Take Home Points Acute rhinosinusitis is a clinical diagnosis The vast majority of acute rhinosinusitis cases are viral in nature and do not require antibiotics Consider the use of antibiotics in select groups with severe disease or worsening s

REBEL EM Book Club – MicroSkills

24 days ago 39m

Podcast Direct Download: Link Release Date: April 16th, 2024 Show Notes The Visible Voices Podcast Dr. Glaucomflecken: Power of Ultrasound with Emergency Medicine Dr. Resa Lewiss Adaira I Landry MD Resa E Lewiss MD is a Professor of Emergency M

REBEL Cast – EMTALA + Reproductive Health Rights

Apr 3rd, 2024 34m 50s

REBEL Cast – EMTALA + Reproductive Health Click here for Direct Download of the Podcast. Dr. Dara Kass is a practicing emergency medicine physician who was most recently as the Regional Director of Region 2 for the US Department of Health and H

REBEL Cast Ep125: 1st 48 Hours of PE Management – How Good Is Unfractionated Heparin?

Apr 1st, 2024 17m

Background: The mainstay of treatment for symptomatic pulmonary embolism (PE) is anticoagulation (AC). Patients with higher-risk PE may require advanced interventions such as thrombolytic therapy, surgical thrombectomy, or even extracorporeal

REBEL Cast Ep124: Nitrates in Right Sided MIs?

Mar 18th, 2024 12m 21s

Background: Nitrates can help improve symptoms and ischemia in the setting of acute myocardial infarction. Current teaching holds that nitrates should be avoided in patients with potential right ventricular myocardial infarction (RVMI), due to

REBEL Core Cast 119.0 – Sleep Hygiene

Mar 6th, 2024 4m 13s

REBEL Core Cast 119.0 – Sleep Hygiene Click here for Direct Download of the Podcast Employ sleep strategies: Anchor sleep: a period of sleep that overlaps each day regardless of your night shift schedule to provide a guidepost for your body clo

REBEL Core Cast 118.0 – IM vs PO NSAIDs

Feb 21st, 2024 4m 13s

REBEL Core Cast 118.0 – IM vs PO NSAIDs Click here for Direct Download of the Podcast Bottom Line Up Top: There is no difference in analgesic efficacy between oral and intramuscular NSAIDs. Clinical Scenario: A 34-year-old woman presents to the

REBEL Core Cast 117.0 – Infections of Pregnancy

Feb 7th, 2024 5m 15s

Take Home Points Infections are a leading cause of maternal mortality worldwide. Prompt recognition is critical in management. Most infectious processes will require admission and close observation for improvement or decompensation. REBEL Core

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Jan 29th, 2024 28m 22s

Background: Massive pulmonary embolism defined as sustained hypotension (SBP <90mmHg) has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) [1]. However, full-dose

REBEL Core Cast 116.0 – Achilles Tendon Rupture

Jan 24th, 2024 5m 32s

Take Home Points Achilles tendon rupture is a clinical diagnosis. The Thompson Test should be applied in all suspected cases. Remember to brace or splint a rupture, even if suspected, in the resting equinus position for optimal healing and prev

REBEL Core Cast 115.0 – Cardiogenic Shock

Dec 27th, 2023 27m 33s

Take Home Points: Know clinical (cold extremities, oliguria, confusion, dizziness, narrow pulse pressure) and laboratory markers (metabolic acidosis, elevated creatinine, lactic acidosis) of hypoperfusion. An elevated lactate is a danger sign a

REBEL Core Cast 114.0 – Carbon Monoxide Toxicity

Dec 13th, 2023 12m

Take Home Points: Carbon monoxide is a colorless, odorless, and tasteless gas that results from incomplete combustion of any carbon containing product. Exposure often occur unintentionally from indoor use of gas powered generators, camp stoves,

REBEL Core Cast 113.0 – ACS Therapies and Management

Nov 29th, 2023 24m 20s

Take Home Points: All STEMIs should be loaded with dual antiplatelet therapy. Prasugrel (Effient) is avoided as there is an increase in bleeding complications if the patient requires a CABG. NSTEMI cases can be challenging to manage. Consult Ca

REBEL Core Cast 112.0 – Awareness During Paralysis

Nov 15th, 2023 17m 53s

Take Home Points: Dose your RSI meds correctly. Reach for post-intubation sedation at the same time you are asking for your induction agent and paralytic. Propofol is a great choice for post-intubation sedation, and if your patient becomes h

REBEL Core Cast 111.0 – Cardiac Testing

Oct 25th, 2023 24m 20s

Take Home Points: A CCTA is an anatomic test to determine if a patient has normal coronary arteries, non-obstructive disease, or obstructive disease. The warranty period for a CCTA is anywhere from 3-10 years depending on the characteristics of

REBEL Core Cast 110.0 – On Shift Learning Pearls

Oct 11th, 2023 11m 43s

Take Home Points: Patients with recent onset atrial fibrillation can safely be cardioverted if they are 1) on anticoagulation 2) Low risk based on CHADS-VASC with onset < 48 hours or 3) High risk based on CHADS-VASC with onset < 12 hours. In an

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

Sep 27th, 2023 10m 38s

Take Home Points: In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. A newly “wide QRS”, especially with hemodynamic instability, should prompt consideration of sodium channel blockade and not ventricular tachy

REBEL Core Cast 108.0 – Angioedema

Sep 13th, 2023 10m 28s

Take Home Points: Airway management is paramount; expect a challenging intubation and consider controlling the airway early if there is apparent airway compromise. Understanding the cause of angioedema (mast cell vs. bradykinin mediated) helps

REBEL Core Cast 107.0 – Vertebral Osteomyelitis

Aug 30th, 2023 7m 40s

Take Home Points Clinical presentation is very nonspecific; evaluate all patients presenting with back pain for infectious risk factors. Baseline labs should not guide diagnosis, but may assist in later management. MRI is key to diagnosis, obta

REBEL Core Cast 106.0 – Nerve Block Basics

Aug 16th, 2023 26m 9s

Take Home Points REBEL Core Cast 106.0 – Nerve Block Basics Click here for Direct Download of the Podcast Resources REBEL EM: Local Anesthetic Systemic Toxicity Sono in Staten Blog: https://www.statenislandem.com/sono-in-staten Core Ultrasound:

REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

Aug 7th, 2023 19m 24s

Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation. The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, alte

REBEL Cast Ep121: The Battle of the Blades – Video Laryngoscopy vs. Direct Laryngoscopy

Jul 31st, 2023 26m 40s

Background: The ongoing debate between video laryngoscopy (VL) and direct laryngoscopy (DL) has ignited intense debate within the emergency medicine and critical care communities. A recent pragmatic, randomized, multicenter trial (The DEVICE Tr

REBEL Core Cast 105.0 – Methylxanthine Toxicity

Jul 26th, 2023 9m 42s

Take Home Points Methylxanthines are a drug class that includes caffeine, theophylline, and theobromine. The three main mechanisms that account for the clinical presentation of methylxanthine toxicity are: catecholamine release, adenosine antag

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

Jul 17th, 2023 17m 48s

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. RSI inherently carries with it risks of complications such as post-in