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.

• • How does “resulting” or the tendency to equate a decision’s quality with its outcome affect learning in and after residency?
  • How does thinking on the spectrum of more or less right impact our utilization of new research or of implementing a consultant’s recommendations?
  • How do you avoid decision fatigue during a long shift?

We will discuss these topics and many more on this episode of REBEL Reflections!

Thinking in Bets on Amazon.com

1. The Oxygen-ICU Trial

2. The SOCCER Trial

1. The EXCEL Trial

2. The NOBLE Trial

The PROCAMIO Trial - IV Procainamide vs IV Amiodarone for the Acute Treatment of Stable Wide Complex Tachycardia

1. What 3 things would you tell yourself when you graduated residency
2. What are the 3 biggest mistakes you see new EM graduates making
3. What financial advice would you give the new EM graduate

1. What 3 things would you tell yourself when you graduated residency?
2. What are the 3 biggest mistakes you see new EM graduates make?

Sensitivity of Early Brain CT to Exclude Aneurysmal Subarachnoid Hemorrhage

1. Reducing D2B times <90min
2. Continuous vs Interrupted CPR in OHCA

Topic #1: Intravascular Complications of Central Venous Catheter (CVC) Access
Topic #2: US vs Landmark Technique for Peripheral IV Access

REBELCast Top 5 AHA 2015 Guidelines Updates for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC)

1. FAST US Examination as a Predictor of Outcomes After Resuscitative Thoracotomy

2. Blunt Trauma Thoracotomy

Topic #1: Home Treatment of Low Risk Venous Thromboembolism with Rivaroxaban

Topic #2: RV Dilation on Bedside Echo Performed by ED Physicians

Topic #1: MET for Renal Colic
Topic #2: Use of the Broselow Tape to Estimate Pediatric Weights

Topic #1: The AVOID Trial - Supplemental O2 vs Room Air for STEMI

Topic #2: The FLORALI Trial - High Flow Nasal Cannula (HFNC) for Acute Hypoxemic Respiratory Failure

• Topic #1: Corticosteroids in Allergic Reactions & Anaphylaxis
• Topic #2: Age of Packed Red Blood Cells (PRBCs) in Critically Ill Adults)

Topic: Delayed Sequence Intubation (DSI) of the Hypoxic and Agitated Patient

1. What Mean Arterial Pressure (MAP) should we target in sepsis?
2. What Hemoglobin (Hb) transfusion threshold should we target in sepsis?
3. How good is SIRS criteria for screening in severe sepsis?
4. What are the take home messages from the sepsis trilogy?

1. Heroic medical measures in the crashing asthmatic
2. Intubation of the crashing asthmatic
3. Ventilator management of the crashing asthmatic

Topic: Is active Compression Decompression CPR with Augmentation of Negative Intrathoracic Pressure for Treatment of Out-of-Hospital Cardiac Arrest superior to standard CPR?

• Topic #1: Basic Life Support (BLS) vs Advanced Cardiac Life Support (ACLS) in Out of Hospital Cardiac Arrest (OHCA)
• Topic #2: PROMISE Trial: Anatomic vs Functional Testing for CoronarymArtery Disease (CAD)

Topic #1:  Oseltamivir (Tamiflu) in the Treatment of Influenza

Topic #2: Use of the HEART Score in Low Risk Chest Pain Patients

Topic #1: Administration of Rapid Sequence Intubation (RSI) Medications via an Intraosseous line.

Topic #2: Compressions During Charging (CDC) in Out of Hospital Cardiac Arrest (OHCA)

Can we give cephalosporins to patients with a history of penicillin allergy without risking a significant allergic reaction?

Welcome to REBELCast Episode 1, where Mat, Swami, and I are going to tackle a couple of scenarios to help your clinical practice. Today, we are going to specifically tackle two different topics:

Topic #1: Clinically Important Biphasic Anaphylaxis

Topic #2: Total Lymphocyte Count (TLC) as a Surrogate Marker for CD4 Counts

For those who haven't checked out the site already R.E.B.E.L. EM stands for Rezaies's Evidence Based Evaluation of Literature in Emergency Medicine.  The blog was launched in October 2013, and continues to grow every month, and with that growth we are excited to announce the introduction of REBELCast.