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.
Now that I am working up in the ICU, one of the devices that I am frequently coming across is the Impella device. This is not something we get much training on downstairs in the ED. Below is a summary ...
Recently, I put out a video on the dirty epi drip (YouTube and TikTok) and in that video I discuss the use of this modality when in a pinch (i.e. can’t get push-dose pressors and/or a pump is not available ...
Background Information: Refractory out of hospital cardiac arrest (OHCA) is defined as prolonged cardiac arrest and cardiac arrest without return of spontaneous circulation (ROSC). In addition to an already morbid condition, the chances of these patients surviving drops below 5% ...
Background: Oral factor Xa inhibitors (FXi) have been associated with major and fatal bleeding events, including intracranial hemorrhage (ICH). In randomized controlled trials, both rivaroxaban and apixaban are associated with ICH at rates that range from 0.1 to 4% (Agnelli ...
Mechanical Ventilation is a modality commonly used in the critically ill, but many providers, may not have a strong understanding of the basics. Emergency Medicine and Critical Care Physicians need to have a firm grasp of the basic concepts of ...
Background: The utility of pharmacological interventions for patients with OHCA are rather limited with no robust evidence that they improve outcomes. Calcium, one of the pharmacological options has both inotropic and vasopressor effects. Additionally, calcium plays an important role in ...
There are generally 3 main congenital heart diseases presentations that young children between ages of 0 days to about 3 months will present with. Often times you will see experts split these congenital heart lesions into 2 categories: Cyanotic vs ...
Background Information: Diabetic Ketoacidosis (DKA) is a life-threatening complication of diabetes that we frequently encounter in both the emergency department (ED) and intensive care unit (ICU). While intravenous fluid replacement remains one of several cornerstones of therapies, much debate exists ...
Background Information: The management of patients in cardiogenic shock is often multifactorial, consisting of mechanical circulatory support, vasopressors and inotropes. While the latter two are the foundation of therapy, the literature is scarce on whether milrinone or dobutamine will be more ...
I have started to split my time between the ED and ICU. Obviously these two areas of clinical care have their similarities, but also have their differences. So I decided to create this post to put things that I have ...
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