REBEL Cast

Explore the benefits and limitations of coronary CTN geography as a cardiac test for low-risk chest pain patients. Learn about the importance of selecting appropriate tests based on symptoms and considering limitations. Understand the usefulness of CCTA and nuclear stress tests in assessing heart conditions. Trust your intuition alongside test results.

Take Home Points: Patients with recent onset atrial fibrillation can safely be cardioverted if they are 1) on anticoagulation 2) Low risk based on CHADS-VASC with onset < 48 hours or 3) High risk based on CHADS-VASC with onset < 12 hours. In anaphylaxis, think, “If A, B or C, give E.” If the patient ... Read more The post REBEL Core Cast 110.0 – On Shift Learning Pearls appeared first on REBEL EM - Emergency Medicine Blog.

This podcast discusses the significance of ECG in evaluating overdose patients and the connection between QRS prolongation and sodium channel blockade. It explores ECG changes seen in tricyclic antidepressant and Diphenhydramine overdoses. The importance of considering sodium channel blockade as a differential diagnosis for widened QRS intervals is highlighted. Treatment recommendations for wide, complex tachycardia caused by sodium channel blockade with sodium bicarbonate are provided.

Take Home Points: Airway management is paramount; expect a challenging intubation and consider controlling the airway early if there is apparent airway compromise. Understanding the cause of angioedema (mast cell vs. bradykinin mediated) helps dictate directed management. Urticaria and pruritus = MAST CELL mediated, which is treated like a standard allergic reaction. REBEL Core Cast ... Read more The post REBEL Core Cast 108.0 – Angioedema appeared first on REBEL EM - Emergency Medicine Blog.

A podcast discusses vertebral osteomyelitis, a rare condition characterized by inflammation of the vertebra caused by infection. The challenges in diagnosing the condition and the importance of advanced imaging for accurate diagnosis are explored. The podcast also emphasizes the need for surgical consultation for patients with neurologic symptoms and the challenges of pathogen-directed therapy in the emergency department.

Topics in this podcast include the significance of nerve blocks for emergency medicine doctors, the use of nerve blocks for older patients, the advantages of using rupivacane for nerve blocks, effective pain blocks for rib and pelvic fractures, tips for maximizing success with nerve blocks, and the importance of learning nerve blocks for emergency clinicians.

Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation.  The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge. Traditional RSI entails preoxygenation followed by ... Read more The post REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients appeared first on REBEL EM - Emergency Medicine Blog.

Background: The ongoing debate between video laryngoscopy (VL) and direct laryngoscopy (DL) has ignited intense debate within the emergency medicine and critical care communities. A recent pragmatic, randomized, multicenter trial (The DEVICE Trial) compared the two techniques to determine if VL outperformed DL in first-pass success (FPS). In this blog post, we explore the study’s ... Read more The post REBEL Cast Ep121: The Battle of the Blades – Video Laryngoscopy vs. Direct Laryngoscopy appeared first on REBEL EM - Emergency Medicine Blog.

Take Home Points Methylxanthines are a drug class that includes caffeine, theophylline, and theobromine. The three main mechanisms that account for the clinical presentation of methylxanthine toxicity are: catecholamine release, adenosine antagonism, and phosphodiesterase inhibition. Beta agonism will lead to hyperlactatemia, hypokalemia, hyperglycemia, and tachycardia. Adenosine antagonism may lead to seizures and/or supraventricular tachycardia that ... Read more The post REBEL Core Cast 105.0 – Methylxanthine Toxicity appeared first on REBEL EM - Emergency Medicine Blog.

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession.  RSI inherently carries with it risks of complications such as post-intubation hypotension and cardiac arrest in the most extreme cases.  It is possible that the induction agent used could play an important ... Read more The post REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED? appeared first on REBEL EM - Emergency Medicine Blog.