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Rebel Category: REBEL EM

The Kompas Trial: Sodium Bicarbonate Prehydration in Adults with CKD Prior to Contrast-Enhanced CT

Background: Most guidelines recommend prehydration prior to iodine-based contrast media to prevent postcontrast acute kidney injury (PC-AKI) in patients with CKD.  There is, however, a lack of evidence for the effectiveness of this as well as the potential adverse effects ...

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Renal and Genitourinary

COVID-19 Hypoxemia: A Better and Still Safe Way

I have been thinking a lot about patients with COVID-19 and the pulmonary pattern that they develop.  This disease process has been categorized like ARDS, but the reality is it is not like “typical” ARDS.  Lung compliance is often normal ...

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Infectious DiseaseResuscitation

Lopinavir-Ritonavir in Hospitalized Patients with Severe COVID-19

Background: Since the introduction of SARS-CoV-2 to the world in December 2019, there have been no medications approved or proven effective for the treatment of this pandemic. Lopinavir is an HIV protease inhibitor that is combined with Ritonavir to increase ...

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Infectious Disease

COVID-19: A Powerful Message from Italy

On Feb 21st, a patient by the name of Aldo, a 72-year-old male, came to our ED with fever and progressive dyspnea. In addition, his chest x-ray showed an interstitial pattern. It was on this day that COVID19 had arrived ...

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Infectious Disease

Spontaneous Pneumothorax: Stand There and Do Nothing?

Background: Most published clinical guidelines on the management of primary spontaneous pneumothorax (PSP) advocate for a conservative approach of observation for small asymptomatic pneumothoraces (PTX).(1,2) However, procedural re-expansion with a catheter or chest tube is recommended for all large pneumothoraces, regardless ...

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Procedures and SkillsThoracic and Respiratory
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