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Rebel Category: REBEL Crit

Single Syringe Adenosine for SVT?

Background: The 2015 American Heart Association guidelines for Adult Advanced Cardiac Life Support recommend adenosine in non-hypotensive patients in regular narrow-complex supraventricular tachycardia (SVT).  Adenosine has a rapid onset and a half-life that is <10 seconds, which makes it an ...

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Cardiovascular

AVERT-Shock: Vasopressin for Acute Hemorrhage?

You are working at a Level 1 Trauma Center; a 35-year-old female arrives via EMS from the scene of a motor vehicle accident. She was an unrestrained passenger, ejected 50 feet. She was hypotensive and hypoxic on scene with concern ...

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ResuscitationTrauma

SMART Trial Part 2: Secondary Analysis of Balanced Crystalloids vs Saline in Sepsis

Background: Saline (0.9% sodium chloride) has historically been one of the most common intravenous fluids administered in critically ill adults.  However, the supraphysiologic chloride concentration can cause hyperchloremia, metabolic acidosis, renal vasoconstriction and alter immune function.  There is nothing normal ...

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Endocrine, Metabolic, Fluid, and Electrolytes

CITRIS-ALI: Vitamin C in Patients with Sepsis and Severe Acute Respiratory Failure

Background: In 2016, Paul Marik published a study in Chest demonstrating a decrease in hospital mortality of 32% for sepsis patients treated with vitamin C, thiamine and hydrocortisone.  The Marik protocol(as it has come to be known), entails IV ...

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Infectious Disease

ICU-ROX: Conservative vs Usual O2 Therapy During Mechanical Ventilation in the ICU

Background: The IOTA trial, was a systematic review and meta-analysis of 25 RCTs enrolling 16,000 patients with sepsis, critical illness, stroke, trauma, MI, cardiac arrest, and/or emergency surgery. In this review it was found that liberal use of O2 resulted ...

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Resuscitation

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