Podcasts about rebel em

LISTENER DISCRETION IS ADVISED. REFERENCES: Ferrada P, García A, Duchesne J, Brenner M, Liu C, Ordóñez C, Menegozzo C, Salamea JC, Feliciano D. Comparing outcomes in patients with exsanguinating injuries: an Eastern Association for the Surgery of Trauma (EAST), multicenter, international trial evaluating prioritization of circulation over intubation (CAB over ABC). World J Emerg Surg. 2024 Apr 25;19(1):15. doi: 10.1186/s13017-024-00545-8. PMID: 38664763; PMCID: PMC11044388. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypoxemia Kills (Part 2 of 3)", REBEL EM blog, September 29, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypoxemia-kills-part-2-of-3/. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/. Scott Weingart, MD FCCM. EMCrit 30 – Hemorrhagic Shock Resuscitation. EMCrit Blog. Published on August 15, 2010. Accessed on December 27th 2024. Available at [https://emcrit.org/emcrit/trauma-resuscitation-dutton/ ].

Listener discretion is advised. References: PMID 28196622 PMID 35166796 PMID 26062607 Salim Rezaie, "Does My Patient with Chest Pain Have Acute Coronary Syndrome?", REBEL EM blog, November 23, 2015. Available at: https://rebelem.com/does-my-patient-with-chest-pain-have-acute-coronary-syndrome/.

LISTENER DISCRETION IS ADVISED References: Anand Swaminathan, "REBEL Cast Ep107: The BOUGIE Trial – Bougie First in All Emergency Intubations?", REBEL EM blog, February 17, 2022. Available at: https://rebelem.com/rebel-cast-ep107-the-bougie-trial-bougie-first-in-all-emergency-intubations/. AirTraq vs. Bougie: PMID 28515522 McGrath vs. AirTraq: PMID 28781449 Bougie vs. Stylet: PMID 29800096 Rigid vs. Standard Stylet: PMID 22273475

Today we share an episode recorded on REBEL Cast as an audio REBEL EM Book Club episode.  Host Anand "EMSwami" Swaminathan a REBEL EM author, medical news commentator, emergency medicine physician and expert medical educator speaks with  Resa Lewiss and Adaira Landry about their book, MicroSkills: Small Actions, Big Impact published by HarperCollins in April 2024.  Special thanks to Salim Rezaie. "For those who haven't checked out the site already R.E.B.E.L. EM stands for Rational Evidence Based Evaluation of Literature in Emergency Medicine. The blog was launched in October 2013, and continues to grow every month, and with that growth we are excited to give you REBEL Cast. This podcast will review evidence based literature and end with a clinical take home point for your clinical practice." Pick up a copy: MicroSkills: Small Actions, Big Impact   Subscribe: The Visible Voices Podcast Subscribe: R.E.B.E.L Cast

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.

RSI - Resuscitation sequence intubation is still a foreign term in some countries. In this episode I shed some light into the practice of the same in your EDs. Learn up more from the following resources and incorporate it into your airway management techniques. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/. https://litfl.com/intubation-hypotension-and-shock/ https://www.acepnow.com/article/timing-resuscitation-sequence-intubation-for-critically-ill-patients/ https://www.emdocs.net/r-e-b-e-l-em-critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/

Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM. Case: A 57-year-old woman with hypertension, […] The post SGEM#409: Same as it Ever Was – Tamiflu for Influenza? first appeared on The Skeptics Guide to Emergency Medicine.

Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma. NEJM 2023. Guest Skeptic: Dr. Salim Rezaie is a community emergency physician in San Antonio, TX.  He is the Creator and founder of REBEL EM, a free, critical appraisal blog that tries to cut down knowledge translation gaps of […] The post SGEM#408: Hey, I, Oh I'm Still Alive – Is it due to TXA? first appeared on The Skeptics Guide to Emergency Medicine.

Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC?.  This stemmed a lot of discussion in the background between Swami, myself, and Scott.  We felt it was worthwhile to record this as a podcast to better flush out some nuanced points. ... Read more The post REBEL Cast Ep119: A Discussion with Scott Weingart on the CT FIRST Trial appeared first on REBEL EM - Emergency Medicine Blog.

Gwenny and Ashley came on the podcast to talk about dealing with sick pediatric patients. References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/. Lucking, S. Maffei, F., Tamburro, R., &  Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide. Nagler, Joshua. Cheifetz, Ira. (2021). Initiating Mechanical Ventilation in Children. Up-to-Date.

References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/. Nishimura, Masaji. (2016). High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respiratory Care, 61(4), 529-41. Sharma S, Danckers M, Sanghavi D, et al. High Flow Nasal Cannula. [Updated 2022 Sep 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526071/

Listner questions and my (rambling) answers. REFERENCES Baize, Kohman, Stoffel, Weigartz. (2021). Albuterol versus terbutaline in emergency department management of asthma or COPD exacerbation. Critical Care Medicine 49(1 suppl 1): 410. Busti. (2015). Nitroglycerin Use in the Initial Management of Ischemic Pain from Acute Myocardial Infarction (NSTEMI, STEMI). Available: https://www.ebmconsult.com/articles/nitroglycerin-use-in-initial-management-ischemic-pain-acute-myocardial-infarction-nstemi-stemi Mike Sarraille, George Randle, Josh Cotton. The Talent War: How Special Operations and Great Organizations Win on Talent. Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/.

References (I didn't alphabetize them...sorry): Bello G, De Santis P, Antonelli M. Non-invasive ventilation in cardiogenic pulmonary edema. Ann Transl Med. 2018 Sep;6(18):355. doi: 10.21037/atm.2018.04.39. PMID: 30370282; PMCID: PMC6186545. Bendjelid K, Schütz N, Suter PM, et al. Does continuous positive airway pressure by face mask improve patients with acute cardiogenic pulmonary edema due to left ventricular diastolic dysfunction? Chest 2005;127:1053-8. 10.1378/chest.127.3.1053
 Frey, Michael. (2011). CPAP and Cardiogenic Pulmonary Edema. RT Magazine. Available at https://rtmagazine.com/disorders-diseases/chronic-pulmonary-disorders/asthma/cpap-and-cardiogenic-pulmonary-edema/ Chakraborty RK, Hamilton RJ. Calcium Channel Blocker Toxicity. [Updated 2022 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537147/ Salim Rezaie, "Pearls from ResusX Rewired 2020", REBEL EM blog, October 10, 2020. Available at: https://rebelem.com/pearls-from-resusx-rewired-2020/. Joshua Bucher. “Cervical Collars for C-Spine Trauma: The Facts” EMDOCS Blog. Available at: http://www.emdocs.net/cervical-collars-for-c-spine-trauma-the-facts/ Jugdutt, BI, & Warnica, JW. (1988). Intravenous nitroglycerin therapy to limit infarct size, expansion, and complications. Effect of timing, dosage, and infarct location. Circulation, 78(4). Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/. http://derangedphysiology.com/main/required-reading/trauma-burns-and-drowning/

REFERENCES: Capone J, Gluncic V, Lukic A, Candido KD. Physiologically Difficult Airway in the Patient with Severe Hypotension and Metabolic Acidosis. Case Rep Anesthesiol. 2020 Sep 4;2020:8821827. doi: 10.1155/2020/8821827. PMID: 32953182; PMCID: PMC7487120. Kim HJ, Son YK, An WS. Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis. PLoS One. 2013 Jun 5;8(6):e65283. doi: 10.1371/journal.pone.0065283. PMID: 23755210; PMCID: PMC3673920. https://www.openanesthesia.org/co2_transport_bicarbonate/ Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.

A very Happy Doctors' Day to you all! In this episode I discuss some salient points regarding the physiologically difficult airway. There are many physicians I know who are still not aware regarding this concept that can kill patients as soon as we try and save them. Also - EZECON is being organised in Kolkata from 16-17th July,22 and it is going to be an academic feast for the residents. So do register for it. The references for reading up more on the physiologically difficult airways are as follows - 1. Mosier JM, Joshi R, Hypes C, Pacheco G, Valenzuela T, Sakles JC. The Physiologically Difficult Airway. West J Emerg Med. 2015 Dec;16(7):1109-17. doi: 10.5811/westjem.2015.8.27467. Epub 2015 Dec 8. PMID: 26759664; PMCID: PMC4703154. 2. Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559. 3. https://www.acepnow.com/article/crash-a-mnemonic-for-the-physiological-difficult-airway/ 4. Myatra SN, Divatia JV, Brewster DJ. The physiologically difficult airway: an emerging concept. Curr Opin Anaesthesiol. 2022 Apr 1;35(2):115-121. doi: 10.1097/ACO.0000000000001102. PMID: 35165233. 5. Cai SR, Sandhu MRS, Gruenbaum SE, Rosenblatt WH, Gruenbaum BF. Airway Management in an Anatomically and Physiologically Difficult Airway. Cureus. 2020 Sep 24;12(9):e10638. doi: 10.7759/cureus.10638. PMID: 33123451; PMCID: PMC7584327. 6. Kornas RL, Owyang CG, Sakles JC, Foley LJ, Mosier JM; Society for Airway Management's Special Projects Committee. Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesth Analg. 2021 Feb 1;132(2):395-405. doi: 10.1213/ANE.0000000000005233. PMID: 33060492. 7. Mosier, Jarrod M. “Physiologically Difficult Airway in Critically Ill Patients: Winning the Race between Haemoglobin Desaturation and Tracheal Intubation.” British Journal of Anaesthesia 125, no. 1 (July 2020): e1–4. https://doi.org/10.1016/j.bja.2019.12.001. 8. Scott Weingart, MD FCCM. EMCrit 325 – The Hypoxemic Difficult Airway and Preox Discussion with Jarrod Mosier. EMCrit Blog. Published on June 5, 2022. Accessed on June 30th 2022. Available at [https://emcrit.org/emcrit/hypoxemic-difficult-airway/ ]. 9. Salim Rezaie, "An Emergency Difficult Airway Predictor Would be From HEAVEN", REBEL EM blog, January 31, 2018. Available at: https://rebelem.com/emergency-difficult-airway-predictor-heaven/. 10. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/. 11. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.

HEED THE REFERENCES: Anand Swaminathan, "REBEL Core Cast 47.0 Nausea and Vomiting", REBEL EM blog, January 13, 2021. Available at: https://rebelem.com/rebel-core-cast-47-0-nausea-and-vomiting/. Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2015; doi: http://dx.doi.org/10.1016/j.annemergmed.2015.09.031. Furyk, J. S., Meek, R. A., & Egerton-Warburton, D. (2015). Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. The Cochrane database of systematic reviews, 2015(9), CD010106. https://doi.org/10.1002/14651858.CD010106.pub2 Mark Ramzy, "Aromatherapy vs Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients", REBEL EM blog, December 3, 2020. Available at: https://rebelem.com/aromatherapy-vs-oral-ondansetron-for-antiemetic-therapy-among-adult-emergency-department-patients/. Phips, Ashley. (2015). Article Review: RCT of Antiemetic Efficacy in the ED. Available at http://www.emdocs.net/wp-content/uploads/2015/01/AntiemeticUseED-Phipps-.pdf Plewa, Young, Yerman. (20 July 2008). The vomiting patient in the ED: Evaluation and management. Emergency Medicine Reports. Available from https://www.reliasmedia.com/articles/13681-the-vomiting-patient-in-the-ed-evaluation-and-management Scorza K, Williams A, Phillips JD, Shaw J. Evaluation of nausea and vomiting. Am Fam Physician. 2007 Jul 1;76(1):76-84. PMID: 17668843. Wegrzyniak LJ, Repke JT, Ural SH. Treatment of hyperemesis gravidarum. Rev Obstet Gynecol. 2012;5(2):78-84. Yartsev. (2021). Deranged Physiology: Question 10 - Describe the physiology of vomiting. Available from https://derangedphysiology.com/main/cicm-primary-exam/past-papers/2010-paper-1-saqs/question-10p2#answer-anchor

DAS REFERENCES: Bordeianou, L. Yeh, D. Management of SBO in adults. Available at https://www.uptodate.com/contents/management-of-small-bowel-obstruction-in-adults Ellsworth Wright, "REBEL Core Cast – Basics of EM – Diffuse and Flank Abdominal Pain", REBEL EM blog, June 1, 2022. Available at: https://rebelem.com/rebel-core-cast-basics-of-em-diffuse-and-flank-abdominal-pain/. Meadors, K. (n.d.). Abdominal Pain. Retrieved from http://www.emdocs.net/wp-content/uploads/2014/05/AbdominalPain-KMAK.pdf Simon, E. (2017). EM@3AM - Ascending Cholangitis. Available at http://www.emdocs.net/em3am-ascending-cholangitis/ Spangler, R., Van Pham, T., Khoujah, D. et al. Abdominal emergencies in the geriatric patient. Int J Emerg Med 7, 43 (2014). https://doi.org/10.1186/s12245-014-0043-2 PMID 10987108 PMID 32362368 Vercruysse G, Busch R, Dimcheff D, et al. Evaluation and Management of Mechanical Small Bowel Obstruction in Adults [Internet]. Ann Arbor (MI): Michigan Medicine University of Michigan; 2021 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572336/ Zeretzke-Bien, C. (2016). Appendicitis: Pearls and Pitfalls in Adult and Pediatric Populations. Available at http://www.emdocs.net/appendicitis-pearls-and-pitfalls-in-adult-and-pediatric-populations/

In medicine we often draw a solid line between community and academic medicine, but this likely is a fallacy. In fact there is a huge amount of academia that can be found and thrive in a community hospital. In this interview we talk with Dr. Salim Rezaie of the REBEL EM blog and podcast, a man who has walked both sides of this imaginary line between community and academics. In our chat we discuss ways to get involved in academics in the community and the vast array of rewards that come with that including improved patient care, increased fervor for your work, decreased burnout, and increased career longevity.    Authors: Jason Hine MD, Salim Rezaie MD Peer Review: Jeff Holmes MD, Mike Burla MD

Date: October 14th, 2020 Guest Skeptic: Dr.Salim Rezaie is a community emergency physician at Greater San Antonio Emergency Physicians (GSEP), where he is the director of clinical education.  Salim is probably better known as the creator and founder of the wonderful knowledge translation project called REBEL EM. It is a free, critical appraisal blog and podcast […]

This week we dive into a recent article highlighting a major update in the treatment of community acquired pneumonia (CAP) https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_156_0_Final_Cut.m4a Download Leave a Comment Tags: CAP, Macrolides, Pulmonary Show Notes Read More REBEL EM: Update in Community Acquired Pneumonia (CAP) Treatment – Macrolide Resistance

This week we discuss three recent articles looking at esmolol in refractory VF, c-spine clearance and antibiotics after abscess drainage https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_155_0_Final_Cut.m4a Download Leave a Comment Tags: Cardiac Arrest, Cervical Spine, Esmolol, I+D, Infectious Diseases, Journal Club, MRSA, Refractory VF, Trauma Show Notes Read More REBEL EM: Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses Bryan Hayes at ALiEM: Sulfamethoxazole-Trimethoprim for Skin and Soft Tissue Infections: 1 or 2 Tablets BID? The SGEM: SGEM#164: Cuts Like a Knife Core EM: A...

More amazing pearls from our Bellevue morning report series. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_153_0_Final_Cut.m4a Download Leave a Comment Tags: Alcohol Intoxication, Discitis, ESRD, Necrotizing Fasciitis Show Notes Read More Core EM: Spinal Epidural Abscess REBEL EM: Cauda Equina Syndrome Radiopaedia: Discitis LITFL: Necrotizing Fasciitis REBEL Cast: Episode 50 – Intoxicated Patients Can Equal Badness Read More

This week, we discuss penetrating neck trauma and some pearls and pitfalls in management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_152_0_Final_Cut.m4a Download One Comment Tags: Neck Trauma, Trauma Show Notes REBEL EM: Penetrating Neck Injuries Zone 1 Zone 2 Zone 3 Anatomic Landmarks Clavicle/Sternum to Cricoid Cartilage Cricoid Cartilage to the Angle of the Mandible Superior to the Angle of the Mandible Anatomic Structures in Zone Proximal Common Carotid Artery

This week we review some recent publications on steroids in pharyngitis and the VAN assessment in stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_150_0_Final_Cut.m4a Download Leave a Comment Tags: Pharyngitis, Steroids, VAN Assessment Show Notes Read More The SGEM: SGEM #203: Let Me Clear My Sore Throat with a Corticosteroid Core EM: Corticosteroids in Pharyngitis – Systematic Review + Meta-Analysis REBEL EM: Does it Take a VAN to Identify Emergency Large Vessel Occlusion (EVLO) in Ischemic Stroke? REBEL EM: Stroke Workflow in 2018

This episode reviews the identification and management of patients with salicylate toxicity. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_147_0_Final_Cut.m4a Download 4 Comments Tags: Aspirin, Salicylate, Toxicology Show Notes Take Home Points Always consider salicylate toxicity: In patients with tachypnea, hyperpnea, AMS and clear lungs In the presence of an anion gap metabolic acidosis with a respiratory alkalosis Treat salicylate toxicity by alkalinizing the blood and urine to increase excretion Avoid intubation until absolutely necessary. If you do have to intubate, minimize apneic time and consider awake intubation and nake sure your ventilator settings match the patient's necessary high minute ventilation Think about chronic salicylate toxicity in unexplained altered mental status, tachypnea or metabolic acidosis in elderly Know indications for hemodialysis in salicylate toxic patients Read More REBEL EM: Salicylate Toxicity LITFL: Salic...

This week we discuss the disutility of orthostatic vital signs as a diagnostic tool in patients with suspected volume loss. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_140_0_Final_Cut.m4a Download Leave a Comment Tags: Cardiology, Orthostatic Hypotension Show Notes Summary: Based on the limited available evidence, it's unlikely orthostatic vital sign measurement can be used to determine which patients have volume loss and which do not. The baseline prevalence of orthostatic vital signs is common and patients will not always develop orthostatic vital signs in response to volume loss. Therefore, there will both be patients who are orthostatic by numbers without volume loss and there will be patients with volume loss who are not orthostatic by numbers. Symptoms, with the exception of inability to stand to have orthostatics performed, are not useful either. Bottom Line: Based on the low overall sensitivity of orthostatic vital sign measurements, they should not be used to influence clinical decision making. Read More REBEL EM: Orthostatic Hypotension in Volume Depletion References: Skinner JE et al. Orthostatic heart rate and blood pressure in adolescents: reference ranges. J Child Neuro 2010; 25(10): 1210-5. PMID: 20197269 Stewart JM.

This week we dive in to the initial trauma assessment. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_133_0_Final_Cut.m4a Download Leave a Comment Tags: ABCDEs, Trauma Show Notes Take Home Points Development of a systematic approach is essential to rapidly assessing the wide diversity of trauma patients and minimizes missed injures Prepare with whatever information is available before the patient arrives and remember to get a good handoff from the pre-hospital team Complete the primary survey (ABCDEs) and address immediate life threats Round out your assessment with a good medical history and remember to complete a comprehensive head-to-toe exam Read More Shlamovitz GZ, et al. Poor test characteristics for the digital rectal examination in trauma patients. Ann Emerg Med. 2007;50(1):25-33, 33.e1. PMID: 17391807 ER Cast: Gunshot to the Groin with Kenji Inaba EM:RAP: Do We Still Need The C-Collar? YouTube: Death of the Dinosaur: Debunking Trauma Myths by Dr. S.V. Mahadevan REBEL EM:

This week we explore the presentation, diagnosis and management of SBP. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_131_0_Final_Cut.m4a Download Leave a Comment Tags: Gastroenterology, Infectious Diseases, SBP Show Notes Take Home Points SBP is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis An ascites PMN count > 250 cells/mm3 is diagnostic of SBP but treatment should be considered in any patient with ascites and abdominal pain or fever Treatment of SBP is with a 3rd generation cephalosporin with the addition of albumin infusion in any patient meeting AASLD criteria (Cr > 1.0 mg/dL, BUN > 30 mg/dL or Total bilirubin > 4 mg/dL) Read More Oyama LC: Disorders of the liver and biliary tract, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen's Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 90: p 1186-1205. REBEL EM: Spontaneous Bacterial Peritonitis EMRAP: C3 Live Paracentesis Video LITFL: Spontaneous Bacterial Peritoniti...

Should we intubate patients in cardiac arrest? We discuss this topic and some basics of running a good arrest. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_108_0_Final_Cut.m4a Download Leave a Comment Tags: Advanced Airway Management, Cardiac Arrest, Critical Care, Resuscitation Show Notes Take Home Points Intra-arrest intubation does not appear to improve outcomes. For most patients, support with BVM, or possibly an LMA, is adequate. Instead of securing an advanced airway, focus on the two things that clearly make a difference in outcomes – good compressions and defibirillation Good compressions should be fast and hard and you must minimize interruptions in compressions to minimize interruptions in perfusion Don't forget that a great resuscitation requires great preparation. Take whatever time you have to discuss with your team and assign roles. Read More Rebel EM: In-hospital Cardiac Arrest – The First 15 Minues Core EM: Proper Defibrillator Pad Placement + Dual Sequential Defibrillation

This week we welcome Andy Little onto the show to discuss the modified Valsalva maneuver for breaking SVT. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_102_0-AVNRT_Final_Cut.m4a Download Leave a Comment Tags: Adenosine, AVNRT, Cardiology, SVT, Tachydysrhythmia Show Notes Read More Rebel EM: The REVERT Trial – A Modified Valsalva Maneuver to Convert SVT SGEM: This is a SVT and I'm Gonna Revert It Using a Modified Valsalva Manoeuvre Appelboam A et al. Postural Modification to the Standard Valsalva Manoeuvre for Emergency Treatment of Supraventricular Tachycardias (REVERT): A Randomised Controlled Trial. Lancet 2015. PMID: 26314489 Read More

This week we talk about mammal bites - dogs, cats and humans - with a focus on wound closure, antibiotics and rabies prophylaxis. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_94_0_Final_Cut.m4a Download Leave a Comment Tags: Infectious Diseases, Mammal Bites, Rabies Show Notes EM:RAP: Animal Bites – A Short Board Review EM:RAP: Episode 107 Mammalian Bites Rebel EM: Medical Myths in the Management of Dog Bites CDC: Rabies Info References Chen E et al. Primary Closure of Mammalian Bites. Acad EM 2000; 7(2): 157- 162. PMID: 10691074 Paschos NK et al. Primary closure versus non-closure of dog bite wounds. A radomised controlled trial. Injury 2014 45(1): 237-40. PMID: 23916901 Medeiros IM, Saconato H. Antibiotic prophylaxis for mammalian bite (Review). Cochrane Database of Systematic Reviews 2008 (3); PMID:

This week we discuss a recent article in Annals of EM on contrast induced nephropathy and whether the phenomena is real or dogma. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_91_0_Final_Cut.m4a Download Leave a Comment Tags: AKI, CIN, Contrast Induced Nephropathy, Journal Update Show Notes ACR Table on CIN – FOAMCast FOAMCast: Episode 65 – Contrast Induced Nephropathy and Genitourinary Trauma REBEL EM: Contrast Induced Nephropahty: Fact or Myth Core EM: Acute Kidney Injury is not Associated with IV Contrast Use in the ED EM Lit of Note:

This week we discuss the OXYGEN-ICU trial exploring the effect of excess oxygen on ICU mortality. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_78_0_Final_Cut.m4a Download Leave a Comment Tags: Critical Care, ICU, OXYGEN-ICU Study Show Notes Read More The Bottom Line: Normal Oxygen Versus Hyperoxia in the Intensive Care Unit (ICU) (OXYGEN-ICU) ScanCrit: Avoid the Oxygen Reflex REBEL EM: July 2015 REBEL Cast References Giradis M et al. Effect of Conservative vs Conventional Oxygen Therapy on Mortality Among Patients in an Intensive Care Unit: The Oxygen-ICU Randomized Clinical Trial. JAMA. 316(15):1583-1589. 2016. PMID: 27706466 Meyhoff CS et al. PROXI Trial Group. Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA. 2009; 302(14):1543-1550. PMID:

This week we feature a lecture from Anand Swaminathan at our weekly conference on the ED management of acute pulmonary edema https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_71_0_Final_Cut.m4a Download 9 Comments Tags: Acute Decompensated Heart Failure, Acute Pulmonary Edema, ADHF, APE, Cardiovascular Show Notes Read More Core EM: Acute Pulmonary Edema EMCrit: Podcast 1 – Sympathetic Crashing Acute Pulmonary Edema REBEL EM: Morphine Kills in Acute Decompensated Heart Failure emDocs:

This week we feature a lecture from Anand Swaminathan at our weekly conference on the ED management of acute pulmonary edema https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_71_0_Final_Cut.m4a Download 9 Comments Tags: Acute Decompensated Heart Failure, Acute Pulmonary Edema, ADHF, APE, Cardiovascular Show Notes Read More Core EM: Acute Pulmonary Edema EMCrit: Podcast 1 – Sympathetic Crashing Acute Pulmonary Edema REBEL EM: Morphine Kills in Acute Decompensated Heart Failure

This week we discuss the diagnosis and management of pericarditis with a focus on not missing the hidden STEMI. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_65_0_Final_Cut.m4a Download Leave a Comment Tags: ACS, Cardiology, Cardiovascular, Colchicine, Pericarditis, STEMI Show Notes Read More ECG Case of the Week (Amal Mattu): Acute STEMI vs. Pericarditis Part 1 + Part 2 REBEL EM: Colchicine for Treatment of Pericarditis SOCMOB: Pericarditis: Treatment and Diagnosis Pocket Card FOAMcast: Episode 54 – The Pericardium Core EM: Pericarditis

This week we discuss the diagnosis and management of pericarditis with a focus on not missing the hidden STEMI. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_65_0_Final_Cut.m4a Download Leave a Comment Tags: ACS, Cardiology, Cardiovascular, Colchicine, Pericarditis, STEMI Show Notes Read More ECG Case of the Week (Amal Mattu): Acute STEMI vs. Pericarditis Part 1 + Part 2 REBEL EM: Colchicine for Treatment of Pericarditis SOCMOB: Pericarditis: Treatment and Diagnosis Pocket Card FOAMcast: Episode 54 – The Pericardium Core EM: Pericarditis

This week we dive into the PATCH trial investigating the role of platelet transfusions in patients with spontaneous ICH on antiplatelet meds https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_55_0_Final_Cut.m4a Download Leave a Comment Tags: Intracerebral Hemorrhage, PATCH Trial, Platelets Show Notes Read More REBEL EM: The PATCH Trial: Hold the Platelets in Spontaneous Intracerebral Hemorrhage? St. Emlyn's: JC – Platelets for Intracranial Haemorrhage EM Lit of Note: Put the Platelets Away in ICH References

This week we dive into the PATCH trial investigating the role of platelet transfusions in patients with spontaneous ICH on antiplatelet meds https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_55_0_Final_Cut.m4a Download Leave a Comment Tags: Intracerebral Hemorrhage, PATCH Trial, Platelets Show Notes Read More REBEL EM: The PATCH Trial: Hold the Platelets in Spontaneous Intracerebral Hemorrhage? St. Emlyn's: JC – Platelets for Intracranial Haemorrhage EM Lit of Note: Put the Platelets Away in ICH References

This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM:

This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM: Thrombolytics for Acute Stroke

This week we dive into a recent article on pain control in renal colic and how it affects our management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_51_0_Final_Cut.m4a Download Leave a Comment Tags: Analgesia, Kidney Stones, Renal Colic, Urology Show Notes Read More Core EM: Optimal First Line Analgesia in Ureteric Colic ALiEM: Top 10 reasons NOT to order a CT scan for suspected renal colic REBEL EM: Does Use of Tamsulosin in Renal Colic Facilitate Stone Passage Core EM: Medical Expulsive Therapy (MET) in Renal Colic Wang RC. Managing Urolithiasis. Ann Emerg Med 2015 PMID: 26616536 References Pathan SA et al. Delivering safe and effective analgesia for management of renal colic in the emerg...

This week we dive into a recent article on pain control in renal colic and how it affects our management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_51_0_Final_Cut.m4a Download Leave a Comment Tags: Analgesia, Kidney Stones, Renal Colic, Urology Show Notes Read More Core EM: Optimal First Line Analgesia in Ureteric Colic ALiEM: Top 10 reasons NOT to order a CT scan for suspected renal colic REBEL EM: Does Use of Tamsulosin in Renal Colic Facilitate Stone Passage Core EM: Medical Expulsive Therapy (MET) in Renal Colic Wang RC. Managing Urolithiasis. Ann Emerg Med 2015 PMID: 26616536 References Pathan SA et al.

This week we review a number of controversial topics in SSTI management with a focus on the role of antibiotics in abscess management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_45_0_Final_Cut.m4a Download Leave a Comment Tags: Abscess, Cellulitis, Controversy, I+D, Irrigation, TMP-SMX Show Notes Core EM: Predictors of failed outpatient cellulitis treatment EM Nerd: The Case of the Pragmatic Wound REBEL EM: Trimethoprim-sulfamethoxazole for uncomplicated skin abscesses EM Lyceum: Abscess, “Answers” References Peterson D et al. Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients with Uncomplicated Cellulitis. Acad Emerg Med 2014; 21: 526-31. PMID: 24842503

This week we review a number of controversial topics in SSTI management with a focus on the role of antibiotics in abscess management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_45_0_Final_Cut.m4a Download Leave a Comment Tags: Abscess, Cellulitis, Controversy, I+D, Irrigation, TMP-SMX Show Notes Core EM: Predictors of failed outpatient cellulitis treatment EM Nerd: The Case of the Pragmatic Wound REBEL EM: Trimethoprim-sulfamethoxazole for uncomplicated skin abscesses EM Lyceum: Abscess, “Answers” References Peterson D et al. Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients with Uncomplicated Cellulitis. Acad Emerg Med 2014; 21: 526-31. PMID: 24842503...

This week we review how to ventilate the intubated asthmatic patient. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_42_0_Final_Cut.m4a Download One Comment Tags: Asthma, Crashing Asthmatic, Permissive Hypercapnea, Ventilation Show Notes REBEL EM: The Crashing Asthmatic EMCrit: Podcast 15 – The Severe Asthmatic EMCrit: Dominating the Vent: Part I + Part II Read More

This week we review how to ventilate the intubated asthmatic patient. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_42_0_Final_Cut.m4a Download One Comment Tags: Asthma, Crashing Asthmatic, Permissive Hypercapnea, Ventilation Show Notes REBEL EM: The Crashing Asthmatic EMCrit: Podcast 15 – The Severe Asthmatic EMCrit: Dominating the Vent: Part I + Part II Read More

This week we discuss an article on door to balloon time and focus on the EPs role in patients who present with ST elevations on their EKG. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_35_0_Final_Cut.m4a Download Leave a Comment Tags: Cardiology, Door to Balloon Time, Resuscitation, STEMI Show Notes Fanari Z et al. Aggressive measures to decrease “door to balloon” time and incidence of unnecessary cardiac catheterization: potential risks and role of quality improvement. Mayo Clin Proc 2015. PMID: 26549506 REBEL EM: December 2015: All Cardiology REBELCast Read More

This week we discuss an article on door to balloon time and focus on the EPs role in patients who present with ST elevations on their EKG. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_35_0_Final_Cut.m4a Download Leave a Comment Tags: Cardiology, Door to Balloon Time, Resuscitation, STEMI Show Notes Fanari Z et al. Aggressive measures to decrease “door to balloon” time and incidence of unnecessary cardiac catheterization: potential risks and role of quality improvement. Mayo Clin Proc 2015. PMID: 26549506 REBEL EM: December 2015: All Cardiology REBELCast Read More

On this podcast we review some background on AVNRT and focus on Emergency Department management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_20_0_Final.m4a Download 2 Comments Tags: AVNRT, PSVT, REVERT Trial, Tachydysrhythmias Show Notes AVNRT with Aberrancy vs. VT REBEL EM: SVT with Aberrancy Versus VT Amal Mattu's ECG Case of the Week: August 26th, 2013 Valsalva Maneuver ALiEM: Tricks of the Trade: Valsalva Maneuver By Using a 10cc Syringe St. Emlyn's: JC The REVERT Trial Adenosine in AVNRT Larry Mellick: Treating SVT with Adensoine ALiEM: Trick of the Trade: Combining Adenosine with the Flush Verapamil in AVNRT RAGE Podcast: