This week, Jenny and Swami discuss Acute Angle Closure Glaucoma

This week, Jenny and Swami get into some expert level tips and tricks in the management of diabetic ketoacidosis.

This week, Swami chats with Dr. Nilesh Patel, vice chair of the Emergency Department at St. Joe's in Paterson, NJ, about penetrating neck trauma.

This week, Jenny and Swami dive into decompensated hypothyroidism otherwise known as myxedema coma.

This week, Jenny and Swami discuss a couple of recent publications on syncope and how these effect the way we think about managing this common disorder.

Jenny and Swami discuss all the ins and outs of superficial venous thrombosis with a focus on who needs treatment and what treatment is indicated.

This week we review the basics on measles - how to identify it and how to treat.

Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Acute Ischemic Stroke

This week, Jenny and Swami explore common emergencies related to tracheostomies including dislodgement, obstruction and bleeding.

This week, Jenny and Swami discuss a case of epiglottitis with a focus on airway management.

Jenny and Swami discuss blunt cardiac injury with a focus on the spectrum of pathology and diagnostics.

Jenny and Swami review a talk from the All NYC EM conference and dive into the nuances of management of peds status epilepticus.

This week we discuss two recent publications in the NEJM and dive into the non-inferiority study design and how it should be used.

This week, Jenny and Swami discuss two uncommon, but life-threatening, oncologic emergencies: hyperviscosity syndrome and tumor lysis syndrome

This week, Jenny and Swami dive into pearls from a grand rounds talk by Zaf Qasim on traumatic arrest.

This week, Jenny and Swami explore the management and critical actions in accidental hypothermia.

Take Home Points

1. Single dose oral dexamethasone is an excellent choice for asthma exacerbations. It takes away the compliance issue for patients who have trouble getting medications or filling medications once they leave the ED.
2. Antibiotics aren’t always indicated in COPD exacerbations, but are used much more frequently than in asthma exacerbations because the structural changes in the patient’s lung lead to increased bacterial colonization. In general, if the patient has increased cough or sputum production, they probably would benefit from a course of antibiotics
3. In general, azithro alone is no longer a good choice as solo covereage for community acquired pneumonia.  Adding either amoxicillin or cefdinir to you amoxicillin should get you good coverage of both strep pneumo and atypicals.

Take Home Points

1. Bed Up Head Elevated (BUHE) position is a simple intervention that can reduce the rate of intubation-related complications.
2. The bougie should be considered standard practice in all intubations and has an NNT = 11 for 1st pass success.
3. Consider using Suction Assisted Laryngoscopy for Airway Decontamination (SALAD) for all intubations to avoid the failed airway due to contamination.

Take Homes

1. Calcium Channel Blocker (CCB) toxicity usually present with bradycardia and hypotension, but with preserved mental status. This can help differential from Beta Blocker (BB) toxicity, where the patients often have altered mental status.
2. Hyperglycemia is the other hallmark of CCB toxicity, which can help you differentiate from BB. This hyperglycemia may be a harbinger of impending circulatory collapse, so be on guard in a pt with CCB overdose, normal vitals and hyperglycemia
3. Don’t be afraid to use and infuse hyperinsulinemia-euglycemia therapy for BB and CCB toxicity. Have a frank and open conversation with your team about how it works to get everyone on board before your start.
4. TCA overdoses present with a a number of signs and symptoms including anticholinergic symptoms, AMS, hypotension and seizures. Once you identify the TCA toxicity, you’re going to start with fluids and pressors and then move on the antidote which is sodium bicarbonate 1-2 mEq/kg as a bolus followed by a drip. You want to keep pushing sodium bicarb until you see the QRS narrow

A short podcast to announce the launch of a new project under the REBEL EM banner!

Apneic Oxygenation During Rapid Sequence Intubation in the ED

Vitamin C in Sepsis

IV Contrast and Acute Kidney Injury

Angiotensin II for the Treatment of Shock

POCUS During Cardipulmonary Resuscitation

Thrombolyisis in Submassive PE

Conservative vs Conventional O2 Among Patients Going to the ICU

Dosing of Low Dose Ketamine for Pain Control

Dosing of IV Ketorolac

Haloperidol in Gastroparesis

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.