Archive

Rebel Category: REBEL Crit

The FIRST-ABC Step Up Trial: HFNC vs CPAP for Liberation of Respiratory Support in Children?

Background: Respiratory support is a common intervention in pediatric ICUs and can include HFNC and CPAP/BPAP to avoid invasive mechanical ventilation.  HFNC has become more popular due to its ease of use, perceived patient comfort, and the ability to discharge ...

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PediatricsResuscitation

Damping and Arterial Lines

Damping is the influence within a system that is a dissipation of energy during an oscillation.  In other words, think of damping like a shock absorber. Imagine a patient presenting with altered mental status.  All we know about the patient ...

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CardiovascularProcedures and SkillsResuscitation

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of resuscitation (weak recommendation, low-quality evidence). .  Additionally, the Surviving Sepsis Campaign Guidelines state there is insufficient evidence ...

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

Impella Devices 101

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 ...

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Cardiovascular

The Dirty Epi Drip and IV Flow Rates

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 ...

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Resuscitation

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