REBEL Cast

🧭 REBEL Rundown 📝Introduction In this exciting episode of REBEL Cast, host Dr. Mark Ramzy joins forces with renowned educator and speaker, Dr. George Willis. Broadcasting straight from the ACEP 25 in Salt Lake City, the duo talk about bringing together the international emergency medicine community, as they reflect on their experiences at the Increment Conference in Murcia, Spain, and preview the upcoming event this spring. Click here for Direct Download of the Podcast. 🤔What's IncrEMentuM? A new conference and a pivotal gathering for emergency medicine professionals worldwide, has become an essential platform for education, collaboration, and advocacy, especially in light of emergency medicine’s recent recognition as a specialty in Spain. The conference is praised for its outstanding production quality, engaging speakers, and its capacity to foster a global community of emergency care professionals. 🦪Pearls from George's IncrEMentuM 2025 Lectures:Pearls from George's IncrEMentuM 2025 Lectures: Sodium Bicarbonate Use:Appropriate Use: Focus on specific instances like metabolic acidosis with renal failure or severe metabolic cases with tox patients (e.g., salicylate or TCA overdose).Emphasis on Patient-Centric Care: Treat the patient, not the number; avoid harmful overreliance on bicarb based solely on lab resultsDiabetic Ketoacidosis (DKA):Balanced Solutions: Preferenced over normal saline to prevent hyperchloremic acidosis.Potassium Management: Oral potassium is effective and should be utilized, challenging the myth of impaired gastric absorption in DKA.Squid Protocol: Usage of ultra-rapid insulin subcutaneously as an alternative to insulin drips in mild to moderate DKA cases.We covered this topic before on REBEL EM. Check out the post here and the podcast hereCrashing Aortic Dissection:Hypotension Insights: Do not attribute sudden hypotension solely to medication; prioritize ruling out tamponade or cardiogenic shock.Ultrasound Utilization: Essential tool for detecting complications like tamponade or low EF due to myocardial infarction or aortic valve regurgitation.Controlled Pericardial Drainage: Crucial technique to stabilize hemodynamics without increasing mortality, avoiding extensive fluid removal.Here’s a helpful algorithmic infographic to reference for aortic dissection patients:Image Courtesy of Dr. Mark Ramzy, DO (@MRamzyDO) HyperkalemiaNot every patient needs calcium. Dont just give it prophylatically, only those with EKG changes should get it and get enough of it.Give an appropriate dose of your other medications. That includes giving 10 units of insulin and 2 amps of dextrose 50. One when they get the 10 units of insulin and the other 30 minutes laterPatients may be dehydrated, dont give them furosemide or diuretics. Those patients need fluid to help perfuse their kidneys and eliminate potassiumHere’s the Algorithm George mentioned in the episodeHere’s a REBEL REVIEW breaking down the different electrolytes in each of the types of fluids: 🫣Teasers from George's IncrEMentuM 2026 Lectures: Severe Thyroid Storm:Diagnosis Reminder: Consider thyroid storm in febrile patients with altered mental status; order TSH tests.Beta Blocker Administration: Use ultrasound to assess heart function before administering propranolol to prevent low output heart failure.Medication Timing: Administer iodine after antithyroid drugs.Refractory Hypoglycemia:Early Use of Octreotide: Beneficial in sulfonylurea-induced cases; initiate treatment promptly for better efficacy.Broadened Perspective: Consider other endocrine disorders as potential causes beyond typical measures.Modern Management of SCAPE:Bolus Dose Nitroglycerin: A recommended practice for quick patient stabilization and improved outcomes in SCAPE scenarios.We covered this topic before on REBEL EM, see Dr. Marco Propersi’s post here See you in Spain!  The upcoming conference aims to gather world-class educators once more and promises an enriching experience for all attendees. George Willis, along with many others, will bring significant discourse to the event. For more information on the IncrEMentuM Conference and to register, visit their website! See you there! Mark Ramzy, DO Co-Editor-in-Chief RWJBH / Rutgers Health, Newark NJ George Willis, MD Vice Chair and Assistant Program Director UT Health, San Antonio, TX 🔎 Your Deep-Dive Starts Here REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy 🧭 REBEL Rundown 📝Introduction In this exciting episode of REBEL ... Endocrine, Metabolic, Fluid, and Electrolytes Read More REBEL Core Cast – DKA: Beyond the Basics Part 2 – SCOPE DKA-Trial Managing diabetic ketoacidosis (DKA) requires careful consideration of fluid therapy, ... Endocrine, Metabolic, Fluid, and Electrolytes Read More REBEL Core Cast – DKA: Beyond the Basics Part 1 – The SQuID Protocol In this episode of REBEL Cast, we dive into part ... Endocrine, Metabolic, Fluid, and Electrolytes Read More REBEL Core Cast 18.0 – DKA Tips and Tricks Take Home Points When looking at pH and bicarb, the ... Endocrine, Metabolic, Fluid, and Electrolytes Read More The post REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy appeared first on REBEL EM - Emergency Medicine Blog.

Fluid choice is crucial in managing severe diabetic ketoacidosis. The SCOPE-DKA trial shows that Plasma-Lyte corrects acidosis faster than normal saline, which may worsen acidosis due to its chloride content. The trial's design strengthens its findings, but it highlights the need for more research comparing different fluid types. Important metrics like base excess and strong ion difference are often overlooked when assessing acid-base status. The podcast discusses ethical considerations and the impact of protocols on patient care and nursing workload.

Explore the innovative SQuID Protocol for managing mild-to-moderate DKA using subcutaneous insulin instead of IV drips. Discover the impressive results: fewer ICU admissions and shorter ED stays, while nursing workloads remain unchanged. Delve into critical concepts like focusing on closing the anion gap over just normalizing blood sugar. Learn why pediatric approaches can inform adult practices, and how the two-bag system effectively manages insulin without risking hypoglycemia, offering a fresh perspective on DKA treatment.

Explore the art of mechanical ventilation with insights on balancing oxygenation and ventilation. Discover why aiming for adequacy over perfection can prevent harm. Learn how Mean Airway Pressure (MAP) truly drives oxygenation, and understand the importance of PEEP in keeping alveoli open. The hosts discuss optimizing tidal volume and respiratory rate while managing patients with obstructive diseases, emphasizing the need for time to exhale. Tune in for practical strategies that transform chaos into calm control at the bedside!

Dive into the complexities of mechanical ventilation with an exploration of key modes used in the ICU. Discover the significance of controlled, assisted, and supported breaths. Learn that no single mode guarantees better outcomes; comfort for the patient is crucial. Examine the ins and outs of popular modes such as Assist Control and Pressure Support, along with potential pitfalls like the SIMV's tendency to create dyssynchrony. Get equipped to match ventilator settings to patient needs, ensuring optimal care.

🧭 REBEL Rundown Click here for Direct Download of the Podcast. ⏰ Highlights 00:00 Introduction to Rebel Cast00:10 Highlighting the Incrementum Conference 202600:34 Meet the Founders of Incrementum01:21 The Journey to Incrementum04:27 The Recognition of Emergency Medicine in Spain06:04 What is Incrementum?08:14 Bringing Together Top Emergency Medicine Experts11:38 Exciting Sessions to Look Forward To15:54 Conclusion and Invitation to Incrementum 2026 📝 Introduction In this special episode of Rebel Cast, we spotlight the Incrementum Conference in Spain, a significant event in emergency medicine. Hosts welcome Dr. Francisco ‘Paco’ Campillo Palma and Dr. Carmen Maria Cano, founders of Incrementum, to discuss the recognition of emergency medicine as a specialty in Spain. They share their journey of creating the conference, emphasizing the importance of education, collaboration, and growth. The discussion also touches on this year’s conference highlights, including sessions on mental health and evidence-based medicine, and the exceptional lineup of speakers. Listeners are encouraged to attend the conference in April 2026 for an enriching experience. 📌 Bottom Line Join us in Spain this April for the Increment Conference!👉 Register now at incrementum-conference.com Post Peer Reviewed By: Mark Ramzy, DO (X: @MRamzyDO) 👤 Co-Editor-In-Chief Marco Propersi DO All Things REBEL EM Meet The Team 🔎 Your Deep-Dive Starts Here Incrementum Conference 2026: Revolutionizing Emergency Medicine in Spain In this special episode of Rebel Cast, we spotlight the ... Read More REBEL Core Cast 138.0: A Simple Bedside Approach to Shock In this episode, we will dive into a simple yet ... Cardiovascular Read More REBEL Core Cast 134.0 – Acetaminophen Toxicity Acetaminophen (APAP) overdose remains one of the most common causes ... Toxicology Read More Street Medicine: Compassionate Care for the Unhoused Introduction: In this episode of Rebel Cast, host Marco Propersi, ... Read More REBEL Core Cast 131.0 – Traumatic Arthrotomy Take Home points: Always suspect an open joint if there ... Trauma Read More REBEL Core Cast 130.0 – Omphalitis Take Home Points Early diagnosis: erythema and warmth of the ... Pediatrics Read More The post Incrementum Conference 2026: Revolutionizing Emergency Medicine in Spain appeared first on REBEL EM - Emergency Medicine Blog.

Dive into the fundamentals of mechanical ventilation with an engaging breakdown of the three types of breaths: Control, Assist, and Spontaneous. Discover how each breath type influences patient involvement and care. The discussion also highlights breath delivery methods—Volume vs. Pressure—unpacking their implications for lung compliance. Use fun sports analogies to make these concepts more relatable and easier to grasp, ensuring that even the most complex ventilator modes become manageable!

Discover the life-saving benefits of intraosseous lines in emergency medicine, especially during cardiac arrest. Fast placement and reliable access can deliver critical medications. Learn about the optimal locations for inserting these lines, and the differences in flow rates across various sites. Also discussed are key limitations, like potential dislodgement and the unreliability of lab results drawn from these lines. Not just for trauma, IO lines are vital in medical emergencies and challenging IV situations, particularly in pediatric patients.

Dive into the world of pneumothorax decompression with insights on recognizing tension pneumothorax, especially in critical scenarios. Learn why traditional needle decompression might not cut it and why finger thoracostomy takes the crown for effectiveness and reliability. Discover how ultrasound can quickly confirm diagnoses and the importance of swift action in emergency medicine. This discussion highlights the need to think beyond classic techniques and emphasizes better practices for patient care.

Discover the intriguing nature of shock as a clinical diagnosis, emphasizing that it's more than just a number. Learn to assess patients rapidly using the 'four L's' — mental status, limb temperature, urine output, and lactate levels. Find out how pulse pressure can reveal shock type, from narrow pressures indicating cardiogenic issues to wide pressures pointing towards distributive shock. The hosts stress the importance of systematic bedside evaluation, reinforcing that even basic techniques can uncover critical insights.