Archive

Rebel Category: REBEL EM

Rebellion in EM 2019: What the Fluid? Wieters vs Bryant

Normal saline started being used based on work done in the 1830s with cholera.  We are still doing the same thing the same way and it’s not until recently we have begun to ask the hard questions about why we ...

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Endocrine, Metabolic, Fluid, and Electrolytes

Does CRP Help Reduce Antibiotic Prescriptions in Acute COPD Exacerbations?

Background: Unwarranted use of antibiotics has several deleterious effects which include, antimicrobial resistance, wasted resources, adverse effects, negative affect on the microbiome of patients, and distracts from potentially more effective interventions. There has recently been a huge push for tests such ...

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Infectious DiseaseThoracic and Respiratory

Pregnancy-Adapted YEARS Algorithm for PE – Ready for Prime Time?

Background: The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, thus requiring dependence on objective testing. Decision instruments such as PERC and the Wells’ score help stratify patients to low or high probability, enabling focused ...

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Cardiovascular

Should We Not Be Using IVC Filters in Trauma Patients?

Background: Trauma patients can be a rather difficult patient population to treat with multiple ongoing issues.  There is always a balance of hemorrhage control vs prophylaxis for venous thromboembolism (VTE), as both can cause increased morbidity and mortality.  One method to ...

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Trauma

A Randomized Control Trial Comparing Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the ED

Background Information: Non-steroidal Inflammatory drugs (NSAIDs) such as Ibuprofen are of the one of the most commonly used oral analgesics in the emergency department. 1 These medications work by inhibiting the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). These are two enzymes ...

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Toxicology

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