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.
Background: Every year there are a handful of “game changing” publications that truly change how we care for our patients. One such paper was a paper by Scott Weingart and Richard Levitan in the Annals of Emergency Medicine in 2011 ...
As we have discussed in previous posts, the care of patients with cardiac arrest is a key skill for Emergency Providers. ACLS provides a foundation for care but is rife with shortcomings including, but not limited to, reliance on outdated ...
As the world of Free Open Access Medical Education has expanded over the last 5 years, one area that has been a laggard is the traditional journal. Although some journals release a limited number of articles in an open access format ...
Advanced Cardiac Life Support (ACLS) provides a well structured framework for those who resuscitate infrequently. There is room to move beyond the algorithm to potentially provide better care for our patients for those who resuscitate frequently. I will describe some ...
So you are minding your own business when a 60 year old patient comes in after witnessed Out-Of-Hospital Cardiac Arrest (OHCA). She had a witnessed arrest, good bystander CPR and the prehospital team shocked her out of ventricular fibrillation (vfib), ...
Background: Vasopressors are frequently used in critically ill patients with hemodynamic instability both in the emergency department (ED) as well as intensive care units (ICUs). Typically, vasopressors are given through central venous catheters (CVCs) as opposed to peripheral intravenous (PIV) ...
Patients with pulseless electrical activity (PEA) account for almost 1/3 of cardiac arrest and even more troublesome is that the survival rate is significantly worse than patients with shockable rhythms. Both the European and American ACLS guidelines stress the importance ...
We’ve had some heated debates on the topic of hands-on defibrillation (HOD) for the past few years. We all know the most important time to avoid a pause during CPR is the perishock pause (). We also know that despite ...
Since 2002, the surviving sepsis campaign (SSC) has stated that best practice in sepsis care includes: early recognition, source control, appropriate/timely antibiotic therapy, resuscitation with intravenous fluids (IVF) and vasoactive medications. Resuscitation of the septic patient in the emergency department ...
There are more than 750,000 cases of severe sepsis and septic shock in the US each year. Most patients who present with sepsis receive their initial care in the emergency department. In 2001, there was a landmark study by Rivers ...
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