnessed, only 1 in 5 patients will receive bystander ...

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Resuscitation

Classic Journal Review: The OPALS Study

  The Ontario Prehospital Advanced Life Support (OPALS) Study Background: Sudden cardiac arrest is common and, obviously, very bad. In the US, there are about 500,000 cardiac arrests each year. About half of these cardiac arrests are OHCA and the ...

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Resuscitation

The Role of TEE in Cardiac Arrest

Background: Sudden cardiac arrest has very poor outcomes; less than 11% of patients in cardiac arrest in the Emergency Department survive to discharge from the hospital. The management of cardiac arrest is algorithmic because providers have limited tools at their ...

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CardiovascularResuscitation

Why You Should More Than Consider a Vasopressin, Steroid, and Epinephrine (VSE) Cocktail

The newly published 2015 AHA guidelines recommend that: “In IHCA, the combination of Vasopressin, Epinephrine, and Methylprednisolone and post-arrest Hydrocortisone as described by Mentzelopoulos et al. maybe considered; however, further studies are needed before recommending the routine use of this strategy ...

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Resuscitation

CPR in Out of Hospital Cardiac Arrest: Man vs Machine

Background: In cardiac arrest, high quality, uninterrupted CPR is essential to help improve survival rates. In theory, mechanical CPR should provide CPR at a standard depth and rate for prolonged periods without a decline in quality, which should help improve ...

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Resuscitation

The HEAT Trial – Acetaminophen in ICU Patients with Fever

Background: Acetaminophen (paracetamol) is commonly used to lower the temperature of patients with fever suspected to be causeed by an infection in both homes across the world and the hospital. There are, however, opposing theories to the utility of decreasing ...

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Resuscitation

The SPLIT Trial: Saline vs Plasma-Lyte Fluid Therapy

There has been a lot of debate over the recent years about the safety of crystalloid fluid therapy in acutely ill patients. Several observational studies have shown an increased risk of acute kidney injury (AKI)  with the use of normal ...

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Endocrine, Metabolic, Fluid, and Electrolytes
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