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Rebel Category: REBEL EM

The REVIVED Trial: PCI in Patients with Severe Ischemic Left Ventricular Systolic Dysfunction?

Background: Coronary artery disease can result in hibernating myocardium (chronic myocardial contractile dysfunction) due to ischemia.  The theory is that there is reduced coronary blood flow and increased myocardial demand resulting in impaired contractility. Whether reversal of myocardial hibernation by …

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Cardiovascular

COCA Trial Follow-Up: Calcium vs Placebo on Long-Term Outcomes of OHCA

Background: The Calcium for Out-of-Hospital Cardiac Arrest (COCA) trial was a randomized, placebo-controlled, double-blind trial of calcium compared to placebo in OHCA.  COCA found no improvement in sustained ROSC but, rather, a trend towards harm for their primary outcome. Additionally, …

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CardiovascularResuscitation

The EvK Trial: Ketamine vs Etomidate for Rapid Sequence Intubation

Background: The use of ketamine and etomidate for induction in rapid sequence intubation is heavily debated. The Ketased Trial (Jabre 2009) reported no significant difference between the two induction agents. However, recently the National Emergency Airway Registry reported ketamine is …

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Resuscitation

Non-Sterile Gloves for Suturing Traumatic Lacerations?

Background: Traumatic lacerations presenting to the emergency department are, by definition, contaminated (ie non-sterile).  Standard management involves irrigation, local anesthesia, closure and tetanus update if required. The existing literature has never shown benefit to sterile gloves in these types of …

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Procedures and SkillsTrauma

The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis

The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis James C. Fletcher, MD, FACEP and Nicholas Slattery, MD Background: Diverticulitis is a common finding amongst Emergency Department patients, accounting for more than 360,000 visits in …

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Abdominal and Gastroinstestinal

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