Shows
REBEL CastREBEL Core Cast 150.0: Emergency Medicine Consults: How to Call a Consult + Handle PushbackIn this episode of Rebel Core Content, Swami breaks down one of the most important (and most underrated) skills in emergency medicine: how to give a clean, effective consult—and what to do when you get pushback. Learn a simple 4-step framework to structure every consult (introduce yourself, lead with the ask, give a focused summary, and close the loop), plus ready-to-use scripts for common scenarios. We also cover how to respond to refusals, keep conversations professional, and escalate appropriately when patient safety or disposition is at risk.
2026-02-1207 minREBEL CastREBEL CAST: The RSI Trial – Ketamine vs Etomidate in Rapid Sequence IntubationREBEL Cast: The RSI Trial — Ketamine vs Etomidate in Critically Ill Adults In this episode, we break down the 2025 NEJM RSI trial comparing ketamine and etomidate for tracheal intubation in critically ill adults (Casey et al., PMID: 41369227). This multicenter randomized trial enrolled 2,365 patients across ED and ICU settings and asked a clinically important question: does ketamine improve 28-day mortality compared with etomidate? What we cover: Primary outcome: no statistically significant difference in 28-day mortality Secondary signal: higher "cardiovascular collapse" with ketamine, largely driven by new/increased vasopressor use, not cl...
2026-02-0829 minREBEL CastREBEL CAST - RENOVATE Trial: HFNC vs BPAP in Acute Respiratory Failure📌 Key Points 💨 HFNC met criteria for non-inferiority to BPAP for preventing intubation or death within 7 days in four of the five ARF subgroups. 🧪 Bayesian dynamic borrowing increased power across subgroups but created variable certainty, especially in smaller groups such as COPD. 🫁 The immunocompromised hypoxemia subgroup did not meet non-inferiority, leading to early trial stopping for futility. ⚖️ Rescue BPAP use, subgroup-specific exclusion criteria, and non-standardized BPAP delivery are important contextual factors that influence how subgroup results should be interpreted. 📝 Introduction Bilevel Positive Airway Pressure (BPAP) has long been a foundational modality in the management of acute respiratory failure (ARF), particularly in COPD exacerbatio...
2026-02-0519 min
REBEL CastREBEL MIND Ep4 – Rest Is Not Sleep: The Seven Dimensions of True Recovery🗝️Key Points Rest isn't a luxury; it's a necessity and differs significantly from sleep in terms of mental and physical recovery needs. Uncovering the seven types of rest can highlight diverse needs: physical, mental, sensory, creative, emotional, social, and spiritual. Rest from high-stress environments such as the ED is crucial for reducing exhaustion, enhancing decision-making, and maintaining empathy. The necessity for intentional rest: tailor your rest strategies to meet personal recharge needs effectively. Rest should be deserved, not earned—it's a vital component of overall health and wellness, on par with nutriti...
2026-02-0420 minREBEL CastREBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia 🗝️ Key Points 💉 Hydrocortisone Saves Lives: The 2023 Cape Cod Trial (NEJM) showed a clear mortality benefit and reduced need for intubation in severe CAP patients treated with hydrocortisone. 📊 Guidelines Are Catching Up: The SCCM (2024) and ERS now recommend steroids for severe CAP, while ATS/IDSA updates are still pending. 🔥 Redefining "Severe": Patients requiring high FiO₂ (>50%), noninvasive or mechanical ventilation, or PSI >130 meet criteria for steroid therapy — even outside the ICU. 🍬 Main Risk = Hyperglycemia: Elevated glucose was the most consistent adverse effect, but rates of GI bleed and secondary infection were not increased. 🧭 Early, Targeted Use Matters: Start hyd...
2026-02-0221 minREBEL CastREBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Sara Crager and Ryan Ernst 📝Introduction Welcome to this special edition of the REBEL Cast, where we unravel key highlights and educational insights from the IncrEMentuM Conference in Spain. This event is a cornerstone for advancing emergency medicine education, drawing esteemed speakers and participants from around the globe. As emergency medicine gains traction in Spain, this conference has become an essential platform for knowledge exchange and professional growth. Today, host Dr. Mark Ramzy shines a spotlight on two phenomenal educators: Drs. Sara Crager and Ryan Ernst who shared their expertise and experiences at this transformative gathering last spring. 🤔What's IncrEMentuM?...
2026-01-2936 min
REBEL CastREBEL MIND Ep3 - Performance Coaching in Medicine📌 Key Points 💪 Building Resilience: Rebel MIND, in partnership with Arena Labs, introduces a science-based performance coaching platform specifically tailored for healthcare professionals, focusing on stress management and burnout prevention. 🤝 Personal Insights: Jackie Penn shares her journey from exercise science to digital coaching, highlighting the importance of tailored coaching in high-pressure environments like healthcare. 🎯 Clinician-Centric Approach: Understanding unique challenges faced by ER doctors, the program provides practical tools for stress and transition management, improving both professional and personal life balance. 💻 Revolutionary Wearables: Utilizing wearables, the program offers objective feedback on recovery and health metrics, allowing personalization of strategies to enhance clin...
2026-01-2830 min
REBEL CastREBEL MIND Ep2: Performance Under Pressure - What Medicine Can Learn from Elite Teams🗝️Key Points 🎯Partnership Focus: New collaboration with Arena Labs aimed at enhancing healthcare worker wellness. 🏃🏽♂️➡️Personalized Coaching: Tools and coaching programs designed for stress management and performance improvement. 📊Data-Driven Insights: Utilizing wearable sensor data to tackle burnout effectively. 🌄Broad Impact: Offers a unique opportunity to contribute to large-scale healthcare improvements. 📝 Introduction Welcome back to Rebel MIND, the podcast series where we dive into crucial aspects of healthcare worker well-being. In this episode, hosted by Mark and Marco, we're excited to introduce a collaboration with Arena Labs. Arena Labs is helping us measure healthcare performance through innovative prog...
2026-01-2139 minREBEL CastREBEL Core Cast 148.0–Demystifying Non-Invasive Ventilation & HiFlow 🗝️ Key Points 💨 NIV = Support without a tube: CPAP, BiPAP, and HFNC improve oxygenation and reduce the work of breathing. 🫁 CPAP = Continuous pressure: Best for hypoxemic patients (e.g., pulmonary edema, OSA). ⚖️ BiPAP = Two pressures (IPAP/EPAP): Great for hypercapnic failure (e.g., COPD, obesity hypoventilation). 🌬️ HFNC = Heated, humidified high flow: Reduces effort, improves comfort, and enhances oxygen delivery. 🩺 Supportive, not definitive: NIV stabilizes patients while the underlying cause is treated. 📝 Introduction Non-invasive ventilation (NIV) refers to respiratory support provided without endotracheal intubation. The most common modalities include continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), and high...
2026-01-1223 min
REBEL CastREBEL MIND: The Dunning Kruger Effect - Why Looking Inward Improves Patient CareWelcome to REBEL MIND—Mastering Internal Negativity during Difficulty. In this series, we turn the same critical lens REBEL EM uses for literature inward—into mindset, leadership, and psychological safety—so we can deliver better care outward to patients and teams. In this episode and blog post, host Mark Ramzy and co-host Kim Bambach (Assistant Professor of Emergency Medicine, The Ohio State University) explore a deceptively simple question: How accurately can we assess our own performance? The answer hinges on a classic cognitive bias that touches all of us in emergency medicine. 🗝️Key Points ...
2026-01-0727 minREBEL CastREBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple📝 Introduction Learn how to interpret PIP, Pplat, PEEP, and driving pressure on the ventilator. Understand lung compliance, VILI prevention, and ARDS ventilation strategies. 🗝️ Key Points 💨 Peak vs. Plateau Pressures: PIP reflects total airway resistance and compliance, while Pplat isolates alveolar compliance—elevations in both suggest decreased lung compliance (e.g., ARDS, pulmonary edema, pneumothorax). 🧱 PEEP Protects Alveoli: Maintains alveolar recruitment and prevents collapse; typical range 5–8 cmH₂O, but higher levels may benefit moderate–severe ARDS. ⚙️ Driving Pressure (ΔP = Pplat − PEEP): Lower ΔP reduces atelectrauma and improves outcomes; optimize by adjusting PEEP thoughtfully. 💥 Prevent VILI: Keep Pplat < 30 cmH₂O, use low ti...
2025-12-2214 minREBEL CastREBEL Core Cast 146.0–Ventilators Part 4: Setting up the VentilatorVentilator management can feel overwhelming—there are so many knobs to turn, numbers to watch, and changes to make. But before adjusting any settings, it's crucial to understand why the patient is in distress in the first place, because the right strategy depends on the underlying cause. In this episode, we'll walk through three different cases to see how the approach changes depending on the problem at hand.
2025-12-0819 minREBEL CastREBEL Core Cast: Pediatric Respiratory Emergencies: Beyond Viral SeasonKey Tips for Managing Pediatric Respiratory Cases In this episode of the Rebel Core Content Podcast, host Swami and PEM specialist Dr. Elise Perlman dive into critical insights for managing respiratory cases in infants, babies, and toddlers during the viral season. They discuss important pearls such as assessing patients from the doorway, localizing respiratory sounds, and differentiating between upper and lower airway obstructions. They also elaborate on managing common conditions like bronchiolitis, asthma exacerbations, and identifying zebras among routine viral cases. The episode provides valuable tips for emergency medical professionals to enhance patient care and avoid missing serious conditions.
2025-12-0420 minREBEL CastREBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley 📝Introduction Welcome to this special edition of the REBEL Cast, where we unravel key highlights and educational insights from the IncrEMentuM Conference in Spain. This event is a cornerstone for advancing emergency medicine education, drawing esteemed speakers and participants from around the globe. As emergency medicine gains traction in Spain, this conference has become an essential platform for knowledge exchange and professional growth. Today, host Dr. Mark Ramzy shines a spotlight on three distinguished speakers: Dr. Jess Mason, Dr. Tarlan Hedayati, and Dr. Simon Carley, who shared their expertise and experiences at this transformative gathering last spring....
2025-11-2020 minREBEL CastREBEL Core Cast 145: Understanding QTc Prolongation: Causes, Risks, and ManagementThe QT interval is a vital part of ECG interpretation, reflecting the heart's electrical recovery after each beat. When prolonged, it can set the stage for torsades de pointes. Understanding how to measure and correct the QT interval, identify high-risk medications, and act quickly when TdP occurs is essential for every clinician. This guide walks you through the physiology, interpretation, common causes, and emergency management of QTc prolongation to keep your patients safe.
2025-11-1814 minREBEL CastREBEL Core Cast 144: Tourniquet TipsIntroduction In this episode of the Rebel Core Content podcast, Swami provides crucial tips on using tourniquets. Highlighting the significance of these life and limb-saving devices, the discussion focuses on the optimal placement of tourniquets, emphasizing placing them 2-3 inches (5-6 cm) above the bleeding source and avoiding joints. Swami also advises on the correct way to tighten the tourniquet using the Velcro strap first, followed by minimal use of the windless. The importance of noting the application time to avoid prolonged arterial flow interruption is also discussed. The episode concludes with a reminder to visit the podcast's website for...
2025-11-0303 minREBEL CastREBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy📝Introduction: In this exciting episode of REBEL Cast, host Dr. Mark Ramzy joins forces with renowned educator and speaker, Dr. George Willis. Broadcasting straight from the ACEP 25 in Salt Lake City, the duo talk about bringing together the international emergency medicine community, as they reflect on their experiences at the Increment Conference in Murcia, Spain, and preview the upcoming event this spring. 🤔What's IncrEMentuM? A new conference and a pivotal gathering for emergency medicine professionals worldwide, has become an essential platform for education, collaboration, and advocacy, especially in light of emergency medicine's recent recogn...
2025-10-2317 min
REBEL CastREBEL Cast - DKA Part 2: Beyond the Basics - The SCOPE-DKA Trial🗝️Key Points 💧 Fluid Choice Matters: Plasma-Lyte, a balanced crystalloid, corrected acidosis faster than normal saline in severe DKA patients, with no increase in adverse events. 🧪 Chloride Load Concerns: Normal saline's high chloride content can worsen acidosis, potentially slowing bicarb recovery even after the anion gap closes. 🔬 Study Design Strengths: The SCOPE-DKA trial was a cluster crossover, open-label RCT, protocolizing all variables except fluid type, enhancing the reliability of its findings. 🧮 Base Excess & Strong Ion Difference: Base excess/deficit and strong ion difference are valuable but underutilized tools for assessing acid-base status—don't rely solely on pH or bicarb. ⚠️ Limitations & Next Step...
2025-10-2115 min
REBEL CastREBEL Cast - DKA Part 1: Beyond the Basics - The SQuID Protocol🔑 Key Points 🛏️ Fewer ICU Admissions Only 5 patients in the SQuID group required ICU care vs 99 in the traditional insulin drip group. ⏱️ Shorter ED Stays ED length of stay dropped by ~3 hours in the SQuID group—an operational win in crowded departments. 💉 No Drop in Nursing Workload Despite using subQ insulin, nurses still performed hourly glucose checks and frequent injections. 🧪 Focus on the Anion Gap DKA resolution = closing the anion gap, not just normalizing blood sugar—critical concept for trainees and nurses alike. 👶 Peds Has the Edge Pediatric ICUs routi...
2025-10-0615 minREBEL CastREBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator 🗝️ Key Points ❌ Don't chase perfect numbers: Adequate and safe is often better than "perfect but harmful." 💨 Oxygenation levers: Start with FiO₂ and PEEP, but remember MAP is the true driver. 🫁 Ventilation levers: Adjust RR and TV, tailored to underlying physiology. 🚫 Watch your obstructive patients: Sometimes less RR is more. 📝 Introduction When you take the airway, you take the wheel and you now control the patient's oxygenation and ventilation. In this REBEL Crit episode, Dr. Lodeserto and Dr. Acker walk through the physiology, ventilator strategies, and clinical curveballs that separate calm control from chaos at the bedside.
2025-10-0212 minREBEL CastREBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes 🗝️ Key Points 💨 Start with Breath Types: Controlled, assisted, and supported breaths are the foundation of all modes. 🛌 Comfort Over "Best Mode": No mode improves mortality — focus on patient synchrony and comfort. ✅ Know the Big 5 Modes: AC: All controlled or assisted (volume or pressure). PS: Fully spontaneous, great for SBTs. PRVC: Pressure-delivered, volume-targeted hybrid. SIMV: Mixed mode, less favored in adults. VS: Spontaneous mode with adaptive pressure. ⚠️ Watch for Pitfalls: PRVC may under-ventilate in agitation. SIMV often causes dyssynchrony. 🎯 Bottom Line: Master mode mechanics and match the vent to the patient — not the other way around. 📝 Introduction Mechanical ventilation ca...
2025-09-2220 minREBEL CastIncrementum Conference 2026: Revolutionizing Emergency Medicine in Spain ⏰ Highlights 00:00 Introduction to Rebel Cast 00:10 Highlighting the Incrementum Conference 2026 00:34 Meet the Founders of Incrementum 01:21 The Journey to Incrementum 04:27 The Recognition of Emergency Medicine in Spain 06:04 What is Incrementum? 08:14 Bringing Together Top Emergency Medicine Experts 11:38 Exciting Sessions to Look Forward To 15:54 Conclusion and Invitation to Increment 2026 📝 Introduction In this special episode of Rebel Cast, we spotlight the Incrementum Conference in Spain, a significant event in emergency medicine. Hosts welcome Dr. Francisco 'Paco' Campillo Palma and Dr. Carmen Maria Cano, founders of Incrementum, to discuss the recognition of emergency medicine as a specialty in Spain. They share their jour...
2025-09-1818 minREBEL CastREBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of BreathesKey Points: 💨 Master the 3 Types of Breaths Control, Assist, and Spontaneous — know the difference before tackling ventilator modes. 📦 Breath Delivery: Volume vs. Pressure Volume-Targeted = fixed volume → monitor pressure 📈 Pressure-Targeted = fixed pressure → monitor volume 🫁 Lung Compliance = Pressure-Volume Relationship Volume mode: ↑ pressure = ↓ compliance (stiff lungs) Pressure mode: ↓ tidal volume = ↓ compliance 🏋️♂️ Use Analogies to Simplify The pull-up analogy makes complex concepts easier to grasp and remember. 🧱 Build the Foundation First Before diving into complex ventilator modes, get solid on breath types, delivery methods, and lung mechanics. Introduction: For many medical residents, the ICU can feel like stepping into a pressu...
2025-09-1511 minREBEL CastREBEL Core Cast 140: The Power and Limitations of Intraosseous Lines in Emergency MedicineLimitations of IO access include: Placing an IO in a bone with a proximal fracture, a previous IO placement attempt or any circulatory compromise proximal to the site is contraindicated Blood work drawn from an IO are generally not accurate, so once the patient has been resuscitated with the IO, intravenous blood draws are recommended Dislodgement is common; it is best to use the stabilizer that comes with the IO kit; if the kit does not have a stabilizer, stack lots of gauze on both sides of the IO needle and tape it down Best site for IO? While proximal...
2025-09-0115 minREBEL CastREBEL Core Cast 139.0: Pneumothorax Decompression Show Notes: On this episode of the Rebel Cast, Swami takes a deep dive into pneumothorax decompression, focusing on the need for improvements beyond the classic teachings. Covering scenarios where immediate decompression is critical, particularly in tension pneumothorax, Swami discusses the limitations of needle decompression, especially in the second intercostal space at the midclavicular line. He highlights the importance of using POCUS for diagnosis and recommends skipping needle decompression in favor of finger thoracostomy for a more reliable and effective treatment. Key takeaways emphasize recognizing tension pneumothorax in various clinical situations and the advantages of finger thoracostomy over traditional techniques.
2025-08-1804 minREBEL CastREBEL Core Cast 138.0: A Simple Bedside Approach to Shock In this episode, we will dive into a simple yet effective bedside approach to a patient in shock. By using quick physical exam findings and bedside vitals (particularly pulse pressure), you can form a quick assessment of the likely underlying etiology of a critically ill patient.
2025-08-0420 minREBEL CastREBEL Core Cast 137.0: A Simple Approach to Sinus TachycardiaSinus tachycardia is the most prevalent cardiac dysrhythmia in critically ill patients, yet it often receives less attention than it warrants. While the rhythm itself is not inherently dangerous, it serves as a crucial indicator of underlying physiological disturbances that require prompt evaluation and management.
2025-07-2117 minREBEL CastREBEL Core Cast 136.0: A Simple Approach to the Tachypneic PatientIn this episode, we focus on the bedside evaluation of the tachypneic patient. Tachypnea (increased respiratory rate) can be an early indicator of serious illness, but not every tachypneic patient is on the verge of arrest. The key is honing your bedside assessment to recognize who is at risk for rapid deterioration and why. We break down a practical approach you can use immediately at the bedside.
2025-07-0715 minREBEL CastREBEL Core Cast 135.0: A Simple Approach to Hypoxemia (vs. Hypoxia)In this episode, we break down a practical bedside approach to hypoxemia. We clarify the difference between hypoxemia (low oxygen in the blood) and hypoxia (low oxygen at the tissue level), and walk through the major causes of hypoxemia that you need to recognize quickly at the bedside.
2025-06-1619 min
REBEL CastREBEL Core Cast 134.0 - Acetaminophen ToxicityAcetaminophen (APAP) overdose remains one of the most common causes of acute liver failure in the United States. While its therapeutic use is widespread and generally safe, unintentional overdoses and delayed presentations can lead to devastating outcomes. In this episode of REBEL Cast, Swami breaks down the pathophysiology, clinical course, diagnostic approach, and evidence-based management of APAP toxicity—including when to initiate NAC, how to apply the Rumack-Matthew nomogram, and the evolving role of adjunctive therapies like fomepizole. Whether you're in the ED or elsewhere , this is core content every clinician should know.
2025-06-0218 minREBEL CastREBEL Cast - Street Medicine: Compassionate Care for the Unhoused In this episode of Rebel Cast, host Marco Propersi, along with co-hosts Steve Hochman and Kim Baldino, delve into the practice and importance of street medicine—the direct delivery of healthcare to homeless and unsheltered individuals. Special guests Dr. Jim O'Connell, a pioneer of street medicine, and Dr. Ed Egan, a recent street medicine fellowship graduate, share their experiences and insights on serving this vulnerable population. They discuss the origins, scope, and challenges of street medicine, the ethical dilemmas faced, and the profound impact of building trust and community with patients. The conversation underscores the necessity of integrating street medicine wi...
2025-04-0255 minREBEL CastREBEL Cast - Is Pip-Tazo Harming Sepsis Patients? In this episode of RebelCast, host Dr. Marco Propersi and guest Dr. Lynnsey Moss discuss the comparative study of piperacillin-tazobactam versus cefepime in the treatment of undifferentiated sepsis. They discuss a recent retrospective cohort study which examines 90-day mortality rates is sepsis patients treated with these antibiotics. The researchers explore the role of anti-anaerobic coverage and its potential for disrupting the gut microbiome. Key points discussed include the method of instrumental variable analysis, the validity of study findings, and a comparison with the ACORN trial. The episode concludes with a cautious stance on changing clinical practice based on these findings. 00:00 I...
2025-01-1418 min
2024-12-1806 min
REBEL CastREBEL Cast - A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI DetectionIn this episode of Rebelcast, hosts Dr. Marco Propersi and Dr. Joe Bove discuss the Queen of Hearts, a groundbreaking AI tool changing the game in EKG interpretation for detecting occlusive myocardial infarctions. Joined by experts Dr. Pendell Meyers and Dr. Steve Smith, they delve into the nuances of OMI classification and highlight the advanced capabilities of this AI model. The conversation covers the development, validation, and implementation of the Queen of Hearts AI model, its potential impact on emergency medicine, and its future implications for medical education and practice.
2024-12-0844 min
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REBEL CastREBEL Core Cast 128.0 - Toxic AlcoholsWe're back with our in house toxicologist Dr. Sanjay Mohan chatting about toxic alcohol ingestin.
2024-10-0216 min
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2024-07-2427 min
REBEL CastREBEL Core Cast 126.0 - Peds Hem Onc EmergenciesThis week we're featuring a cross post from the Only in Staten podcast on peds hem onc emergencies.
2024-07-1024 min
2024-06-2607 min
REBEL CastREBEL Core Cast 124.0 - Hyperinsulinemia Euglycemia TherapyThis week we sit down with our in house toxicologist Dr. Sanjay Mohan to chat about HIET.
2024-06-1214 min
2024-06-0618 min
REBEL CastREBEL Cast 128: The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver in re-establishing normal sinus rhythm in patients with Paroxysmal SVT. MVM exaggerates venous return to the heart and increases vagal outflow by elevating the patient's legs. However, the success rate of the MVM is still significantly lower than that of intravenous adenosine, the first-line pharmacological therapy for treating PSVT, which establishes NSR by transiently slowing electrical conduction through the AV node. Given that these two treatment options operate via different physiologic mechanisms, could MVM and IV adenosine be c...
2024-05-3107 min
REBEL CastREBEL Core Cast 123.0 - Posterior EpistaxisThis week we discuss the management of posterior epistaxis.
2024-05-2906 min
2024-05-1508 min
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REBEL CastREBEL Core Cast 121.0 - Acute SinusitisThis week, we discuss acute sinusitis and identifying patients who will benefit from antibiotics.
2024-05-0105 min
REBEL CastREBEL Cast Ep127: From Debate to Data: Emerging Insights into RSI Induction with Ketamine vs EtomidateResuscitationists have debated the choice of induction agents in rapid sequence intubation (RSI) for decades. Critics of etomidate will highlight its link to adrenal suppression in critically ill patients (Albert 2011), while critics of ketamine will highlight the higher incidence of post-intubation hypotension (Mohr 2020). Amidst the debate, the Ketased Trial (Jabre 2009), a large multicenter prospective, single-blind randomized clinical trial (RCT), reported no significant difference in SOFA scores or 28-day mortality between the two induction agents. However, the EvK trial (Matchett 2022) identified a statistically significant difference in 7-day mortality but not 28-day mortality in favor of ketamine. However, methodological concerns from...
2024-04-1809 minREBEL CastREBEL Book Club - MicroSkillsSwami sits down with Emergency Physicians and the authors of the soon to be released book MicroSkills Drs. Adaira Landy and Resa Lewiss.
2024-04-0939 min
REBEL CastREBEL Cast - EMTALA + Reproductive HealthSwami sits down with Drs. Dara Kass and Monica Saxena to discuss the EMTALA law and current challenges in the area of reproductive health.
2024-04-0334 min
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2024-03-2010 min
REBEL CastREBEL Reflections Episode 5: Thinking in BetsAnnie 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 f...
2024-03-1335 min
REBEL CastREBEL Core Cast 119.0 - Sleep HygieneSwami chats with Brendan Freeman, Emergency doc and medical education fellow at Staten Island University Hospital about improving our sleep hygiene.
2024-03-0620 min
REBEL CastREBEL Cast Ep125: Short vs Standard Abx in Pedi UTIs (The SCOUT Trial)There is a shifting paradigm towards shorter durations of antibiotics in pediatric infections. Conflicting international guidelines recommend treatment of urinary tract infection (UTI) with antibiotic courses ranging from just 3 days to 7–14 days. Antimicrobial resistance is a global health crisis, underscoring the importance of antibiotic stewardship. Investigators in the SCOUT Trial examine the impact of short-course (5 day) antibiotic therapy in UTI, with potentially far reaching implications. https://rebelem.com/pediatric-utis-short-course-vs-standard-course-antibiotics-is-it-time-for-a-change/
2024-03-0419 min
REBEL CastREBEL Cast Ep126: Corticosteroids in Severe Community Acquired Pneumonia (The CAPE COD Trial)Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. Corticosteroids have excellent anti-inflammatory and immunomodulatory effects that could mitigate some of the inflammation caused by pneumonia. There have been several randomized trials that have shown glucocorticoids have positive effects in patients with CAP. However, except for one trial, none showed a between-group difference regarding mortality. We now have the Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial. https://rebelem.com/corticosteroids-in-severe-community-acquired-pneumonia-could-cape-cod-catalyze-a-change-in-critical-care-management/
2024-03-0422 min
2024-02-2812 min
REBEL CastREBEL Core Cast 118.0 - IM vs PO NSAIDsShould we give oral ibuprofen or intramuscular ketorolac in the ED in patients who can take PO?
2024-02-2104 min
REBEL CastREBEL Core Cast 117.0 - Infections of PregnancyThis week we discuss some of the serious infectious processes of pregnancy.
2024-02-0705 min
REBEL CastREBEL Core Cast 116.0 - Achilles Tendon RuptureThis week we discuss the diagnosis and management of Achilles tendon ruptures.
2024-01-2405 min
2024-01-1928 min
REBEL CastREBEL Core Cast 115.0 - Cardiogenic ShockThis week we once again borrow audio from the Only in Staten Podcast and feature a discussion on cardiogenic shock with the director of the CCU at SIUH, Dr. Martin Amor.
2023-12-2727 min
REBEL CastREBEL Core Cast 114.0 - Carbon Monoxide ToxicityWe've got toxicologist Dr. Sanjay Mohan back on to chat about carbon monoxide toxicity in the ED.
2023-12-1312 min
REBEL CastREBEL Core Cast 113.0 - ACS Therapies + ManagementThis week, Swami sits down with director of the Staten Island University Hospital cardiac catheterization lab, Dr. Ruben Kandov, to discuss ACS management.
2023-11-2923 min
REBEL CastREBEL Core Cast 112.0 - Awareness During ParalysisThis week we chat with Dr. Danielle Langan, MedEd Fellow and Attending at Staten Island University Hospital, about awareness during paralysis post-RSI.
2023-11-1517 min
REBEL CastREBEL Reflections Episode 4: The Rise of SupermanSimply put, flow is the peak of human performance, maximum focus with maximum responsiveness, an optimal state of consciousness. This state of mind is accessible to anyone under the right circumstances and has huge implications to how we live, work and train. In this podcast episode, three Emergency Medicine Physicians, Drs. Marco Propersi, Dan Wolf and Will Smith, discuss flow in relation to working in the ED, how it intersects with medical training, on shift performance and even in daily life outside the hospital. Does the high stakes life or death environment in the ED allow us...
2023-11-0133 min
REBEL CastREBEL Core Cast 111.0 - Cardiac TestingFrom the Only in Staten Podcast - Swami sits down with cardiologist Dr. Samantha Lee to chat about cardiac testing.
2023-10-2524 min
REBEL CastREBEL Core Cast 110.0 - On Shift Learning PearlsThis week, Swami shares some pearls from a recent critical care shift.
2023-10-1111 min
REBEL CastREBEL Core Cast 109.0 - Na Channel Blocker PoisoningToxicologist Sanjay Mohan is back to discuss sodium channel blocker poisoning management.
2023-09-2710 min
2023-09-1310 min
REBEL CastREBEL Core Cast 107.0 - Vertebral OsteomyelitisThis week we chat about an uncommon, but potentially lethal, cause of back pain.
2023-08-3007 min
REBEL CastREBEL Core Cast 106.0 - Nerve Block BasicsThis week we sit down with Dr. Billy Caputo, Associate Professor of EM and residency director at SIUH to chat about nerve blocks.
2023-08-1626 min
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REBEL CastREBEL Core Cast 105.0 - Methylxanthine ToxicityToxicologist and ED doc Sanjay Mohan is back talking methylxanthines.
2023-07-2609 min
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2023-06-1533 min
REBEL CastREBEL Cast Ep 118 – The PROCOAG Trial - 4 Factor PCC in Trauma Patients at Risk for Massive Transfusion Protocol
2023-06-1316 min
REBEL CastREBEL Core Cast 103.0 - Caustic IngestionThis week, we chat with toxicologist Sanjay Mohan about caustic ingestions.
2023-06-0712 min
REBEL CastREBEL Core Cast 102.0 - Burn ManagementThis week, Swami sits down with Dr. Mike Cooper, Director of the Staten Island University Hospital Burn Center, to talk emergency burn management.
2023-05-2427 min
REBEL CastREBEL Core Cast 101.0 - Imaging in Renal ColicThis week, we discuss the indications for imaging in renal colic.
2023-05-1007 min
2023-05-1022 min
REBEL CastREBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension
2023-05-0420 min
REBEL CastREBEL Core Cast 100.0 - Alcoholic KetoacidosisThis week, Swami sits down with EM doc and toxicologist Sanjay Mohan to chat about alcoholic ketoacidosis.
2023-04-2607 min
REBEL CastREBEL Core Cast 99.0 - Bundle Branch BlocksThis week we discuss RBBB, LBBB as well as LPFB and LAFB.
2023-04-0505 min
REBEL CastREBEL Core Cast 98.0 - AVNRTThis week we chat about AVNRT - diagnosis, management and why we shouldn't be getting troponins on the vast majority of cases.
2023-03-2212 min
REBEL CastREBEL Core Cast 98.0 - Acute Vision Loss IISwami explores some common causes of non-traumatic, acute, monocular vision loss including retinal detachment and CRAO.
2023-03-0807 min2023-03-0214 min2023-03-0117 min2023-02-2819 min
REBEL CastREBEL Core Cast 96.0 - Acute Vision Loss ISwami explores some common causes of non-traumatic, acute, monocular vision loss including glaucoma and giant cell arteritis.
2023-02-2209 min
2023-02-0807 min
2023-01-2512 min
REBEL CastREBEL Core Cast 93.0 - Lithium ToxicityThis week, Swami sits down with Dr. Danielle Langan to chat about lithium toxicity.
2023-01-1112 min
2022-12-1403 min
REBEL CastREBEL Core Cast 91.0 - Testicular TorsionThis week we discuss testicular torsion focusing on some pearls and pitfalls.
2022-11-3008 min