REBEL Cast

Take Home Points SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation.  The rate of concurrent DVT and PE in patients with SVT is 25% and 5%, respectively. REBEL Core Cast 50.0 – Superficial Venous Thrombosis Click here for Direct Download of Podcast Definition: The presence of a clot in a ... Read more

Background: Science by press release. Not the way any of us would choose to operate but, the COVID pandemic has made this a reality. It’s vital that we understand that while pharmaceutical companies have a responsibility to release this information, we as clinicians should not be practicing medicine based on press releases. Of course, these ... Read more

Take Home Points Consider ruptured AAA in patients (especially those > 50 years of age) with unexplained hypotension, back or abdominal pain All ruptured AAAs should be considered unstable regardless of vital signs as rapid deterioration is common A ruptured AAA is 100% fatal without surgical or endovascular intervention. Mobilize your surgical colleagues early REBEL ... Read more

Take Home Points Frostbite is a severe, localized cold-induced injury due to freezing and thawing of tissue. We usually see these injuries affecting the ears, nose, cheeks, chin, fingers, and toes. Patients will complain of cold, numb or stiff sensations and discoloration of the skin.   Critical ED treatment starts with rewarming in a warm, ... Read more

Take Home Points Nausea and Vomiting has an exceedingly large differential – don’t just anchor on GI presentations H&P important – Duration, frequency, content, and associated symptoms Alcohol swab -> If no line and want quick treatment give swab Ondansetron -> oral you can give without hesitation but if giving IV check QTC / electrolytes ... Read more

Background: Current trauma resuscitation prioritizes control of bleeding and uses massive transfusion protocols to prevent and treat coagulopathy. This is typically done in the form of massive transfusion protocols delivered in proportions that approach the composition of whole blood. Two strategies to help guide this replacement of blood products are conventional coagulation tests and viscoelastic ... Read more

Back in April 2020, on REBEL Cast episode 79 we sat down to discuss COVID-19.  Specifically, we focused on not intubating patients early and why ARDSnet may not be the best ventilator paradigm for patients with COVID-19.  By popular demand, we decided to follow up on this podcast.  We are now just about 9 months ... Read more

Background: Intravenous alteplase is the current standard care for treatment of acute ischemic stroke (AIS) despite active debate on the research supporting its use.  The window for its use has been restricted to <3h of symptom onset based on the results of the NINDS trial and extended to a time window of <4.5h based on ... Read more

Take Home Points This is a resuscitative hysterotomy – focus is on saving the mother first. Delivering the fetus can improve venous return thus increasing chance to save mom Don’t focus on gestational age to make the decision – if you think the belly is big enough to be causing compression of vascular structures, the ... Read more

Take Home Points Be sure to consider mesenteric ischemia in any elderly patient with abdominal pain or lower gastrointestinal (GI) complaints.  Remember, the presentation can be tricky to find and they may have a reassuring abdominal exam. Ask about artherosclerotic risk factors, history of cardiovascular disease including atrial fibrillation and prior embolic events, and a ... Read more