February 26, 2019

Online educational resources, social media, and asynchronous education increasingly dominate innovation and continuing medical education for practicing emergency physicians. The “Free Open-Access Medical Education” (FOAM) movement has utilized the power of global connectivity to drive narrowing of the knowledge translation window, however critics have urged caution and warned of error, as many of these resources lack peer review or quality control [1]. REBEL EM is an online educational resource widely used throughout the FOAM community, garnering an average of 3,000 - 30,000 views/engagements per educational post, and satisfying all quality indicators that have been previously identified as markers of reliability and usability for digital scholarship [2]. To this end, we at REBEL EM are conducting a survey looking at rates of certain medication usage in the treatment of renal colic.  This is the follow up survey after the publication of the LIDOKET trial.

February 18, 2019

Background: The use of intravenous lidocaine for analgesia in patients presenting to the emergency department (ED) with renal colic has gained recent traction and interest, and was previously explored on the REBEL EM blog. Literature has been mixed, with one trial (Soleimanpour 2012) demonstrating analgesic benefit, but two smaller trials (Firouzian 2016) (Motamed 2017) finding no such role for IV lidocaine. Nonetheless, uptake has been brisk (Fitzpatrick 2016). The authors of this study (The LIDOKET Trial) sought to better define the utility of IV lidocaine for the treatment of renal colic.

March 26, 2018

Background: Welcome back to REBEL Cast episode 47.  In this issue we are going to talk about some recent trials published in the past year that have gotten some love in the FOAMed world.  We have been meaning to discuss these trials, but just simply didn't have the time until now.  What trials are we reviewing?
  • The age of PRBCs in transfusion
  • The usefulness of lidocaine in renal colic
  • The utility of oxygen therapy in Stroke

December 6, 2016

Background : For anyone who has taken care of a patient with renal colic, the agony they experience is indelible.  I have had several female patients even tell me that the pain is worse than child birth.  Treatment of renal colic comes down to two key components: treatment of pain and expediting passage of the stone.  Many medications have been tested for the former, and we have discussed the latter on our blog before (HERE and HERE). We had a recent resident journal club discussing a trial comparing IV lidocaine (1.5mg/kg) vs IV morphine (0.1mg/kg) for treatment of pain.

April 25, 2016

Background: Many Out-of-Hospital Cardiac Arrest (OHCA) are attributable to ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). Both are said to be treatable presentations of OHCA, due to their responsiveness to defibrillation. VF and VT can persist or recur after defibrillation with an inverse relationship between the duration of OHCA, the recurrences of arrhythmias, and ultimately resuscitation outcomes. Amiodarone and lidocaine are both recommended by the advanced cardiovascular life support (ACLS) guidelines to help promote successful defibrillation in refractory ventricular fibrillation or pulseless ventricular tachycardia and to prevent recurrences. In previous randomized controlled trials patients receiving amiodarone vs placebo or lidocaine in OHCA were more likely to have return of spontaneous circulation (ROSC) and to survive to hospital admission. However the effects of amiodarone on survival to hospital discharge or neurologic outcome still remain uncertain. Should we be using anti-dysrhythmic drugs in out-of-hospital cardiac arrest?
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