Archive

Rebel Category: REBEL EM

Clinical Conundrum: Do I Have to Replace the Nail After an Avulsion?

Bottom Line Up Top: Replacing the nail into the eponychial fold doesn’t appear to be critical to nail regrowth and  cosmetic outcomes of finger injuries with nail avulsion. Clinical Scenario: A 6-year-old boy presents to the Peds ED with an ...

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Trauma

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

Background  In 1979, Hiroshi Natori was the first to appreciate the sonographic changes that occur in the inferior vena cava (IVC)’s diameter with ventilation in spontaneously breathing patients, mechanically ventilated patients, and those with carcinogenic and tuberculoid cardiac tamponade.1 They ...

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CardiovascularResuscitationThoracic and Respiratory

Balancing Innovation and Reality: Evaluating AI’s Role in STEMI Diagnosis

Background: ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring rapid diagnosis and intervention. While ECGs play a central role in detecting STEMI, misinterpretations often occur, leading to unnecessary catheterization or missed diagnoses. With advancements in artificial intelligence (AI), ...

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Cardiovascular

Clinical Conundrum: Should Acute Asthma Exacerbations Be Discharged From the ED With Combination Beta Agonist/Corticosteroid Inhalers?

Bottom Line Up Top: In patients with mild to moderate asthma exacerbations that are stable for discharge home, there is evidence to support discharging patients from the ED with combination Inhaled Corticosteroid/Long-Acting Beta Agonist (ICS-LABA) maintenance therapy. Clinical Scenario: A ...

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Thoracic and Respiratory

Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

Background: Sickle cell disease (SCD) affects an estimated 300,000 infants born worldwide each year and has a total estimated prevalence of 100,000 in the United States alone (Piel 2017). Within this population, over 90% of healthcare encounters are due to ...

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Hematology and OncologyResuscitation

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