PODCAST

REBEL EM – Emergency Medicine Blog

Salim R. Rezaie, MD

Rational Evidence-Based Evaluation of Literature

health & fitness medicine

All Episodes

Clinical Conundrum: Do I Have to Replace the Nail...

REBEL EM – Emergency Medicine Blog ·

2025/02/28

Bottom Line Up Top: Replacing the nail into the eponychial fold doesn’t appear to be critical to nail regrowth and cosmetic outcomes of finger injuries with nail avulsion. Clinical Scenario: A 6-year-old boy presents to the Peds ED with an injury to their left 2nd digit. The finger was caught in a car door, injuring ... Read moreThe post Clinical Conundrum: Do I Have to Replace the Nail After an Avulsion? appeared first on REBEL EM - Emergency Medicine Blog.

en-US

IVC Distensibility Index vs Collapsibility Index:...

REBEL EM – Emergency Medicine Blog ·

2025/02/24

Background In 1979, Hiroshi Natori was the first to appreciate the sonographic changes that occur in the inferior vena cava (IVC)’s diameter with ventilation in spontaneously breathing patients, mechanically ventilated patients, and those with carcinogenic and tuberculoid cardiac tamponade.1 They noticed how spontaneously breathing patients had their IVC collapse with inspiration; and ventilated patients had ... Read more The post IVC Distensibility Index vs Collapsibility Index: Using the Correct

en-US

Balancing Innovation and Reality: Evaluating AI’s...

REBEL EM – Emergency Medicine Blog ·

2025/02/03

Background: ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring rapid diagnosis and intervention. While ECGs play a central role in detecting STEMI, misinterpretations often occur, leading to unnecessary catheterization or missed diagnoses. With advancements in artificial intelligence (AI), there is potential for machine learning models to assist in more accurate detection of STEMI. ... Read moreThe post Balancing Innovation and Reality: Evaluating AI’s Role

en-US

D-Dimer in High-Risk PE: A Gamble Worth Taking?

REBEL EM – Emergency Medicine Blog ·

2025/01/21

\Background: The current standard care for evaluating pulmonary embolism (PE) advises against D-dimer testing in patients with a high clinical probability. European and American guidelines emphasize a sequential diagnostic approach based on pretest probability assessment using either a formal clinical decision instrument (e.g., Wells’, Revised Geneva) or clinical gestalt. D-dimer testing is commonly used to ... Read moreThe post D-Dimer in High-Risk PE: A Gamble Worth Taking? appeared first

en-US

Clinical Conundrum: Should Acute Asthma Exacerbations...

REBEL EM – Emergency Medicine Blog ·

2025/01/15

Bottom Line Up Top: In patients with mild to moderate asthma exacerbations that are stable for discharge home, there is evidence to support discharging patients from the ED with combination Inhaled Corticosteroid/Long-Acting Beta Agonist (ICS-LABA) maintenance therapy. Clinical Scenario: A 21-year-old man with a history of asthma presents with difficulty breathing for the past two ... Read moreThe post Clinical Conundrum: Should Acute Asthma Exacerbations Be Discharged From the ED With Combination

en-US

Rethinking Fluid Resuscitation in Vaso-Occlusive...

REBEL EM – Emergency Medicine Blog ·

2024/12/23

Background: Sickle cell disease (SCD) affects an estimated 300,000 infants born worldwide each year and has a total estimated prevalence of 100,000 in the United States alone (Piel 2017). Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) (Kidwell 2021). VOE is often complicated by hypovolemia, making fluid administration ... Read moreThe post Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice

en-US

REBEL Core Cast 133.0 – TMJ Dislocation

REBEL EM – Emergency Medicine Blog ·

2024/12/18

Take Home points: Atraumatic TMJ dislocations are typically anterior in nature and can be reduced by a variety of techniques in the ED Traumatic TMJ dislocations often involve mandible fractures and typically require open reduction and fixation in the operating room Consider using the syringe, gag and extraoral reduction techniques first line as they frequently ... Read more The post REBEL Core Cast 133.0 – TMJ Dislocation appeared first on REBEL EM - Emergency Medicine Blog.

en-US

Clinical Conundrum: Should We Always Treat Fever in...

REBEL EM – Emergency Medicine Blog ·

2024/12/17

Bottom Line Up Top: There doesn’t appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. Only treat fever if it causes the patient distress. Clinical Scenario: A 45-year-old woman presents with cough and shortness of breath. Vitals are BP 114/42, HR 138, T 102.1, ... Read more The post Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis? appeared first on REBEL EM - Emergency Medicine Blog.

en-US

REBEL Core Cast 132.0 – Recent-Onset AFib

REBEL EM – Emergency Medicine Blog ·

2024/12/04

Take Home points: If the patient is low risk with CHA2DS2-VASc (men < 2, women < 3), cardioversion is safe up to 48 hours from onset. In higher risk patients, we should reserve cardioversion unless there is clear onset less than 12 hours or the patient has been anticoagulated for 3 weeks. Consider anticoagulation in ... Read moreThe post REBEL Core Cast 132.0 – Recent-Onset AFib appeared first on REBEL EM - Emergency Medicine Blog.

en-US

Threading the Needle: Bougie-First Intubation

REBEL EM – Emergency Medicine Blog ·

2024/11/25

Background: In 2018, the BEAM Trial, a small single-center randomized clinical trial, conducted in the emergency department at Hennepin County Medical Center, demonstrated that bougie use significantly increased the first-attempt intubation success rate compared to the endotracheal tube with stylet (98% vs 87% (absolute difference, 11% [95% CI, 7% to 14%]).1 Conversely, the 2021 BOUGIE ... Read moreThe post Threading the Needle: Bougie-First Intubation appeared first on REBEL EM - Emergency

en-US

Rosh Review My EMCert Monthly Question

REBEL EM – Emergency Medicine Blog ·

2024/11/21

A parent presents to the ED with their 6-week-old infant for evaluation of a fever. The infant was born full term and has no other symptoms. Physical exam is normal and vital signs are HR is 150 bpm, SpO2 is 99%, and a rectal T is 101.4°F (38.6°C). Blood cultures are sent and lab results ... Read more The post Rosh Review My EMCert Monthly Question appeared first on REBEL EM - Emergency Medicine Blog.

en-US

Levitan/Rezaie Practical Airway Course

REBEL EM – Emergency Medicine Blog ·

2024/11/19

View Course Dates This 2-day course provides an in-depth look at effective surgical airway management techniques that you will actually use in your next emergency airway. There is a unique focus on airway anatomy and imaging combined with one-of-a-kind opportunity to practice the techniques on a large variety of non-embalmed, specially prepared cadavers. This is ... Read more The post Levitan/Rezaie Practical Airway Course appeared first on REBEL EM - Emergency Medicine Blog.

en-US

6:54

REBEL Core Cast 131.0 – Traumatic Arthrotomy

REBEL EM – Emergency Medicine Blog ·

2024/11/13

Take Home points: Always suspect an open joint if there is a laceration, regardless of size, the lies over joint CT scan of the affected joint is widely considered to be the standard approach to evaluation but the saline load test may be useful in certain circumstances. Obtain emergency orthopedics consultation for all open joints ... Read more The post REBEL Core Cast 131.0 – Traumatic Arthrotomy appeared first on REBEL EM - Emergency Medicine Blog.

en-US

Is Pip-Tazo Harming Sepsis Patients?

REBEL EM – Emergency Medicine Blog ·

2024/11/11

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. Literature comparing the two regimens has largely focused on the adverse effects of each medication, rather ... Read more The post Is Pip-Tazo Harming Sepsis Patients? appeared first on

en-US

Elbow Dislocations

REBEL EM – Emergency Medicine Blog ·

2024/11/06

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow (Cohen 1998) Posterolateral is the most common type of dislocation (80%) Demographics Most commonly affects ... Read more The post Elbow Dislocations appeared first on REBEL EM - Emergency Medicine

en-US

6:13

REBEL Core Cast 129.0 – Gastric Lavage

REBEL EM – Emergency Medicine Blog ·

2024/10/16

Take Home Points Orogastric lavage may still play an important role in treatment of the overdose patient. Do not perform lavage if the ingestion has limited toxicity at any dose or the ingested dose is unlikely to cause significant toxicity. Strongly consider orogastric lavage in a patient who has taken an overdose of drugs that ... Read moreThe post REBEL Core Cast 129.0 – Gastric Lavage appeared first on REBEL EM - Emergency Medicine Blog.

en-US

Clinical Conundrums: Should Ketamine be Preferred...

REBEL EM – Emergency Medicine Blog ·

2024/09/23

Bottom Line Up Top: Based on the available evidence, we should strongly consider ketamine over etomidate as our default induction agent in critically ill patients. Clinical Scenario: A 48 year old man presents with fever, hypotension, hypoperfusion and hypoxemia. Workup reveals multifocal pneumonia and oxygenation only marginally improves with non-invasive ventilation. You decide to intubate ... Read more The post Clinical Conundrums: Should Ketamine be Preferred Over Etomidate in RSI? appeared

en-US

Rosh Review My EMCert Monthly Question

REBEL EM – Emergency Medicine Blog ·

2024/09/09

A newborn boy presents to the emergency department shortly after a home delivery. The mother had routine prenatal care and reports that he was due in 2 days. The patient appears term and vigorous but is in respiratory distress and gasping for air. His heart rate is 80 bpm. What percent of oxygen should you ... Read more The post Rosh Review My EMCert Monthly Question appeared first on REBEL EM - Emergency Medicine Blog.

en-US

The Ducanto Catheter—It Sucks!

REBEL EM – Emergency Medicine Blog ·

2024/09/02

Background: Emergency intubations present a unique set of challenges, particularly when dealing with heavily contaminated airways. Anesthesiologist, Dr. James DuCanto, developed the DuCanto catheter to enhance airway management in these high-stakes situations. The commonly used 14 Fr Yankauer catheter, with its smaller bore, may struggle to clear heavily contaminated airways effectively. In contrast, the 28 ... Read moreThe post The Ducanto Catheter—It Sucks! appeared first on REBEL EM - Emergency

en-US

Nirmatrelvir for Vaccinated or Unvaccinated Adult...

REBEL EM – Emergency Medicine Blog ·

2024/08/28

Background: The clinical burden of severe COVID-19 triggered a pharmaceutical race to find effective, easily accessible, oral treatments that could decrease the morbidity and mortality associated with the disease. Nirmatrelvir is an oral antiviral agent that inhibits the SARS-CoV2 main protease involved in viral replication. It is administered with ritonavir, which inhibits the cytochrome P450-3A4 ... Read moreThe post Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with COVID-19

en-US

132 results

REBEL EM – Emergency Medicine Blog

All Episodes

Similar Podcasts

Доктор Тройняшкин

Доктор Тройняшкин

The Dry Eye Treatment PODCAST

Dry Eye Treatment

Différent et alors ?

PATRICK SULAY

Kyle Kingsbury Podcast

Kyle Kingsbury

The Real Weight Loss Coach

Matty Lansdown