REBEL Cast

Explore the critical steps for managing hyperkalemia in emergency care. Learn why an EKG is essential upon patient presentation, especially for those with renal issues. Discover the common causes, including medications and massive cell death, that lead to elevated potassium levels. Hear about the alarming cardiac effects and neuromuscular symptoms that can arise. The discussion emphasizes timely interventions like administering calcium salts for unstable patients, showcasing the urgency in tackling this common electrolyte disorder.

Take Home Points Management of severe beta-blocker and calcium-channel blocker toxicity should occur in a stepwise fashion: potential gastric decontamination, multiple lines of access, judicious fluids, calcium, glucagon, and vasopressors as needed. Initiation of high dose insulin therapy requires a tremendous amount of logistical and cognitive resources as it requires cross-disciplinary collaboration and is prone ... Read more The post REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy appeared first on REBEL EM - Emergency Medicine Blog.

Discover the rare yet life-threatening condition of posterior epistaxis. The discussion focuses on its unique symptoms and the crucial differences from anterior epistaxis. Learn about effective diagnosis and management protocols, as well as treatment options. The speakers emphasize rapid control techniques and the necessity of surgical intervention. They also highlight the importance of involving ENT specialists and ensuring proper monitoring for affected patients.

The discussion kicks off with an exploration of the implications of andexanet alfa in treating factor 10A inhibitor-related brain hemorrhages, stressing the need for more research. It critically assesses the drug’s hemostatic efficacy and raises concerns about biases in clinical trials funded by its manufacturer. Key criticisms focus on patient outcomes, with a striking emphasis on the risk of thrombotic events. Finally, the conversation highlights the importance of transparency and ethical standards in medical research.

Neutropenic fever poses serious risks, especially for chemotherapy patients. The podcast discusses its causes, emphasizing that the body's own flora can be the biggest threat. Quick administration of broad-spectrum antibiotics is crucial in reducing mortality. Additionally, management strategies such as initial resuscitation and collaboration with infection specialists are highlighted. The shift in infection prevalence from gram-negative to gram-positive is another important point, making vigilant monitoring essential.

Background: The holy grail of outcomes in OHCA is survival with good neurologic outcome.  The only interventions proven to increase this outcome are high quality CPR and defibrillation in shockable rhythms.  Ventilation is also an important component of resuscitation in OHCA.  Excess minute ventilation can adversely affect hemodynamics due to increased intrathoracic pressure (i.e. decreased ... Read more The post REBEL Cast Ep126: Should We Not Be Recommending Small Adult BVMs in OHCA? appeared first on REBEL EM - Emergency Medicine Blog.

Take Home Points Acute rhinosinusitis is a clinical diagnosis The vast majority of acute rhinosinusitis cases are viral in nature and do not require antibiotics Consider the use of antibiotics in select groups with severe disease or worsening symptoms after initial improvement. REBEL Core Cast 121.0 – Acute Sinusitis Click here for Direct Download of ... Read more The post REBEL Core Cast 121.0 – Acute Sinusitis appeared first on REBEL EM - Emergency Medicine Blog.

Podcast Direct Download: Link Release Date: April 16th, 2024 Show Notes The Visible Voices Podcast Dr. Glaucomflecken: Power of Ultrasound with Emergency Medicine Dr. Resa Lewiss Adaira I Landry MD Resa E Lewiss MD is a Professor of Emergency Medicine at the University of Alabama at Birmingham. A TEDMED speaker and TimesUp Healthcare founder, she’s ... Read more The post REBEL EM Book Club – MicroSkills appeared first on REBEL EM - Emergency Medicine Blog.

Dr. Dara Kass, an emergency medicine physician and former Regional Director for the U.S. Department of Health and Human Services, is joined by Dr. Monica Saxena, an assistant professor at Stanford and advocate for reproductive justice. They delve into how the Emergency Medical Treatment and Labor Act (EMTALA) shapes access to reproductive health services. The discussion highlights the legal challenges post-Dobbs v. Jackson, the tension between state laws and federal protections, and the critical need for greater awareness of patient rights and physician advocacy.

Background: The mainstay of treatment for symptomatic pulmonary embolism  (PE) is anticoagulation (AC).  Patients with higher-risk PE may require advanced interventions such as thrombolytic therapy, surgical thrombectomy, or even extracorporeal membrane oxygenation (ECMO). Because of its short half-life and availability of a reversal agent, unfractionated heparin (UFH) is commonly used when percutaneous or surgical interventions ... Read more The post REBEL Cast Ep125: 1st 48 Hours of PE Management – How Good Is Unfractionated Heparin? appeared first on REBEL EM - Emergency Medicine Blog.