Archive

Rebel Category: REBEL Crit

Dispatcher-Assisted Cardiopulmonary Resuscitation (DA-CPR)

Background: The two biggest keys to successful survival with good neurological outcome in out-of-hospital cardiac arrest (OHCA) are high-quality CPR and early defibrillation. Dispatcher-assisted (DA) CPR is a novel concept to not only improve the rate of CPR being performed, but …

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Resuscitation

The Great Debate Between Balanced and Unbalanced Crystalloids Continues

Background: Although the debate over balanced (i.e. lactated ringers, PlasmaLyte) vs unbalanced (i.e. 0.9% saline) crystalloids has not been settled, fluid resuscitation continues to be a fundamental therapy given to critically ill patients.  0.9% saline is one of the most common …

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Endocrine, Metabolic, Fluid, and Electrolytes

If You’re Going to do the Thoracotomy…do a Clamshell

Every now and again someone raises the issue on social media about resuscitative thoracotomy.  What are the indications (we have the EAST guidelines for that), what are the risks (highlighted in this important recent paper), and of course, whether EM …

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Trauma

FLORALI-2: Non-Invasive Ventilation (NIV) vs High-Flow Nasal Cannula (HFNC) as Pre-Oxygenation Prior to Intubation

Background:Tracheal intubation is a common procedure performed on critically ill patients. In these patients, there is a high risk of life-threatening complications associated with the procedure, with severe hypoxemia being one of the more common. Development of severe hypoxemia, in turn, …

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Resuscitation

Pulse Checks in Cardiac Arrest Should be Dead

Background: In an older study published in Resuscitation 1998 [1], ED physicians, ICU physicians, and nurses tried to identify a carotid pulse in a healthy male volunteer with normal blood pressure. 43.1% of the health professionals required >5 seconds to detect the …

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Resuscitation

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