Thu, 18 April 2024
REBEL Cast Ep127: From Debate to Data: Emerging Insights into RSI Induction with Ketamine vs Etomidate
Resuscitationists have debated the choice of induction agents in rapid sequence intubation (RSI) for decades. Critics of etomidate will highlight its link to adrenal suppression in critically ill patients (Albert 2011), while critics of ketamine will highlight the higher incidence of post-intubation hypotension (Mohr 2020). Amidst the debate, the Ketased Trial (Jabre 2009), a large multicenter prospective, single-blind randomized clinical trial (RCT), reported no significant difference in SOFA scores or 28-day mortality between the two induction agents. However, the EvK trial (Matchett 2022) identified a statistically significant difference in 7-day mortality but not 28-day mortality in favor of ketamine. However, methodological concerns from the EvK Trial warrant a cautious interpretation of the data. In light of these and several other recent high-quality clinical trials comparing ketamine and etomidate, this meta-analysis aims to provide a point estimate of the mortality rate.
Direct download: From_Debate_to_Data_Emerging_Insights_into_RSI_Induction_with_Ketamine_vs_Etomidate.m4a
Category:general -- posted at: 8:00am CDT |
Tue, 9 April 2024
Swami sits down with Emergency Physicians and the authors of the soon to be released book MicroSkills Drs. Adaira Landy and Resa Lewiss. |
Wed, 3 April 2024
Swami sits down with Drs. Dara Kass and Monica Saxena to discuss the EMTALA law and current challenges in the area of reproductive health. |
Mon, 25 March 2024
Direct download: REBEL_Cast_Ep125_-_First_48_Hours_of_PE_Management_-_How_Good_is_Unfractionated_Heparin.mp3
Category:general -- posted at: 11:32am CDT |
Wed, 20 March 2024
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Wed, 13 March 2024
Annie Duke, a former World Series of Poker champion, details some of the psychology of decision making in the high-risk gambling in her book, Thinking in Bets. In poker, important decisions must be made quickly in the midst of extreme uncertainty and repeated in rapid succession with each new hand. To learn and improve in this environment, these players learn to embrace uncertainty, tease the luck out of their outcomes and avoid common biases when reviewing their prior performance. As doctors working in Emergency Medicine we often have do the same thing and the wrong decision could potentially be fatal. In this episode of Rebel Reflections, four Emergency Medicine Physicians, Jacob White, Marco Propersi, Dan Wolf and Will Smith, discuss how thinking in bets while dealing with levels of uncertainty can benefit our performance and learning in the Emergency Department.
We will discuss these topics and many more on this episode of REBEL Reflections! |
Wed, 6 March 2024
Swami chats with Brendan Freeman, Emergency doc and medical education fellow at Staten Island University Hospital about improving our sleep hygiene. |
Mon, 4 March 2024
There is a shifting paradigm towards shorter durations of antibiotics in pediatric infections. Conflicting international guidelines recommend treatment of urinary tract infection (UTI) with antibiotic courses ranging from just 3 days to 7–14 days. Antimicrobial resistance is a global health crisis, underscoring the importance of antibiotic stewardship. Investigators in the SCOUT Trial examine the impact of short-course (5 day) antibiotic therapy in UTI, with potentially far reaching implications. https://rebelem.com/pediatric-utis-short-course-vs-standard-course-antibiotics-is-it-time-for-a-change/ |
Mon, 4 March 2024
Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. Corticosteroids have excellent anti-inflammatory and immunomodulatory effects that could mitigate some of the inflammation caused by pneumonia. There have been several randomized trials that have shown glucocorticoids have positive effects in patients with CAP. However, except for one trial, none showed a between-group difference regarding mortality. We now have the Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial. https://rebelem.com/corticosteroids-in-severe-community-acquired-pneumonia-could-cape-cod-catalyze-a-change-in-critical-care-management/ |
Wed, 28 February 2024
Direct download: REBEL_Cast_Ep124_-_Nitrates_in_Right_Sided_Myocardial_Infarction.mp3
Category:general -- posted at: 10:25am CDT |
Wed, 21 February 2024
Should we give oral ibuprofen or intramuscular ketorolac in the ED in patients who can take PO? |
Wed, 7 February 2024
This week we discuss some of the serious infectious processes of pregnancy. |
Wed, 24 January 2024
This week we discuss the diagnosis and management of Achilles tendon ruptures. |
Fri, 19 January 2024
Direct download: REBEL_Cast_Ep123_-_Quarter_Dose_Alteplase_in_Massive_PE.mp3
Category:general -- posted at: 12:04pm CDT |