Archive

Rebel Category: REBEL EM

The NICO Trial: NIV in Comatose Patients with Acute Poisoning

Background:  Patients with decreased level of consciousness due to alcohol, drugs, or medications commonly present to the ED. These patients can be at risk of vomiting and aspiration and often prompts clinicians to pursue definitive airway management to avoid pneumonia ...

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ResuscitationToxicology

Non-Invasive Blood Pressure Monitoring in Critically Ill Adults?

Background: Patients with shock frequently present with hypotension.  Many of these patients are started on vasopressor and inopressor medications to assist in efforts to normalize blood pressure to help improve organ perfusion. In shocky patients, arterial lines are often used ...

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CardiovascularResuscitation

The Needle Vs. The Knife for Spontaneous Pneumothorax: A Closer Look at the EXPRED Study

Background:  The optimal management of primary, spontaneous pneumothorax (sPTX) remains an area of active debate. The British Thoracic Society recommends the least invasive approach possible. In contrast, the American College of Chest Physicians favors first-line chest tube drainage for any ...

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Thoracic and Respiratory

The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

Background: Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. Tenecteplase, a modified version of ...

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Neurology

Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. It can be used to distinguish between various conditions, including chronic obstructive pulmonary disease (COPD) exacerbation, acute heart failure (AHF), pleural effusion, pulmonary edema, pericardial ...

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Procedures and SkillsThoracic and Respiratory

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