I am fortunate to work in a hospital system that is very forward thinking.  We have a phenomenal relationship with our intensivists, and I have been fortunate enough to have several discussions with them about how we are managing COVID-19 in our ICUs.  For full transparency, I don’t work up in the ICU, but had ... Read more

Take Home Points Small to Moderate Size Pneumothorax – consider managing conservatively with observation (need to make sure consulting services on same page) Needle aspiration for spontaneous pneumothorax recommend by British Thoracic and European Respiratory Societies 1 in 5 patients requiring a chest tube will suffer complications – many are iatrogenic in nature. Practice procedure ... Read more

Background: Upper endoscopy allows for the identification of the source of bleeding as well as hemostatic treatment for actively bleeding lesions In patients with upper gastrointestinal bleeding (UGIB).  Definitive treatment with endoscopic hemostatic treatment can potentially stop bleeding in high-risk lesions and reduce further bleeding and the need for surgery. The optimal time for endoscopy ... Read more

Take Home Points Forget the “traditional” needle decompression landmark Decompress at 4th or 5th intercostal space in the anterior axillary line REBEL Core Cast 32.0 – Needle Decompression Click here for Direct Download of Podcast Diagnosis Tension pneumothorax is a clinical diagnosis Expect the pathology in a patient with chest injury, hypotension, unilateral breath sounds, ... Read more

Goals of lung protective mechanical ventilation: Minimizing harm during mechanical ventilation with a lung-protective strategy with: Low tidal volume (TV) Limit plateau pressure to <30mmHg...

Early reports have shown that COVID-19 is most likely causing a hypercoagulable state, however the prevalence of acute VTE and exactly how to treat it...

In this episode of REBEL Cast,I sit down with Richard Levitan and talk about some ideas from his experience in New York, where he spent...

Take Home Points N95 masks ideally should be single use but in COVID19 times, safe reuse practices are critical. The best approach to reuse is...

Airway Pressure Release Ventilation (APRV) is a mode of ventilation that allows spontaneous breathing throughout the ventilation cycle.  It is a time-cycled mode of ventilation...

Take Home Points Hyperthyroidism can present along a spectrum from the minimally symptomatic to severely decompensated and presentation can vary with age If there are...