Background information: Buprenorphine and buprenorphine-containing medications are being used in emergency departments for treatment of patients with opioid use disorder (1). Buprenorphine is a high-affinity partial agonist of the μ-opioid receptor. Buprenorphine has a higher affinity for the μ-opioid receptor than full agonists such as heroin, oxycodone, fentanyl, and methadone. Thus, if a patient is ... Read more
More episodes from "REBEL Cast"
REBEL Core Cast 72.0 – Lung US
21:32Take Home Points: Lung ultrasound is simple, quick and accurate for real time, bedside assessment of your patient with acute undifferentiated dyspnea PTX: least dependent area, shallow depth, lung sliding, lung point CHF: scan across the 4 zones of the chest, look for B lines Bringing this to the bedside can give you diagnostic closure ... Read more The post REBEL Core Cast 72.0 – Lung US appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Cast Ep106: The COCA Trial – Calcium in Cardiac Arrest
14:00Background: The utility of pharmacological interventions for patients with OHCA are rather limited with no robust evidence that they improve outcomes. Calcium, one of the pharmacological options has both inotropic and vasopressor effects. Additionally, calcium plays an important role in the management of hyperkalemia which is a significant cause of cardiac arrest. There have been ... Read more The post REBEL Cast Ep106: The COCA Trial – Calcium in Cardiac Arrest appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Cast Ep 105: Thrombolysis Before Endovascular Therapy for LVO Acute Ischemic Stroke
22:19In this episode of REBEL Cast, Anand Swaminathan and I sit down to discuss the utility of thrombolysis prior to Endovascular therapy for LVO acute ischemic stroke. The discussion is broken up into two potential scenarios: Not all facilities are comprehensive stroke centers In comprehensive stroke center, time from door to groin puncture will be ... Read more The post REBEL Cast Ep 105: Thrombolysis Before Endovascular Therapy for LVO Acute Ischemic Stroke appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Core Cast 71.0 – Troubleshooting the Vent
16:00Take Home Points: DOPES is not just a memory tool. It give you a structured approach to taking care of vented patients with vital sign changes. Check for dislodgement of the tube, obstruction of the tube, pneumothorax, equipment failure, breath stacking and dyssynchrony. Don’t forget that the patient can have more than one issue; always ... Read more The post REBEL Core Cast 71.0 – Troubleshooting the Vent appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Core Cast 70.0 – Open Fractures
7:00Take Home Points: Prioritize ABCs and systematic evaluation of the trauma patient with an open fracture as one third of these patients have multiple injuries Assess neurovascular status and immediately reduce and immobilize if compromised Give appropriate antibiotics as soon as possible Consult orthopedics for operative management as soon as possible REBEL Core Cast 70.0 ... Read more The post REBEL Core Cast 70.0 – Open Fractures appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Crit Cast Ep5.0 – Conquering Congenital Cardiac Lesions
15:29There are generally 3 main congenital heart diseases presentations that young children between ages of 0 days to about 3 months will present with. Often times you will see experts split these congenital heart lesions into 2 categories: Cyanotic vs Acyanotic lesions. Either is an acceptable approach as long as you split the acyanotic lesions ... Read more The post REBEL Crit Cast Ep5.0 – Conquering Congenital Cardiac Lesions appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Cast Ep104: VAM-IHCA – Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest
13:07Background: Two prior trials compared the addition of vasopressin 20 IU (for each dose of epinephrine) and methylprednisolone 40mg to placebo for in hospital cardiac arrest. The 1st trial was published in 2009  and the second in 2013 . In the 2009 study, the combination of vasopressin-epinephrine and methylprednisolone improved survival. In the 2013 ... Read more The post REBEL Cast Ep104: VAM-IHCA – Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Core Cast 69.0 – Epiglottitis
10:05Take home points: Epiglottitis has demonstrated a resurgence in the adult population. It is no longer a pediatric only disease. The classic presentation of epiglottitis (3Ds of drooling, dysphagia and distress) is uncommon Epiglottitis should be high on your differential for the bounce-back patient who continues to complain of worsening sore throat Definitive diagnosis is ... Read more The post REBEL Core Cast 69.0 – Epiglottitis appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Cast Ep103: Outpatient COVID-19 Therapy
32:04I was fortunate enough to record a podcast on Rob Orman’s, Stimulus podcast on Oct 14th, 2021. We both felt it was an important enough topic that we should post it on both his and my site. The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing. In this podcast ... Read more The post REBEL Cast Ep103: Outpatient COVID-19 Therapy appeared first on REBEL EM - Emergency Medicine Blog.
REBEL Core Cast 68.0 – Pericarditis
8:47Take-Home Points Always consider STEMI as the diagnosis prior to diagnosing pericarditis. If the EKG shows convex ST elevations, reciprocal ST depressions, or dynamic changes, the patient is much more likely to have a STEMI. Patients with pericarditis should be treated with a combination of NSAID/Aspirin and Colchicine Patients with large pericardial effusions, tachycardia out ... Read more The post REBEL Core Cast 68.0 – Pericarditis appeared first on REBEL EM - Emergency Medicine Blog.