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Rebel Category: REBEL EM

AID-ICU Trial: Haloperidol for Treatment of ICU Delirium

Background Information: Delirium is a common and serious condition in patients in the intensive care unit (ICU). It is estimated to affect 30-50% of patients in the ICU and haloperidol is the most frequently used agent in treatment (3).  One …

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NeurologyPyschobehavioralToxicology

The PALACE Trial: Direct Oral PCN Challenge in Patients with Low-Risk PCN Allergy?

Background: Many patients report a vague history of penicillin allergy. The vast majority of these self-reported allergies are untrue (< 5%) .  Literature including patients with penicillin allergies also show longer, more complicated hospital courses. Standard practice for identifying errant allergy …

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Allergy and Immunology

The ARAMIS Trial: DAPT vs Alteplase in Minor Nondisabling Acute Ischemic Stroke

Background: Current stroke guidelines recommend IV alteplase for patients with acute ischemic stroke presenting within 4.5hrs of symptom onset based on the NINDS and ECASS III publications. Both NINDS and ECASS III excluded patients with mild stroke symptoms but failed …

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Neurology

Peri-Intubation Hypotension – Dose Induction Dose Matter?

Background: Rapid Sequence Intubation (RSI) is a procedure fraught with potential complications including hypotension which, in turn, can result in cardiovascular collapse. While there are numerous potential causes of hypotension peri-RSI, induction medications represent an important, modifiable variable. Over the …

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Procedures and Skills

Don’t Become Obsolete: The EM Physician’s Fight Against Procedural Decay

INTRODUCTION You’re moonlighting in a remote access hospital. EMS radios in for a burn patient and to anticipate a difficult airway. You can hear the tension in their voice. They’re rolling up now. The patient is horribly burned. She was …

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Procedures and Skills

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