POPULARITY
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/ ].
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
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 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.
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/.
In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain management in the polytrauma, Nour Khatib on a rural EM case on management of near-drowning patient, Sara Reid delivers a polio primer, Anand Swaminathan on head-up CPR... The post EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Near-Drowning, Polio, Head-up CPR appeared first on Emergency Medicine Cases.
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/.
Revisiting our most listened to episode from season 6, our hosts Drew, Tanner, and Andy sit down and discuss Wellbeing with guests Salim Rezaie, and Ademola Adewale!
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/.
In this month's EM Quick Hits podcast, Anand Swaminathan on tips and tricks in polytrauma, Rohit Mohindra on diagnosis and management of toxic megacolon, Jesse McLaren on ECG in pulmonary embolism, Victoria Myers on approach to the patch call for cardiac arrest, Brit Long on when to do a CT head before LP, Salim Rezaie on nebulized ketamine - the ketaBAN study... The post EM Quick Hits 33 Polytrauma Tips & Tricks, Toxic Megacolon, ECG in PE, Patch Calls, CT Before LP, Nebulized Ketamine appeared first on Emergency Medicine Cases.
The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing. Today we have a conversation with Salim Rezaie, MD whose dive into this literature couldn't be much deeper. We discuss which subgroup of patients might benefit from monoclonal antibodies, why the jury is still out on the benefit of ivermectin, the role of inhaled budesonide, and outpatient anticoagulation which hasn't been studied, but hopefully will be someday. Listen on: iTunes Spotify Stitcher Guest Bio: Salim Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. He currently works as a community emergency physician at Greater San Antonio Emergency Physicians (GSEP) where he is the director of clinical education. Salim is the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that tries to cut down knowledge translation gaps of research to bedside clinical practice. Hear more from Salim on Stimulus #16 Accumulation of Marginal Gains. We Discuss: The fact that the best treatment of COVID-19 is prevention through vaccination [2:30]; The value and purported benefit of monoclonal antibodies [03:21]; Whether a rapid antibody test would help predict seronegativity [06:30]; Specifically which monoclonal antibodies are being used in Salim's shop [07:40]; The irony of people demanding monoclonal antibodies, but refusing vaccination because they don't know what's in it [08:50]; Why you can't trust everything you read about COVID-19 therapy in a news headline [12:40]; One of the largest ivermectin studies which was based on falsified data, yet continues to influence the results of meta-analyses [15:30]; Inhaled budesonide for COVID-19 symptom control [22:00]; The slippery slope of outpatient anticoagulation [23:39]; The things Salim might do if he had symptomatic COVID-19 and was well enough to be managed as an outpatient [27:25]; And more. Shownotes by Melissa Orman, MD For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob:Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing. Today we have a conversation with Salim Rezaie, MD whose dive into this literature couldn't be much deeper. We discuss which subgroup of patients might benefit from monoclonal antibodies, why the jury is still out on the benefit of ivermectin, the role of inhaled budesonide, and outpatient anticoagulation which hasn't been studied, but hopefully will be someday. Listen on: iTunes Spotify Stitcher Guest Bio: Salim Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. He currently works as a community emergency physician at Greater San Antonio Emergency Physicians (GSEP) where he is the director of clinical education. Salim is the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that tries to cut down knowledge translation gaps of research to bedside clinical practice. Hear more from Salim on Stimulus #16 Accumulation of Marginal Gains. We Discuss: The fact that the best treatment of COVID-19 is prevention through vaccination [2:30]; The value and purported benefit of monoclonal antibodies [03:21]; Whether a rapid antibody test would help predict seronegativity [06:30]; Specifically which monoclonal antibodies are being used in Salim's shop [07:40]; The irony of people demanding monoclonal antibodies, but refusing vaccination because they don't know what's in it [08:50]; Why you can't trust everything you read about COVID-19 therapy in a news headline [12:40]; One of the largest ivermectin studies which was based on falsified data, yet continues to influence the results of meta-analyses [15:30]; Inhaled budesonide for COVID-19 symptom control [22:00]; The slippery slope of outpatient anticoagulation [23:39]; The things Salim might do if he had symptomatic COVID-19 and was well enough to be managed as an outpatient [27:25]; And more. Shownotes by Melissa Orman, MD For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob:Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
Have you been "unwell" lately? Are you wondering how to tackle your personal wellness and how you can help effect change in the system you work to promote wellness? Then take a listen as our hosts (Drew, Tanner, and Andy) sit down and discuss Wellbeing with guests Salim Rezaie, and Ademola Adewale!
In this month's EM Quick Hits podcast: Justin Morgenstern on the evidence for NG tubes in SBO, Jesse MacLaren on recognition of hyperacute T-waves vs other causes of tall T-waves, Brit Long on malignant otitis externa clinical pearls, Salim Rezaie on the value of CCTA in NSTEMI, Justin Morgenstern on the value of CCTA in low-risk chest pain, Hans Rosenberg on how to use the Canadian Syncope Score and it's validation in Canada... The post EM Quick Hits 31 NG Tubes in SBO, Hyperacute T-Waves, Malignant Otitis Externa, CCTA in NSTEMI and Low-risk Chest Pain, Canadian Syncope Score appeared first on Emergency Medicine Cases.
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
Anand Swaminathan on LAST prevention, recognition and management, Emily Austin on sodium nitrite suicide kit poisoning, methemoglobinemia and methylene blue, Hans & Erin Rosenberg on post-intubation analgesia and sedation, Salim Rezaie on short-term tetracaine for corneal abrasions new evidence, Jesse MacLaren on differentiating ST deviation in occlusion MI from other causes, Robert Maunder on a 3 step approach to coping and building resilience during the COVID pandemic... The post EM Quick Hits 26 LAST, Sodium Nitrite Poisoning, Post-intubation Care, Tetracaine for Corneal Abrasion, ST Segment in Occlusion MI, Coping with COVID appeared first on Emergency Medicine Cases.
In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM and is a follow up on the last episode regarding trying not to intubate early. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-20. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.
In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM and is a follow up on the last episode regarding trying not to intubate early. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-20. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.
In this month's EM Quick Hits podcast we have Salim Rezaie on clinical probability adjusted D-dimer for pulmonary embolism, Bourke Tillmann on ARDS for the ED Part 2, Brit Long & Michael Gottlieb on pharyngitis mimics, Justin Hensley on the many faces of barotrauma, Hans Rosenberg & Peter Johns on assessment of continuous vertigo and Justin Morgenstern & Jeannette Wolfe on gender-based differences in CPR... The post EM Quick Hits 23 – Clinical Probability Adjusted D-dimer, ARDS Part 2, Pharyngitis Mimics, Barotrauma, Vertigo, CPR Gender-Based Differences appeared first on Emergency Medicine Cases.
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 free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Primary Care RAP show. Earn CME on your commute while getting the latest practice-changing primary care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/PCRAPPOD Post-contrast AKI (or contrast induced nephropathy as it used to be called) is one of those hot-button issues in modern medicine. Is it really a thing? Was it ever, really? Neda Frayha, MD sits down with Salim Rezaie, MD of Rebel EM for an invigorating conversation about this controversial topic and what the literature actually tells us about it. Pearls: The term contrast-induced nephropathy has fallen out of favor to post-contrast AKI because the debate about contrast’s role in kidney injury rages on. Much of the recent literature has not shown a difference in AKI for those who receive a CT with contrast. Earlier studies were based on contrasts of higher volume and osmolarity given arterially that are not routinely used today. Remember that studies excluded those who had a renal transplant, GFR4. Terminology: contrast-induced nephropathy has fallen out of favor to post-contrast AKI because we aren’t sure if contrast is really the culprit Issues with the literature: Many studies involved high volume, high osmolar contrast given arterially, not venous, low volume or low osmolar contrast Early studies used 15,000 milliosmole contrast whereas today we are using 320-800 milliosmoles or even iso-osmolar contrast Shown that route does make a difference. People receiving arterial contrast (ie: coronary angiography) are more at risk of AKI Studies are observational so you cannot get to causation, just association Other potential risk factors: comorbid conditions (diabetes, heart failure, hypertension), volume depletion, concurrent medications (vancomycin, NSAIDs, diuretics) Are outcomes clinical or patient-oriented (ie: dialysis, death, increased length of stay) or a lab value change? New literature: 1. Annals of EM 2017 (Hinson et. al) Single center Retrospective cohort study 17,000 patients who underwent CT with contrast, without contrast or no CT at all Excluded if Cr > 4mg/dL or renal transplant Bottomline: no difference in patient-oriented outcomes (dialysis, mortality) 2. Annals of EM 2017 (Aycock et. al) Meta-analysis 28 articles with 100,000 patients Bottomline: no difference in patient-oriented outcomes (dialysis, mortality) 3. Lancet 2017 (AMACING trial) Randomized control trial (three parallel group, open label, non-inferiority) Excluded if GFR
Due to 'The Big C', ECHO Yacht Club was cancelled... but life goes on, and so does our podcast. We decided to turn lemons into lemonade and have our friend and emergency medicine powerhouse Dr. Sal Rezaie join us for a discussion based on what-would-have-been our Yacht Club presentation. Everyone carries a card that says they know how to manage tachydysrhythmias. But what happens when your interventions don’t work? In this podcast episode, we focus on recent evidence suggesting alternate means of management when the patient remains refractory to conventional therapy. Though controversial, we will NOT be spewing ACLS algorithms. It’s time to live your life a quarter of a milligram at a time. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction. ------------------------------------------------ Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com Creative Commons Attribution 3.0 Unported License https://creativecommons.org/licenses/by/3.0/deed.en_US
Salim Rezaie on HALT-IT trial for TXA in unstable GI bleed, Sarah Reid on pediatric DKA update in fluid management and cerebral edema, Hans Rosenberg on POCUS in shoulder dislocations via CJEM, Arun Sayal on Lisfranc injury pearls and pitfalls, Justin Morgenstern on RECOVERY Trial for Dexamethasone in COVID pneumonia, Walter Himmel on getting what you need from consultants... The post EM Quick Hits 21 TXA in GI Bleed, Pediatric DKA, POCUS for Shoulder Dislocations, Lisfranc Injuries, Dexamethasone for COVID Pneumonia, Consultation Tips appeared first on Emergency Medicine Cases.
A conversation with Dr. Salim Rezaie on discipline vs stubbornness, working through depression, transforming his body from 260 lbs to super fit, the aggregation of marginal gains, and intentional living. About our guest: Salim Rezaie is double board certified in internal medicine and emergency medicine. In addition to working clinically as an emergency physician, he runs one of the most popular medical education websites on the planet, Rebel EM. We discuss: What has been most challenging for Salim while caring for patients in the ED during the COVID-19 pandemic [03:20]; The spark for Salim’s transformation from being “festively plump” to super fit [06:30]; Tips for embarking on a diet and exercise program, and the importance of actually scheduling time to do it [10:35]; How intermittent fasting was a way for Salim to engage in the cultural practice of Ramadan [15:45]; The distinction between discipline and being stubborn [19:30]; Why success relies on the aggregation of marginal gains [22:46]; Social media and how these tools are only as good as the person who uses it [26:00]; The lifestyle of instant gratification and how people often don’t appreciate the hard work that goes into something for it to be successful [26:55] Why comparing yourself to others is the opposite of gratitude [31:00]; The stigma of mental illness and 3 things Salim learned in psychotherapy [00:35:12]; The value of embracing failure equally as you would success [43:30]; Salim’s core principles and priorities [44:30]; The most unexpected book that Salim has read in the last year [48:20]; And more. For Complete Show Notes: Click here To Learn More About Stimulus: https://www.stimuluspodcast.com/
A conversation with Dr. Salim Rezaie on discipline vs stubbornness, working through depression, transforming his body from 260 lbs to super fit, the aggregation of marginal gains, and intentional living. About our guest: Salim Rezaie is double board certified in internal medicine and emergency medicine. In addition to working clinically as an emergency physician, he runs one of the most popular medical education websites on the planet, Rebel EM. We discuss: What has been most challenging for Salim while caring for patients in the ED during the COVID-19 pandemic [03:20]; The spark for Salim’s transformation from being “festively plump” to super fit [06:30]; Tips for embarking on a diet and exercise program, and the importance of actually scheduling time to do it [10:35]; How intermittent fasting was a way for Salim to engage in the cultural practice of Ramadan [15:45]; The distinction between discipline and being stubborn [19:30]; Why success relies on the aggregation of marginal gains [22:46]; Social media and how these tools are only as good as the person who uses it [26:00]; The lifestyle of instant gratification and how people often don’t appreciate the hard work that goes into something for it to be successful [26:55] Why comparing yourself to others is the opposite of gratitude [31:00]; The stigma of mental illness and 3 things Salim learned in psychotherapy [00:35:12]; The value of embracing failure equally as you would success [43:30]; Salim’s core principles and priorities [44:30]; The most unexpected book that Salim has read in the last year [48:20]; And more. For Complete Show Notes: Click here To Learn More About Stimulus: https://www.stimuluspodcast.com/
*Editor's note: As of June 4, 2020, The Lancet article by Mehra MR et al has been retracted. (https://www.thelancet.com/lancet/article/s0140673620313246) In this Hippo Education short, Dr.Salim Rezaie from REBEL EM and Lit Matters critically appraises two papers published on Friday May 22nd, 2020. He discusses what the evidence shows for both remdesivir & hydroxychloroquine/chloroquine as effective treatment or prophylaxis for COVID-19. To view the references and show notes from this podcast Click here
*Editor's note: As of June 4, 2020, The Lancet article by Mehra MR et al has been retracted. (https://www.thelancet.com/lancet/article/s0140673620313246) In this Hippo Education short, Dr.Salim Rezaie from REBEL EM and Lit Matters critically appraises two papers published on Friday May 22nd, 2020. He discusses what the evidence shows for both remdesivir & hydroxychloroquine/chloroquine as effective treatment or prophylaxis for COVID-19. To view the references and show notes from this podcast Click here
*Editor's note: As of June 4, 2020, The Lancet article by Mehra MR et al has been retracted. (https://www.thelancet.com/lancet/article/s0140673620313246) In this Hippo Education short, Dr.Salim Rezaie from REBEL EM and Lit Matters critically appraises two papers published on Friday May 22nd, 2020. He discusses what the evidence shows for both remdesivir & hydroxychloroquine/chloroquine as effective treatment or prophylaxis for COVID-19. To view the references and show notes from this podcast Click here
Mark is joined by EPM board member Salim Rezaie to talk about the COVID-19 pandemic and its impact on society, the success of physical distancing, impact on the economy, the importance of New York physicians and the likelihood of an even more dangerous second wave. Listen in to one of EPM Talk's more fascinating discussions about Coronavirus.
Dr. Miguel Reyes sits down with EMRA 45 Under 45 winner Salim Rezaie, MD, to discuss how he was nominated and awarded this recognition. How REBEL EM came to be and the future plans for the website, podcast and conference. Additionally, we discuss how to be productive and the power of being 1% better everyday. Host: Miguel Reyes, MD@miguel_reyesMD Guest: Salim Rezaie, MD, FACEP @srrezaie Key Resources: RebelEM.com
In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, Ashika Jain, MD FAAEM FACEP RDMS; David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM discussing trying not to intubate early & why ARDSnet may be the wrong ventilator paradigm during COVID-19. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-19. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.
Hey there REBEL Cast listeners, Salim Rezaie here. For me and I am sure many COVID-19 has been quite the whirlwind. So much information, so... The post REBEL Cast Ep79: COVID-19 – Trying Not to Intubate Early & Why ARDSnet may be the Wrong Ventilator Paradigm appeared first on REBEL EM - Emergency Medicine Blog.
In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, Ashika Jain, MD FAAEM FACEP RDMS; David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM discussing trying not to intubate early & why ARDSnet may be the wrong ventilator paradigm during COVID-19. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-19. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.
In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, Ashika Jain, MD FAAEM FACEP RDMS; David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM discussing trying not to intubate early & why ARDSnet may be the wrong ventilator paradigm during COVID-19. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-19. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.
In this special edition EM Quick Hits podcast, Drs. Eddy Lang, Salim Rezaie, Anand Swaminathan, Jonathan Sherbino and Reuben Strayer share their experience with the COVID-19 pandemic and offer some practical tips... The post EM Quick Hits 14 – COVID-19 Your Colleagues’ Experiences and Practical Tips appeared first on Emergency Medicine Cases.
As healthcare professionals, we all recognize the increased risks we face as we care for our patients during the COVID-19 pandemic, but we must also care for ourselves, especially when we come home to our families. It’s normal to be concerned and one of the first things we can do is to start having conversations and plan ahead. Featuring Aaron Bright, MD and Salim Rezaie, MD
For healthcare professionals who do not often receive immediate laboratory results and diagnostic imaging reports, we’ll highlight unique diagnostic patterns and pitfalls with COVID-19 patients. Featuring Aaron Bright, MD and Salim Rezaie, MD
Most healthcare professionals are familiar with oxygen supplementation and nebulizers, maybe even CPAP/BiPAP. Most of us should have some Basic Life Support (BLS) training to use a bag-valve-mask (BVM) in case of emergency. But there are some of this changes with COVID-19. Featuring Aaron Bright, MD and Salim Rezaie, MD
For healthcare professionals who may get called in to help with COVID-19 patients, you will most likely be asked to help triage and manage ambulatory suspected COVID-19 patients. Here’s what you need to know. Featuring Aaron Bright, MD and Salim Rezaie, MD
Most healthcare professionals are familiar with oxygen supplementation and nebulizers, maybe even CPAP/BiPAP. Most of us should have some Basic Life Support (BLS) training to use a bag-valve-mask (BVM) in case of emergency. But there are some of this changes with COVID-19. Featuring Aaron Bright, MD and Salim Rezaie, MD
Most healthcare professionals know what personal protective equipment (PPE) is, but the reality is that many of us don’t use this everyday and are wondering if we’re doing it correctly. Let’s highlight where people make mistakes and expose themselves to risk. Featuring Aaron Bright, MD and Salim Rezaie, MD
For healthcare professionals who may get called in to help with COVID-19 patients, you will most likely be asked to help triage and manage ambulatory suspected COVID-19 patients. Here’s what you need to know. Featuring Aaron Bright, MD and Salim Rezaie, MD
Most healthcare professionals know what personal protective equipment (PPE) is, but the reality is that many of us don’t use this everyday and are wondering if we’re doing it correctly. Let’s highlight where people make mistakes and expose themselves to risk. Featuring Aaron Bright, MD and Salim Rezaie, MD
We know that there's a constant flood of information. So, we produced this podcast mini-series to help rapidly onboard healthcare professionals who don’t see COVID-19 patients regularly. We’re going to keep this simple and short, something you can listen to on your drive into work. We'll point out key clinical pearls and pitfalls that we've learned on the frontlines to help keep you and your patients safe. You can do this. Featuring Aaron Bright, MD and Salim Rezaie, MD
We know that there's a constant flood of information. So, we produced this podcast mini-series to help rapidly onboard healthcare professionals who don’t see COVID-19 patients regularly. We’re going to keep this simple and short, something you can listen to on your drive into work. We'll point out key clinical pearls and pitfalls that we've learned on the frontlines to help keep you and your patients safe. You can do this. Featuring Aaron Bright, MD and Salim Rezaie, MD
For healthcare professionals who do not often receive immediate laboratory results and diagnostic imaging reports, we’ll highlight unique diagnostic patterns and pitfalls with COVID-19 patients. Featuring Aaron Bright MD, and Salim Rezaie, MD
Most healthcare professionals know what personal protective equipment (PPE) is, but the reality is that many of us don’t use this everyday and are wondering if we’re doing it correctly. Let’s highlight where people make mistakes and expose themselves to risk. Featuring Aaron Bright, MD and Salim Rezaie, MD
For healthcare professionals who may get called in to help with COVID-19 patients, you will most likely be asked to help triage and manage ambulatory suspected COVID-19 patients. Here’s what you need to know. Featuring Aaron Bright, MD and Salim Rezaie, MD
Most healthcare professionals are familiar with oxygen supplementation and nebulizers, maybe even CPAP/BiPAP. Most of us should have some Basic Life Support (BLS) training to use a bag-valve-mask (BVM) in case of emergency. But there are some of this changes with COVID-19. Featuring Aaron Bright, MD and Salim Rezaie, MD
As healthcare professionals, we all recognize the increased risks we face as we care for our patients during the COVID-19 pandemic, but we must also care for ourselves, especially when we come home to our families. It’s normal to be concerned and one of the first things we can do is to start having conversations and plan ahead. Featuring Aaron Bright, MD and Salim Rezaie, MD
For healthcare professionals who do not often receive immediate laboratory results and diagnostic imaging reports, we’ll highlight unique diagnostic patterns and pitfalls with COVID-19 patients. Featuring Aaron Bright, MD and Salim Rezaie, MD
As healthcare professionals, we all recognize the increased risks we face as we care for our patients during the COVID-19 pandemic, but we must also care for ourselves, especially when we come home to our families. It’s normal to be concerned and one of the first things we can do is to start having conversations and plan ahead. Featuring Aaron Bright, MD and Salim Rezaie, MD
We know that there's a constant flood of information. So, we produced this podcast mini-series to help rapidly onboard healthcare professionals who don’t see COVID-19 patients regularly. We’re going to keep this simple and short, something you can listen to on your drive into work. We'll point out key clinical pearls and pitfalls that we've learned on the frontlines to help keep you and your patients safe. You can do this. Featuring Aaron Bright, MD and Salim Rezaie, MD
In this episode, special guest Dr. Salim Rezaie joins us again to provide updates on what is going on in the ERs nationwide, the medical community, how people can be the most helpful to themselves and debunking wild theories circulating around related to Coronavirus.
We can't immediately change the process of medicine, the stuff that is kind of a drag and wears us down. What we can change, however, is our mindset. In this episode, we dissect several practices for shift preparation with a common goal of operating at a peak level of performance and experiencing more joy in what we do. Today we learn how to pregame, like a pro. We discuss: When the process of practicing medicine becomes your purpose for being a doctor, you’re at risk for burnout, if not worse. [00:30] The system will not adjust to what you need right now. You have to adjust yourself. [1:45] How accepting gratitude, and other small changes in mindset, can have a logarithmic return on investment. [4:50] The ways that many elite-level performers pregame. They rely on their rituals for peak performance. [07:15] Physicians are elite-level performers who rarely have the time to mentally prepare for each day. [8:40] How some doctors pregame (or not).... Mike Weinstock doesn't pregame [12:06] Clay Smith's pregame distraction [13:20] Joshua Russell's sequence of physical, emotional and mental prep [15:10] Sabrina Adams the BAFERD [18:00] Jaime Hope thinks of her 4 professional identities [19:10] Mizuho Morrison's 3 steps of self talk [21:40] Ran Ran biking to work. [24:20] Joe Dubois walks to work Chris Nickson walks to work Ross Fisher calms during his commute. Haney Mallemat uses mental visualization. Luz Silverio's pregame ritual is to arrive to work 15 minutes early to “chit-chat” with members of her team.[28:40] Alan Sielaff allows sufficient time before the shift to get prepared. [29:30]: Dan McCollum starts the day mentally preparing with the 5 Minute Journal.[31:00] Reuben Strayer mentally prepare for a shift by practicing mindfulness [32:50] Salim Rezaie isolates himself from social media and email for at least 1-2 hours prior to each shift.[35:30] Mike Mallin uses intermittent fasting to improve his focus, attitude, and endurance at work. [37:15] Rich Hamilton treats a shift like it’s a competitive sport. [38:30] Rob's 2 pregame exercises. [41:10] Jocko Willink’s “Good” [44:06] Learn More: https://www.stimuluspodcast.com/ Complete shownotes for this episode: https://www.stimuluspodcast.com/post/2-pregame-like-a-pro
We can't immediately change the process of medicine, the stuff that is kind of a drag and wears us down. What we can change, however, is our mindset. In this episode, we dissect several practices for shift preparation with a common goal of operating at a peak level of performance and experiencing more joy in what we do. Today we learn how to pregame, like a pro. We discuss: When the process of practicing medicine becomes your purpose for being a doctor, you’re at risk for burnout, if not worse. [00:30] The system will not adjust to what you need right now. You have to adjust yourself. [1:45] How accepting gratitude, and other small changes in mindset, can have a logarithmic return on investment. [4:50] The ways that many elite-level performers pregame. They rely on their rituals for peak performance. [07:15] Physicians are elite-level performers who rarely have the time to mentally prepare for each day. [8:40] How some doctors pregame (or not).... Mike Weinstock doesn't pregame [12:06] Clay Smith's pregame distraction [13:20] Joshua Russell's sequence of physical, emotional and mental prep [15:10] Sabrina Adams the BAFERD [18:00] Jaime Hope thinks of her 4 professional identities [19:10] Mizuho Morrison's 3 steps of self talk [21:40] Ran Ran biking to work. [24:20] Joe Dubois walks to work Chris Nickson walks to work Ross Fisher calms during his commute. Haney Mallemat uses mental visualization. Luz Silverio's pregame ritual is to arrive to work 15 minutes early to “chit-chat” with members of her team.[28:40] Alan Sielaff allows sufficient time before the shift to get prepared. [29:30]: Dan McCollum starts the day mentally preparing with the 5 Minute Journal.[31:00] Reuben Strayer mentally prepare for a shift by practicing mindfulness [32:50] Salim Rezaie isolates himself from social media and email for at least 1-2 hours prior to each shift.[35:30] Mike Mallin uses intermittent fasting to improve his focus, attitude, and endurance at work. [37:15] Rich Hamilton treats a shift like it’s a competitive sport. [38:30] Rob's 2 pregame exercises. [41:10] Jocko Willink’s “Good” [44:06] Learn More: https://www.stimuluspodcast.com/ Complete shownotes for this episode: https://www.stimuluspodcast.com/post/2-pregame-like-a-pro
In this episode, our special guest is Dr. R's brother, Salim Rezaie, M.D. He covers everything you need to know about Coronavirus from what it is, the current state of the global outbreak, who really needs to worry, with best things to do for avoidance and how to stay health.
Welcome back to REBEL Cast, I am your host Salim Rezaie. In this episode we are going to review a recent focused 2019 update to... The post REBEL Cast Ep75: 2019 PALS Update appeared first on REBEL EM - Emergency Medicine Blog.
Salim Rezaie on single syringe adenosine for SVT, Sarah Reid on pertussis pearls, Elisha Targonsky on management of hyperemesis gravidarum , Joe Nemeth on the utility of hypertension as a risk factor in EM, Justin Morgenstern on tramadol myths, Reuben Strayer on ketamine only breathing intubation (KOBI)... The post EM Quick Hits 13 – One Syringe Adenosine, Pertussis Pearls, Hyperemesis Gravidarum, Tramadol, Hypertension Myths, KOBI appeared first on Emergency Medicine Cases.
In this episode we rebroadcast 3 great discussions we had over the past couple years reviewing treatment for TIA, stroke, and endovascular therapies for acute ischemic stroke. Thanks to our guest speakers Dr. Kevin Watkins, Dr. Aurelia Cheng, and Dr. Salim Rezaie.
Host: Amy Mackey, MD Guest: Salim Rezaie, MD Guest: Evan Alexandrou, MD By reducing time to therapy, eliminating the need for confirmatory chest x-rays, and reducing the costs associated with these procedures, PICC catheter tip positioning and confirmation using electrocardiogram is revolutionizing vascular access device insertion. To learn more about this technology, Dr. Amy Mackey is joined by Drs. Evan Alexandrou and Salim Rezaie, who share how it works, its use with acute CVCs and dialysis catheters placed in the internal jugular and subclavian veins, and more.
Host: Amy Mackey, MD Guest: Salim Rezaie, MD Guest: Evan Alexandrou, MD By reducing time to therapy, eliminating the need for confirmatory chest x-rays, and reducing the costs associated with these procedures, PICC catheter tip positioning and confirmation using electrocardiogram is revolutionizing vascular access device insertion. To learn more about this technology, Dr. Amy Mackey is joined by Drs. Evan Alexandrou and Salim Rezaie, who share how it works, its use with acute CVCs and dialysis catheters placed in the internal jugular and subclavian veins, and more.
Host: Amy Mackey, MD Guest: Salim Rezaie, MD Guest: Evan Alexandrou, MD By reducing time to therapy, eliminating the need for confirmatory chest x-rays, and reducing the costs associated with these procedures, PICC catheter tip positioning and confirmation using electrocardiogram is revolutionizing vascular access device insertion. To learn more about this technology, Dr. Amy Mackey is joined by Drs. Evan Alexandrou and Salim Rezaie, who share how it works, its use with acute CVCs and dialysis catheters placed in the internal jugular and subclavian veins, and more.
Host: Amy Mackey, MD Guest: Salim Rezaie, MD Guest: Evan Alexandrou, MD By reducing time to therapy, eliminating the need for confirmatory chest x-rays, and reducing the costs associated with these procedures, PICC catheter tip positioning and confirmation using electrocardiogram is revolutionizing vascular access device insertion. To learn more about this technology, Dr. Amy Mackey is joined by Drs. Evan Alexandrou and Salim Rezaie, who share how it works, its use with acute CVCs and dialysis catheters placed in the internal jugular and subclavian veins, and more.
Regardless of your clinical setting, DVT’s are a common entity that we need to be very comfortable working up and treating. And though on the surface the workup and Tx is seemingly straightforward...the truth is there are some nuances and special cases that aren’t completely intuitive...Mizuho Morrison, DO chats with Salim Rezaie, MD about this topic to reveal some practice changing pearls. There is so much more to Urgent Care RAP each month? Click Here to hear more of what you need to be ready each day and we'll toss in 42 CME hours per year to boot.
Allan and Rob's final ResusX Series Podcast where they talk about the Zero Point Survey and its place in the resus room with our friends EM Centered (emcentered.com) and Salim Rezaie (rebelem.com). Zero Point Survey further reading-Cliff Ried's Paper - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166036/EMCRIT's post with Cliff Ried - https://emcrit.org/emcrit/emcrit-wee-zero-point-survey-video-by-cliff-reid/St. Emlyn's blog post - https://www.stemlynsblog.org/jc-the-zero-point-survey-optimising-resuscitation-teams-in-the-ed-st-emlyns/
Allan and Rob have the privilege of sitting down with Salim Rezaie of RebelEM to talk about cervical spine collars and backboard in the ED. RebelEM has has already extensively covered the evidence on collars and backboards. You can find their blog posts and links below. 1. Spinal immobilization in trauma patients2. Cervical spine evaluation and clearance in the intoxicated patient3. Stiell et al. (2018) - A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses4. Skeptics Guide to Emergency Medicine - Ep 232 - An overview and literature evaluation of cervical spine collars and an appraisal of the above paper5. Dr. Ken Milne and Alison Armstrong filmed a news clip on the 2018 Stiell et al. paper for us at NENA 2019.
Post-contrast AKI (or contrast induced nephropathy as it used to be called) is one of those hot-button issues in modern medicine. Is it really a thing? Was it ever, really? Neda Frayha, MD sits down with Dr. Salim Rezaie of Rebel EM for an invigorating conversation about this controversial topic and what the literature actually tells us about it. For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and earn 42 hours of CME per year.
This is the second episode in a podcast series highlighting educators speaking at EMS World Expo in New Orleans in October. In this episode, Ginger Locke, from the Medic Mindset podcast, interviews Dr. Salim Rezaie about his session at Expo, Back to the Drawing Board: Learning Strategies You Should Know.Follow EMS World on Twitter, Facebook, LinkedIn, and Instagram. EMS World Expo will be held Sept. 14–18, 2020 in Las Vegas!
Podcast summary of articles from the April 2019 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include optic nerve sheath diameter for increased ICP, neck trauma management, naloxone prescriptions, atypical hemolytic uremic syndrome, babesiosis and extended board review on endovascular treatment for stroke. Guest speaker is Dr. Salim Rezaie.
We co-hosted (with John Vassiliadis) the SMACC EM Updates half-day conference. We had amazing speakers. Salim Rezaie spoke on TXA for Everything, Ken Milne spoke on hot papers from 2018, and we learned about when ultrasound may be helpful in pediatric lumbar punctures. In addition, Jeremy spoke on what is usual care in sepsis and Lauren spoke on pulmonary embolism: the next generation. In this short podcast we highlight some of our other talks. Aidan Baron (@Aidan_Baron) on Prehospital Updates in Cardiac Arrest This talk focused on focusing on things that are most likely to make a difference in OHCA (bystander CPR and defibrillation) rather than on fun interventions like intubation and adrenaline (epinephrine). Aidan suggests that the future debates and questions in OHCA will be largely philosophical - what outcomes do we care about: neuro intact survival or ROSC or survival? Jabre P, Penaloza A, Pinero D, et al. Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest a randomized clinical trial. JAMA -2018;319(8):779–87. Benger JR, Kirby K, Black S, et al. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018;320(8):779-791. Wang HE, Schmicker RH, Daya MR, et al. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2018;320(8):769-778 Barbra Backus on the future of the HEART score Modified Heart Score (redefining the T or troponin based on newer assays) results in a NPV of 99.8% and classifies 48% of patients as low-risk. Clinically Relevant Adverse Cardiac Events (CRACE) is way less common than major adverse cardiac events (MACE). HEART score of ≤3 ? CRACE is 0.05% Hot Literature in 2019 Lemkes JS, Janssens GN, van der Hoeven NW, et al. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. N Engl J Med. 2019;NEJMoa1816897 Pluymaekers NAHA, Dudink EAMP, Luermans JGLM, et al. Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation. N Engl J Med .2019;NEJMoa1900353.
In this episode Dr. Miguel Reyes interviews Dr. Salim Rezaie about how best to approach and use FOAMed (Free Open Access Medical Education) as a resident. Overview: Have you ever felt overwhelmed with the amount of content out there that comes out on a nearly daily basis? Well if so than this is the podcast for you. Here we talk about how to sift through the FOAM sources and how to implement into your practice as a resident. Really great stuff in this podcast. Key Points Don't FOAM it alone Use peer reviewed FOAM sources Use news aggregator apps to collect all your FOAM into one place Read the textbooks and suppliement with FOAM References / Resources REBELEM Got FOAM Feedly
Drew and Andy had the chance to catch up with the one and only Salim Rezaie while at ACOEP 2018 in Chicago. We spent a bit "talking about nothing" as well as getting updates on the new look REBEL in EM, REBEL Cast and the Rebellion 2019. Music: BenSound
Salim Rezaie from the REBEL EM podcast takes us through the optimal management of cardiac arrest and also explores some of the controversies and difficulties that make the difference to our patients. You can read a lot more about the background to this talk, see the evidence and watch the video on the St Emlyn's site. Just follow this link. https://www.stemlynsblog.org/beyond-acls-salim-rezaie-at-stemlynslive/
Check out our post on the Down East EM blog for shownotes, references and more. Author: Jason Hine MD and Salim Rezaie MD Peer Reviewer: Jeff Holmes MD
Teaching teachers about teaching; lets get super-meta. The Teaching Course. It’s in Alcatraz, Brisbane and Copenhagen. It’s in Melbourne, Manchester and Manila. I’d be exhausted just thinking about it if it didn’t sound like so much fun. Salim Rezaie is a softly spoken, erudite, talented attention avoider. He want’s to credit someone else, he wants you to be happy, he wants to perfect the next slide for his next talk. He doesn’t want to give his next talk quite as much as make the slides but we, the consumers of his inimitable style, are not complaining. Instead we are signed up subscribers, following and forwarding his work because it’s good, very good. Salim is a bit of a pro. He started out on ALIEM. He started RebelEM as a blog and then he got a podcast up and running. He got into this whole education thing, the #FOAMed thing, and from his involvement he became increasingly interested in the processes of the whole teaching/training/learning/simulating/feedback thing. So much so that he realised that there was an appetite, a need, for a resource that helps teachers get better at teaching. So we are educators, we are motivated, we know some stuff, but we are often isolated within our various institutions as the education woman or man. We don’t have our own little cadre of education enthusiasts close by to ask for help, to compare notes, to share techniques. So Salim set one up. He formed a team. He is the leader but he is an incredibly modern type of super-collaborative empathic leader. He is soaking up ideas from all sources. He has gathered a group of super-impressive women and men that help him out. Let’s think for a second about the Teaching Course Faculty. To shed light on this lets bring in my resident philosophical conundrum machine; Cormac. My son Cormac asks me some very important questions. Last week he asked me a good zombie apocolypse question; “Come the Zombie Apocolypse which of your friends would you bring along to help you survive?” That is an interesting question, it is a thought experiment in utilitarian ethics. I’d suggest there are a few candidates in the Teaching Course faculty; Photos Of course one would have to get into the whole #MetaMoments thing that The Teaching Course is embracing, that means feedback, lots of feedback. The imagined “Flipping MedEd Zombie Apocalypse Survival Team” would be giving and receiving lots of feedback. There would be lots of eye contact and hugs. Hopefully not too much to distract them from the zombies which would give the wrong sort of feed back altogether. “Whats that noise? Feedback! I hate feedback. No, wait, hang on, I love feedback.” Neil Young. It is a love hate thing for many of us, but then have you ever been taught how to take feedback? Give it, maybe, but take it? We can tease ourselves for being a bit meta about all this stuff but there is a reason we are talking about it. If we are mentoring young nurses and doctors, if we are running simulation sessions, (and we are), then we do need to think about all this and more. The Teaching Course is a constantly evolving set of distinct and imaginative units. There’s a presenting skills, simulations skills, there’s mindfulness stuff, there’s an awful lot in there. If you are an educator then this course is definitely worth a look. It is so good you may wish to go more than once. I would. I’d go just to get more down-to-earth wisdom from probably my favourite Texan. (Apologies to Cordell Walker.) Accidental old fashioned sage and reluctant FOAMed star, it’s Salim Rezaie @srrezaie Check out these Jellybean Podcasts with other Teaching Course Faculty; Victoria Brazil Natalie May Simon Carley Jesse Spur Chris Nixon Liz Crowe Ashley Liebig Chris Hicks Kat Evans Andy Tagg Mads Astvad Sandra Viggers Paul Grinzi Ross Fisher Julie Derrenger Salim Rezaie It’s like a Jellybean Playlist. I might go and build that Playlist on SoundCloud.
To start the year off, we bring you an episode where Andy had the chance to sit down with 3 previous guests John Casey, Travis Ulmer and Salim Rezaie while attending the ACOEP Scientific Assembly in Denver Colorado. This dynamic group of bearded men and Andy decided to tackle the topic of Delivering Bad News, something everyone in medicine has to do and something we ALL can improve upon. Listen as Travis, Salim, John and Andy tackle this #MoreThanMedicine topic head on.
In Part 2 of our two part podcast on GI Bleed Emergencies Anand Swaminathan and Salim Rezaie kick off with a discussion on the evidence for benefit of various medications in ED patients with upper GI bleed. PPIs, somatostatin analogues such as Octreotide, antibiotic prophylaxis and prokinetics have varying degrees of benefit, and we should know which ones to prioritize. We then discuss the usefulness of the Glasgow-Blatchford and Rockall scores for risk stratification and disposition of patient with upper GI bleeds and hit it home with putting it all together in a practical algorithm. Enjoy! The post Episode 102 GI Bleed Emergencies Part 2 appeared first on Emergency Medicine Cases.
TOTAL EM - Tools Of the Trade and Academic Learning in Emergency Medicine
We are having a special episode to add to what we did with Salim Rezaie on REBEL Cast recently as a guest. While we were there, we talked a lot about the TOAST trial and reviewed our own clinical use of dexamethasone. It is definitely worth your time to visit his page and listen to that podcast. However, we wanted to add our own little supplement to the #FOAMed world by adding a detailed analysis of the paper in true BEEM fashion. Please check all of this out for a more thorough understanding of the topic.
This is from the mic check with Rob Rodgers and Salim Rezaie prior to recording #TwoDudesOneCat. You'll learn what Rob does when he travels oversees. #MoreThanMedicine
Highlights of the conversation between Dr. Rob Rogers and Dr. Salim Rezaie on "Branding yourself and finding a niche" as part of the ALiEM Fellowship Incubator. Podcast Editor: Dr. Jeffrey Rixe
This podcast episode features short excerpts from our mentored Google Hangout session on Bedside Teaching featuring Dr. Salim Rezaie. Podcast editor: Dr. Jeff Rixe
This is EM Cases Journal Jam Podcast 6 - Outpatient Topical Anesthetics for Corneal Abrasions. I've been told countless times by ophthalmologists and other colleagues NEVER to prescribe topical anesthetics for corneal abrasion patients, with the reason being largely theoretical - that tetracaine and the like will inhibit re-epithelialization and therefore delay epithelial healing as well as decrease corneal sensation, resulting in corneal ulcers. With prolonged use of outpatient topical anesthetics for corneal abrasions, corneal opacification could develop leading to decreased vision. Now this might be true for the tetracaine abuser who pours the stuff in their eye for weeks on end, but when we look at the literature for toxic effects of using topical anesthetics in the short term, there is no evidence for any clinically important detrimental outcomes. Should we ignore the dogma and use tetracaine anyway? Is there evidence that the use of topical anesthetics after corneal abrasions is safe and effective for pain control without adverse effects or delayed epithelial healing? To discuss the paper "The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review" by Drs. Swaminathan, Otterness, Milne and Rezaie published in the Journal of Emergency Medicine in 2015, we have EM Cases' Justin Morgenstern, a Toronto-based EM Doc, EBM enthusiast as well as the brains behind the First10EM blog and Salim Rezaie, Clinical Assistant Professor of EM and Internal Medicine at University of Texas Health Science Center at San Antonio as well as the Creator & Founder of the R.E.B.E.L. EM blog and REBELCast podcast. In this Journal Jam podcast, Dr. Morgenstern and Dr. Rezaie also discuss a simple approach to critically appraising a systematic review article, how to handle consultants who might not be aware of the literature and/or give you a hard time about your decisions and much more... The post Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions appeared first on Emergency Medicine Cases.
This is EM Cases Journal Jam Podcast 6 - Outpatient Topical Anesthetics for Corneal Abrasions. I’ve been told countless times by ophthalmologists and other colleagues NEVER to prescribe topical anesthetics for corneal abrasion patients, with the reason being largely theoretical - that tetracaine and the like will inhibit re-epithelialization and therefore delay epithelial healing as well as decrease corneal sensation, resulting in corneal ulcers. With prolonged use of outpatient topical anesthetics for corneal abrasions, corneal opacification could develop leading to decreased vision. Now this might be true for the tetracaine abuser who pours the stuff in their eye for weeks on end, but when we look at the literature for toxic effects of using topical anesthetics in the short term, there is no evidence for any clinically important detrimental outcomes. Should we ignore the dogma and use tetracaine anyway? Is there evidence that the use of topical anesthetics after corneal abrasions is safe and effective for pain control without adverse effects or delayed epithelial healing? To discuss the paper "The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review" by Drs. Swaminathan, Otterness, Milne and Rezaie published in the Journal of Emergency Medicine in 2015, we have EM Cases’ Justin Morgenstern, a Toronto-based EM Doc, EBM enthusiast as well as the brains behind the First10EM blog and Salim Rezaie, Clinical Assistant Professor of EM and Internal Medicine at University of Texas Health Science Center at San Antonio as well as the Creator & Founder of the R.E.B.E.L. EM blog and REBELCast podcast. In this Journal Jam podcast, Dr. Morgenstern and Dr. Rezaie also discuss a simple approach to critically appraising a systematic review article, how to handle consultants who might not be aware of the literature and/or give you a hard time about your decisions and much more... The post Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions appeared first on Emergency Medicine Cases.
Dr. Salim Rezaie of R.E.B.E.L. EM tells his Best Case Ever of a Low Risk Pulmonary Embolism that begs us to consider a work-up and management plan that we might not otherwise consider. With new guidelines suggesting that subsegmental pulmonary embolism need not be treated with anticoagulants, exceptions to Well's Score and PERC rule to help guide work-ups, the adaptation of outpatient management of pulmonary embolism, and the option of NOACs for treatment, the management of pulmonary embolism in 2016 has evolved considerably. In which situations would you treat subsegmental pulmonary embolism? How comfortable are you sending patients home with pulmonary embolism? How does the patient's values play into these decisions? Listen to Dr. Rezaie provide an insightlful perspective on these important issues and much more... The post Best Case Ever 44 Low Risk Pulmonary Embolism appeared first on Emergency Medicine Cases.
Dr. Salim Rezaie of R.E.B.E.L. EM tells his Best Case Ever of a Low Risk Pulmonary Embolism that begs us to consider a work-up and management plan that we might not otherwise consider. With new guidelines suggesting that subsegmental pulmonary embolism need not be treated with anticoagulants, exceptions to Well's Score and PERC rule to help guide work-ups, the adaptation of outpatient management of pulmonary embolism, and the option of NOACs for treatment, the management of pulmonary embolism in 2016 has evolved considerably. In which situations would you treat subsegmental pulmonary embolism? How comfortable are you sending patients home with pulmonary embolism? How does the patient's values play into these decisions? Listen to Dr. Rezaie provide an insightlful perspective on these important issues and much more... The post Best Case Ever 44 Low Risk Pulmonary Embolism appeared first on Emergency Medicine Cases.
Salime Rezaie is assistant professor of Emergency Medicine at UT-San Antonio and co-director of The Teaching Course. Here he discusses the role of heuristics and biases in emergency medicine practice.Download Episode
Salime Rezaie is assistant professor of Emergency Medicine at UT-San Antonio and co-director of The Teaching Course. Here he discusses CPR for the Emergency Physician. Download Episode
In this first ever episode of the Journal Jam podcast, a collaboration between EM Cases, Academic Life in EM and The Annals of Emergency Medicine's Global Emergency Medicine Journal Club, Teresa Chan and I, along with Jeff Kline, Jonathan Kirschner, Anand Swaminathan, Salim Rezaie and Sam Shaikh from ALiEM, discuss the potential for Age Adjusted D-dimer to rule out pulmonary embolism in low risk patients over the age of 50. We discuss 4 key questions about the ADJUST-PE Study from JAMA in March 2014 including: Would you order a CTPA on a 60 year old woman with an age adjusted D-dimer of 590 ng/L? The problem until now has been that the older the patient, the more likely the D-dimer is to be positive whether they have a PE or not, so many of us have thrown the D-dimer out the window in older patients and go straight to CTPA, even in low risk patients. If you are a risk averse doc, this strategy will lead to over-utilization of resources, huge costs, length of stay, radiation effects etc; and if you're not so risk averse, then you might decide not to work up the low risk older patient at all and miss clinically important PEs. expert peer reviewFor all the questions discussed on this podcast, the original Google Hangout interview from which this podcast was based, and the crowd sourced opinions from around world, visit the ALiEM website. Many thanks to all the talented people who made this podcast possible. Together, we're smarter! The post Journal Jam 1: Age Adjusted D-dimer with Jeff Kline and Jonathan Kirschner appeared first on Emergency Medicine Cases.
In this first ever episode of the Journal Jam podcast, a collaboration between EM Cases, Academic Life in EM and The Annals of Emergency Medicine's Global Emergency Medicine Journal Club, Teresa Chan and I, along with Jeff Kline, Jonathan Kirschner, Anand Swaminathan, Salim Rezaie and Sam Shaikh from ALiEM, discuss the potential for Age Adjusted D-dimer to rule out pulmonary embolism in low risk patients over the age of 50. We discuss 4 key questions about the ADJUST-PE Study from JAMA in March 2014 including: Would you order a CTPA on a 60 year old woman with an age adjusted D-dimer of 590 ng/L? The problem until now has been that the older the patient, the more likely the D-dimer is to be positive whether they have a PE or not, so many of us have thrown the D-dimer out the window in older patients and go straight to CTPA, even in low risk patients. If you are a risk averse doc, this strategy will lead to over-utilization of resources, huge costs, length of stay, radiation effects etc; and if you’re not so risk averse, then you might decide not to work up the low risk older patient at all and miss clinically important PEs. expert peer reviewFor all the questions discussed on this podcast, the original Google Hangout interview from which this podcast was based, and the crowd sourced opinions from around world, visit the ALiEM website. Many thanks to all the talented people who made this podcast possible. Together, we're smarter! The post Journal Jam 1: Age Adjusted D-dimer with Jeff Kline and Jonathan Kirschner appeared first on Emergency Medicine Cases.
We now have way too many treatment options for sub-massive and massive pulmonary embolism (PE) patients who aren't coding in front of you. How do you decide which one is right for your patient? To help answer this question, I am joined today by Oren Friedman, pulmonary critical care doc and one of the members of the Cornell PEAC team. Cornell Pulmonary Embolism (PE) Advanced Care Team (PEAC), aka the CLOT Team Oren Friedman MD, Pulm Crit Care; James Horowitz MD, Cardiology; Arash Salemi MD, Cardiac Surgery; Akhilesh Sista MD, Interventional Radiology You can shoot the team an email: peadvancedcare at gmail dot com Who Should We Treat? Wood 2002 PE Mortality Curve 30% normotensive patients have RVD; 10% progressed to shock; 5% in hospital mortality[cite]10859287[/cite] The Better Risk Categories for Pulmonary Embolism Well and Stable Sub-Massive High-Risk Sub-Massive Massive PEITHO Trial NEJM 2014;370(15):1402 Full dose tenecteplase with concurrent heparin Death or hemodynamic decompensation occurred in 2.6% of the tenecteplase group as compared with 5.6% of the placebo group Extracranial bleeding occurred in 32 patients (6.3%) in the tenecteplase group and 6 patients (1.2%) in the placebo group (P0.06 ?g/L or troponin T >0.01 ?g/L. These may be relatively inclusive thresholds. Not all placebo patients developing hemodynamic collapse received subsequent thrombolysis; likewise, almost half of those who received open-label thrombolysis had no hemodynamic collapse. Half the deaths in the placebo arm were “sudden unexplained” or “other”, compared with bleeding or stroke complications in the thromboysis arm. TOPCOAT Trial Jeff Kline's trial was stopped midway through due to an institution change. Complicated primary endpoint with promising, but unusable results [cite]24484241[/cite] For the scoop on this one see the Bottom Line Review post on TOPCOAT MOPETT Trial Half-dose alteplase led to a marked reduction in pulmonary hypertension without sig. complications Sharifi M et al. Moderate pulmonary embolism treated with thrombolysis (from the “MOPETT trial). (J Cardiol 2013; 111: 273) See this prior EMCrit Wee as well on MOPPETT Update: This meta-analysis states that the half-dose may be appropriate, effective, and safe [cite source='pubmed']24412030[/cite] Meta-Analysis Chatterjee et al. have the most current meta-analysis on this topic (JAMA. 2014;311(23):2414-2421) See the Bottom Line Review post on this study Nakamura just published another MA this week; see Rory Spiegel's take on the two here Is it just in the Oldies? Markedly lower risk in