REBEL Cast

Take Home Points Emergency medicine revolves around the differential diagnosis History and physical exam should significantly narrow your differential diagnosis Have an idea of what specific diagnoses are being ruled out when ordering diagnostic tests Always consider the most life-threatening and most common disease processes first – we are a rule out specialty “Red flags” are ... Read more

Take Home Points Emergency medicine revolves around the differential diagnosis History and physical exam should significantly narrow your differential diagnosis Have an idea of what specific diagnoses are being ruled out when ordering diagnostic tests Always consider the most life-threatening and most common disease processes first – we are a rule out specialty “Red flags” are ... Read more

Take Home Points Break the differentials down into bad & painless, bad & painful, and other causes – WOMAN-PE Cardiac causes – mechanical or electrical – look for the obvious and 5 non-obvious causes (WPW, HCOM, ARVD, prolonged QT, and Brugada) Ask the red flag questions – was there a prodrome, signs of seizure activity ... Read more

Take Home Points Be prepared to do everything with these cases, if they can’t provide information, dive into their medication list, history, contact whoever you have to to get more information Keep differentials wide – then approach these cases with the mindset of focal vs generalized weakness and work from there Focal – ask about ... Read more

Take Home Points Key point is to discern between central and peripheral causes – become familiar with the nuances of one and concentrate on that Assume central and convince yourself its peripheral in nature, if at the end of the evaluation, you can’t do that, assume a central cause and do a work-up Using timing ... Read more

Take Home Points Examine all parts of the body, even inside the mouth – this can be the difference between benign and life threatening rashes Truly emergent causes: meningococcemia, TTP, DIC, TSS, SJS, TEN, and necrotizing fasciitis Toxic appearing patients with petechia/purpura = sepsis until proven otherwise Look for medication reactions: Sulfa, Penicillins, NSAID’s, ABX, ... Read more

Take Home Points Look for the red flags – hypotension, environmental exposures, medications (SS, NMS), SIRS/qSOFA criteria Be on the lookout for neutropenic fever – isolate patients, administer abx early, and admit Sepsis definition is changing all the time – be aware of current guidelines Remove pre-existing indwelling lines/catheters in the setting of sepsis – ... Read more

Take Home Points Sprains need more support than just an ace wrap – place them in an aircast or a splint Perform a thorough physical exam – take off their shoes and socks Lisfranc and Maisonneuve injuries are often missed – make sure to exam the bottom of the foot for echymosis, eval for mid ... Read more

Take Home Points Approach leg pain with the seconds, minutes, hours mindset – think about acute limb ischemia, compartment syndrome, and necrotizing fasciitis Do a thorough physical exam – get their shoes and socks off – you will find crazy stuff when you actually look Palpate and image the joint above and below any injury ... Read more

Take Home Points Don’t make bite width to small – look at the curvature of the needle – start the bite at half the curvature of the needle Don’t pull too tight – this will pucker the skin and lead to poor healing due to ischemia at the wound borders Laceration repairs are not sterile! ... Read more