REBEL Cast

The podcast delves into the crucial differences between hypoxemia and hypoxia, emphasizing their significance in clinical settings. It outlines five causes of hypoxemia, including shunt and dead space, along with management techniques for each. Practical insights are shared on maximizing oxygen delivery and recognizing when to escalate care with positive pressure. The hosts also discuss the importance of rapid assessment in critical care, ensuring healthcare professionals can act swiftly in urgent situations.

Acetaminophen (APAP) overdose remains one of the most common causes of acute liver failure in the United States. While its therapeutic use is widespread and generally safe, unintentional overdoses and delayed presentations can lead to devastating outcomes. In this episode of REBEL Cast, we break down the pathophysiology, clinical course, diagnostic approach, and evidence-based management ... Read more The post REBEL Core Cast 134.0 – Acetaminophen Toxicity appeared first on REBEL EM - Emergency Medicine Blog.

Introduction: In this episode of Rebel Cast, host Marco Propersi, along with co-hosts Steve Hochman and Kim Baldino, delve into the practice and importance of street medicine—the direct delivery of healthcare to homeless and unsheltered individuals. Special guests Dr. Jim O’Connell, a pioneer of street medicine, and Dr. Ed Egan, a recent street medicine fellowship ... Read more The post Street Medicine: Compassionate Care for the Unhoused appeared first on REBEL EM - Emergency Medicine Blog.

Discover the serious implications of traumatic arthrotomy, where even small lacerations can expose joints to infection. Learn about essential diagnostic techniques, including the importance of CT scans in evaluating joint injuries. The discussion emphasizes the need for prompt orthopedic consultation and antibiotic administration to prevent complications. You'll also hear about the nuances of physical exams and how specific findings can indicate joint involvement. It's a deep dive into a critical area of emergency medicine that could save lives.

Dive into the critical world of omphalitis, a serious infection affecting newborns. Discover the alarming signs of erythema and warmth around the umbilicus that necessitate immediate action. Learn why early diagnosis is crucial and the role of antibiotics in treatment. Hear about the importance of pediatric surgery consultations to prevent life-threatening complications. The discussion highlights the severe progression of this condition and the aggressive approach needed when symptoms escalate.

Explore the critical role of orogastric lavage in treating drug overdoses. Discover when this procedure is appropriate, especially for highly toxic substances. Learn about the risks associated with lavage and the importance of airway management to prevent aspiration. Timing is essential, and not every case warrants this intervention. Tune in for a deep dive into this rare but vital emergency care technique!

Sanjay Mohan, an in-house toxicologist, dives into the perilous world of toxic alcohols like methanol and ethylene glycol. He discusses how these substances can present symptoms mimicking ethanol intoxication, complicating diagnosis. The conversation highlights key diagnostic challenges, stressing that a normal osmolar gap doesn't rule out ingestion. Mohan also covers critical management strategies, including the use of fomepizole and the importance of early intervention, particularly in cases of severe metabolic acidosis or renal dysfunction.

Take Home Points Anticipate anatomically challenging airways and consider early intubation prior to loss of airway anatomy. Skip the zones of the neck and focus on hard signs of vascular (Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, Signs of stroke) or aerodigestive (Airway compromise, Bubbling wound, Extensive SubQ air, Stridor, Significant hemoptysis/hematemesis). ... Read more The post REBEL Core Cast 127.0 – Penetrating Neck Injuries appeared first on REBEL EM - Emergency Medicine Blog.

Background: Cath lab activation based on ST-elevation myocardial infarction (STEMI) criteria is founded on aging data and requires evolution. In the “Occlusive Myocardial Infarction (OMI) Manifesto,” emergency physicians Dr. Steve Smith, Dr. Pendell Meyers, and Dr. Scott Weingart introduced a new paradigm —OMI vs. non-occlusive myocardial infarction (NOMI). The OMI/NOMI paradigm focuses on the presence ... Read more The post A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI Detection appeared first on REBEL EM - Emergency Medicine Blog.

Joanna Piero, a pediatric hematologist oncologist at Staten Island University Hospital, shares her expertise in managing critical pediatric hematology and oncology emergencies. She emphasizes the life-saving importance of administering antibiotics within an hour for patients with fever and neutropenia. Joanna stresses that fever in sickle cell patients is always an emergency, requiring immediate cultures and treatment. She also discusses crucial red flags in pediatric headaches that may suggest a brain tumor, highlighting the need for swift specialist consultations.