Rebel Category: REBEL EM

The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). MVM exaggerates venous return to the heart …

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ANNEXA-1: Andexanet Alfa Associated with Harm in DOAC Reversal

Background: In May of 2018, Andexanet alfa gained accelerated approval by the FDA for the reversal direct oral anticoagulants (DOACs) despite a lack of robust evidence for use. The 2022 AHA/ASA guidelines give the drug a level 2A recommendation and …

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Hematology and OncologyNeurology

Automated vs Manual Chest Compressions in Out-of-Hospital Cardiac Arrest

Background Information: Out of hospital cardiac arrest (OHCA) is a medical emergency that requires immediate intervention to increase the chance of survival. The global survival rate of OHCA patients who received CPR has increased in the past 40 years [1]. …

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CardiovascularResuscitationThoracic and Respiratory

Rosh Review My EMCert Monthly Question

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Head, Eye, Ear, Nose, and ThroatHematology and Oncology

Sub-Dissociative IV vs Nebulized Ketamine to Treat Pain

Background: IV subdissociative ketamine at a dose of 0.1 to 0.3mg/kg is increasingly being used as an opioid sparing option for short-term acute pain relief. Alternatively, nebulized ketamine can be used for this indication and may have a benefit as …

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OrthopedicsPediatricsProcedures and SkillsTrauma