REBEL Cast

Background: Currently, trauma resuscitation focuses on immediate hemorrhage control, resuscitation with blood products (i.e. PRBCs, plasma) and early administration of tranexamic acid.  The evidence for the use of blood-based resuscitation in the pre-hospital system has been mixed (PAMPer and COMBAT trials). While early administration of blood products makes physiologic sense, proof of benefit is important ... Read more

Take Home Points Compartment syndrome is a life and limb threatening emergency that requires early recognition, prompt diagnosis and immediate management with fasciotomy While clinical evaluation is flawed, pain out of proportion to injury and pain with passive stretch of muscles within the compartment are the best screening tools. Do not wait for the development ... Read more

Bottom Line: 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 ... Read more

In this episode of the REBEL Cast Book Club, Swami, Marco, Steve, and Brandon discuss how the lessons learned from Col. Chris Hadfield’s “An Astronaut’s Guide to Life on Earth” might apply to emergency medicine. REBEL Reflections Episode 3: An Astronaut’s Guide To Life on Earth Click here for Direct Download of the Podcast Post ... Read more

Take Home Points Classically, herpes zoster will present with rash and pain in a dermatomal distribution Immunocompromised patients are at greater risk for significant complications of zoster, including visceral dissemination and zoster ophthalmicus Appropriate therapy includes antiviral therapy within 72 hours of onset of symptoms and analgesia for acute neuritis Disseminated zoster and zoster ophthalmicus ... Read more

Take Home Points Think about flexor tenosynovitis in a patient with atraumatic finger pain.  They may have any combination of these signs: Tenderness along the course of the flexor tendon Symmetrical swelling of the finger – often called the sausage digit Pain on passive extension of the finger and Patient holds the finger in a ... Read more

Background: In the past few years there has been a growing debate between  the use of balanced multielectrolyte solutions (BMES) and saline in the critically ill (See the “for more about this topic” section below). Recent research has yielded inconsistent results with RCTs showing improved mortality (SMART), no change in mortality (BaSICS), and decreased acute ... Read more

REBEL Core Cast 76.0 – Zoom Better Click here for Direct Download of the Podcast Read More P Cubed Presentations: Zoom, Zoom, Zoom P Cubed Presentations: Online Presentation Setup P Cubed Presentations: How To Do An Online Presentation YouTube Tutorials: Link is HERE Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)

Take Home Points: Newer data suggests that the infection and DVT rates for femoral lines are similar to that for internal jugular central lines. In a resuscitation situation, there are likely faster ways to obtain access than a femoral line (ie IO, Peripheral IV). If you are going to place a femoral line, use ultrasound ... Read more

Background: Emergency endotracheal intubation is a potentially life-saving procedure in the management of critically-ill patients. The inherent risks associated with the procedure challenge us to refine our skills and adopt new techniques that can improve our performance. The bougie is an inexpensive device that has gained considerable traction in the last ten years. In 2018, ... Read more