REBEL EM

FEBRUARY 8, 2024

Accuracy of Noninvasive Blood Pressure Monitoring in Critically Ill Adults. J Intensive Care Med 2024. PMID: 38215002 Clinical Question: In critically ill adults in the ICU is noninvasive blood pressure (NIBP) monitoring similar (≤10% difference) to invasive arterial blood pressure (IABP) monitoring? to 1.12; p = 0.03

ICU 123

ICU MICU ALS EMS 123

Emergency Medicine Ireland

MAY 16, 2022

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. I am guilty of over teaching this myself having delivered not one , but 2 talks on the subject, and even a prior tasty morsel of EM on the subject. Today we’re looking at asthma.

Critical Care 40

Critical Care ICU OR EMS 40

Emergency Medicine Ireland

NOVEMBER 1, 2020

Welcome back to the tasty morsels of critical care podcast. DKA is bread and butter for critical care providers. Read More » Welcome back to the tasty morsels of critical care podcast. DKA is bread and butter for critical care providers.

Critical Care 40

Critical Care ICU EMS OR 40

Emergency Medicine Ireland

DECEMBER 24, 2020

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. References: Oh’s Manual Chapter 47 Tasty Morsels of EM 116 It covers Oh’s Manual Chapter 47 looking.

Critical Care 40

Critical Care ICU EMS 40

AAEM RSA

JUNE 30, 2021

Pursuing an emergency medicine residency affords a fast-paced, often unpredictable environment with a diversity of patients unique to the specialty, while the life of an internist involves rounding, longitudinal patient care, and long contemplative sessions pertaining to pathophysiology and diagnosis. Martinez J.

EMS 52

EMS Critical Care ICU ED 52

Emergency Medicine Ireland

JULY 5, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. Oh is quite pro IV infusions and certainly in the ICU and OT this is ubiquitous and generally well done in my experience. Today we look at anaphylaxis. Today we look at anaphylaxis.

Critical Care 40

Critical Care ICU ALS OR 40

Emergency Medicine Ireland

OCTOBER 27, 2020

The knowledge contained will hopefully be sufficient to allow you to not look completely clueless on the ICU round when the topic of PR3+ve ANCA vasculitis comes up. As such this hopefully will occupy the niche of “exam prep/board review” in the already somewhat crowded critical care podcast scene.

Critical Care 40

Critical Care ICU EMS OR 40

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Critical Care 96

Critical Care ED EMS OR 96

REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. J Crit Care. Paper: Owyang CG, et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

Critical Care Scenarios

OCTOBER 31, 2021

Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. An overview of VV ECMO with a focus on COVID-19, with Dr. Kimberly A. Data remains slim,

Interfacility Transport 100

Interfacility Transport Plasma ICU EMS 100

REBEL EM

JUNE 8, 2023

The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med. Rezaie, MD (Twitter: @srrezaie ) The post The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults appeared first on REBEL EM - Emergency Medicine Blog. J Med Toxicol. Am J Emerg Med.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. Anaesth Crit Care Pain Med. Tips for radial artery art lines Imbrìaco G, Monesi A, Spencer TR.

E-9-1-1 52

E-9-1-1 Defibrillator ICU Critical Care 52

ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. 4 With the increasing utilization of EEG, especially continuous EEG, nonconvulsive seizures have been increasingly recognized and diagnosed as a cause of altered mental status in critically ill patients.

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

Don't Forget the Bubbles

AUGUST 28, 2023

You contact ICU, anaesthetics, ENT, and oncology with a plan to attempt more definitive imaging in the prone position (which Ginny tells you is much comfier) What’s the evidence for our emergent management? See their website for more: [link] References Carter BW, Marom EM, Detterbeck FC. A CXR demonstrates a mediastinal mass.

Emergency Management 97

Emergency Management Emergency Manager E-9-1-1 Critical Care 97

REBEL EM

FEBRUARY 2, 2023

2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). This could have biased the results in favor of amiodarone as we’ve covered this before on REBEL EM before The IV amiodarone group required less additional HR control agents to control increased heart rate.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

REBEL EM

SEPTEMBER 29, 2022

For More on This Topic Checkout: CorePendium: Pancreatic Disease Internet Book of Critical Care: Acute Pancreatitis EMCrit: Ep333 – The State of Fluids Show with the EMCrit Core Team The Bottom Line: Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis References: de-Madaria E et al. cc/kg/hour.

ICU 52

ICU ALS Critical Care Emergency Department 52

REBEL EM

MAY 8, 2023

appeared first on REBEL EM - Emergency Medicine Blog. 2,230 records remained after the elimination of duplicates. 2,210 records were excluded after screening.

E-9-1-1 58

E-9-1-1 Critical Care ICU OR 58

EMDocs

JUNE 22, 2024

We’ll keep it short, while you keep that EM brain sharp. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. link] j.ajog.2016.03.012

EMS 111

EMS FFP Ambulance ICU 111

REBEL EM

OCTOBER 5, 2023

ClinicalTrials.gov: NCT02517489 7 Clinical Question: In adult patients with severe community-acquired pneumonia admitted to the ICU, does early hydrocortisone treatment, compared to standard therapy, reduce mortality at 28 days? Patients enrolled from 31 Intensive Care Units in France. ICU-acquired infections were observed in: 9.8%

Critical Care 94

Critical Care ICU E-9-1-1 ALS 94

The Skeptics' Guide to EM

OCTOBER 3, 2021

Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in the Department of Critical Care Medicine at Mayo Clinic Arizona. Case: A 66-year-old woman is brought in by EMS from home with lethargy and hypotension. Reference: Zampieri et al.

OR 130

OR Critical Care ICU Plasma 130

Emergency Medicine Ireland

JANUARY 22, 2024

Welcome back to the tasty morsels of critical care podcast. Today we’ll cover some key exam content, all be it not something you’re likely to run into in the ICU too often. Your ICU probably has it and you’ve typically only seen it as part of management of a potential organ donor in brain death.

Critical Care 52

Critical Care Organ Donor ICU OR 52

REBEL EM

FEBRUARY 29, 2024

3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. The low incidence could be a result of the systematic implementation of bundles known to decrease VAP incidence in the ICU. 4, 8 Paper: Dahyot-Fizelier, C.,

E-9-1-1 119

E-9-1-1 ICU ALS OR 119

REBEL EM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Monitoring cerebral pressures is crucial in assessing the impact of interventions, especially in critical care scenarios.

Critical Care 97

Critical Care E-9-1-1 CPR ALS 97

The Skeptics' Guide to EM

JULY 16, 2022

Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice. She is admitted to the intensive care unit (ICU) for septic shock. Reference: Lamontagne F et al.

ICU 100

ICU ALS Critical Care Emergency Department 100

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. When EMS arrived the patient was in ventricular fibrillation. Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. Two subsequent troponins were down trending.

Coronary 117

Coronary CAD CPR Critical Care 117

REBEL EM

NOVEMBER 30, 2023

Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. 4 studies remained, with a total of 571 patients with sepsis and a history of CHF Critical Result: The weighted OR for death was significantly higher in the <30 × 3 vs. 30 × 3 OR = 1.81, 95% CI = 1.13–2.89, 2.89, p = 0.01.

E-9-1-1 121

E-9-1-1 ALS ACS ICU 121

Critical Care Scenarios

NOVEMBER 15, 2020

” is always, ultimately, the main question of the EM provider. ICU time and ED time are different. In the ICU, we have a useful (albeit sometimes flexible) cap: our total number of beds.* This differs from the main questions of many of their consulting and admitting specialties.*

ICU 100

ICU Life Support Emergency Department ED 100

REBEL EM

AUGUST 12, 2024

When only using a lab value such as creatinine, the authors are making the end-result more heavily favored to only a lab-oriented outcome.

ICU 81

ICU Operating Room Critical Care ALS 81

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

Defibrillator 111

Defibrillator CPR Epinephrine Life Support 111

REBEL EM

SEPTEMBER 5, 2022

Recent studies on patients requiring critical care have demonstrated that hyperoxia is harmful and instead we should be targeting normoxia (SpO2>93%). Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC. Liberal O2 (PaO2 13 to 14kPa (98 to 105mmHg) Initial FiO2 set at 0.6 Liberal O2: 33.9%

ICU 52

ICU ALS OR CPR 52

REBEL EM

JULY 25, 2022

PrePARE Investigators; Pragmatic Critical Care Research Group. Effect of Fluid Bolus on Cardiovascular Collapse Among Critically Ill Adults Undergoing Tracheal Intubation (PrePARE): A Randomised Controlled Trial. appeared first on REBEL EM - Emergency Medicine Blog. No Bolus: 18.2% Absolute difference 2.8%; 95% CI -2.2%

ALS 58

ALS Critical Care ICU OR 58

EMDocs

APRIL 22, 2024

EMS verbalized concern to EPs that an “intracranial bleed” may have precipitated the event. Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., Critical Care Emergency Medicine, McGraw-Hill, pgs 129-132, 2nd ed., Tintinalli, J.E.

ED 98

ED ALS NARCAN OR 98

Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. The QRS is narrow and T waves are much less peaked.

E-9-1-1 52

E-9-1-1 OR STEMI ED 52

EMDocs

OCTOBER 7, 2023

We’ll keep it short, while you keep that EM brain sharp. A 17-year-old girl, in moderate distress, is brought in by EMS after a motor vehicle collision. EMS reports that she was “pinned” underneath the dashboard, and it took several hours to extricate her. Critical Care. Critical Care. 2016;20(1):135.

EMS 98

EMS E-9-1-1 Emergency Department ALS 98

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St.

Emergency Department 98

Emergency Department E-9-1-1 ED ICU 98

REBEL EM

JULY 31, 2023

Background: The ongoing debate between video laryngoscopy (VL) and direct laryngoscopy (DL) has ignited intense debate within the emergency medicine and critical care communities. An emergency medicine resident or critical care fellow performed 91.5% 1420 patients were enrolled. of intubations.

Critical Care 98

Critical Care Emergency Department ICU OR 98

REBEL EM

NOVEMBER 11, 2024

found no difference in mortality in critical care patients treated with vancomycin and piperacillin- tazobactam compared to vancomycin and cefepime or meropenem. 4 The 2023 ACORN Trial ( covered here on REBEL EM ) randomized 2,511 patients requiring antipseudomonal coverage to receive either cefepime or piperacillin-tazobactam.

E-9-1-1 108

E-9-1-1 ALS ICU Critical Care 108