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Rebel Category: REBEL EM

sPESI vs Bova Score title image showing pulmonary embolism risk stratification with discharge and monitoring icons.

MDCalc Wars: sPESI vs Bova Score — PE Risk Stratification Made Practical

Not every normotensive PE patient is truly low risk. sPESI helps identify patients who may be safe for outpatient management, while Bova helps recognize patients at risk for early deterioration despite initially stable vital signs.

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Hematology and OncologyThoracic and Respiratory

HI-PEITHO Trial: Ultrasound-facilitated, Catheter Directed Fibrinolysis for PE

In patients with intermediate-risk pulmonary embolism (PE), does ultrasound-facilitated, catheter-directed fibrinolysis (US-CDT) plus anticoagulation improve clinical outcomes compared to anticoagulation alone?

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ResuscitationThoracic and Respiratory
Lower GI bleeding CTA decision graphic showing a CT scanner with the text: Who needs a CTA? Unstable, active bleeding, bleeding within 4 hours.

Clinical Conundrum — Lower GI Bleeding: Who Needs a CTA?

CTA is the preferred initial test for unstable patients with suspected active lower GI bleeding, but it should not be routinely ordered in all cases. Here’s how to decide who actually benefits.

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Abdominal and Gastrointestinal
Ottawa vs Pittsburgh Knee Rules title image comparing knee x-ray decision rules for acute knee injuries.

MDCalc Wars: Ottawa vs Pittsburgh — Which Knee Rule Should You Use?

Not every knee injury needs an x-ray. This post compares the Ottawa and Pittsburgh Knee Rules, highlighting when each rule applies, how they perform, and common pitfalls for ED clinicians.

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Orthopedics

Clinical Conundrum: What Is the Role of TXA in Dysfunctional Uterine Bleeding?

There are a number of accepted treatments for dysfunctional uterine bleeding (DUB) endometrial ablation and hysterectomy as well as medical treatments like hormonal therapy, NSAIDs and tranexamic acid (TXA). The American College of Obstetrics and Gynecology (ACOG) recommends the use ...

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Obstetrics and Gynecology
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