R.E.B.E.L. EM stands for Rational Evidence Based Evaluation of Literature in Emergency Medicine. We cover a myriad of topics, primarily focusing on evidence-based clinical topics. The mission of REBEL EM is to cut down knowledge translation of research to clinical application (Bench to Bedside).
cool! now explain what this means! thanks! i do not know how to read medical!! i dont know what these terms are! i am not trying to study to become a doctor, can ANYONE explain this in laymans terms? that would be so epic@!!!
@@SalimRezaie thank you!!! i appreciate you answering me!! i was trying to google it for like half an hour last night and all i found was articles written in medical talk and i just couldn't figure out EXACTLY what it all meant. i could infer that something was wrong with how my heart pumps, but not specifically what/how. thanks again! i have an appointment for an echo in 2 weeks.
A quick question. LITFL shows the 3rd criteria is discordant STE >25% (ST/S Ration). Example A shown at 1:25 & 6:15 shows discordant STD that is at 40%. Are we supposed to be including BOTH discordant elevation / depression to the 3rd criteria, or only discordant elevation?
Bro I am 23 year old with no kidney ,bp problems.I had taken Ct with contrast 3 years before Now only I got to know about the iodine contrast.Does the little bit of iodine contrast stay in my body and cause health issues in future orelse that contrast will be completely excreted.kindly answer this Because some of the viruses stay inactive for long time and cause health issue in future.Lyk that the iodine contrast cause reaction or not??
I’ve seen patients tolerate better with a minimum deltaP 8/4 or 9/5 on bipap with high RR and adjusting inspiratory time to assure 1:2- 1:3.6 to prevent more air trapping since Bronchospasm patients will feel overwhelmed with to much inspiratory pressure Delta P. I seen it allow them to take smaller volumes similar with 4ml/kg IBW without getting to high on the PIP to prevent ARDS
I don't know what's this episode all about but I just wanted to have a rant of my own. What I like about you is that you don't claim to be a critical care specialist. This title is being used so loosely by so many people I called the American border medical specialties and I look into it myself there is no such thing as resuscitationist and there is no boards dedicated to it. The American board of medical specialty does not recognize this title but yet so many people due two or three years of something and claim to be critical care specialist Furthermore if I hear that word EVHMO One more time I am going to choke somebody. The bone to pick with you Salim you and the others I don't think you all see children none of your materials has to do anything as much as removing peanuts from a kid's nose. Academic medicine is for weak people
@@SalimRezaie Honestly All I hear from these guys is this crap of ECMO Imagine a kid come in no IV Circling the drain Parents around Anaphylactic shark, Crashing asthmatic Refractory epilepsy Diabetical acidosis crashing Pediatric success Not a word from anyone but ECMO For the 100,000 times how to use the laryngoscope VL versus direct laryngoscopy Ecmo conference Truly nauseating
@@SalimRezaie I'm telling you Celine as many as these sites exist none of them tell you how to deal with the staticus asthmaticus or status epilepticus diesel some dangerous situations try that on a 3-year-old I have dealt with few of these academic medicine is for the weak I spent 8 years during the Iran Iraq war as a field surgeon now this is what I do in the rural community if I hear that word ECMO one more time I'm going to choke Winegart
The way you describe is my preferred way, however there have been national shortages of the 1:10000 epi ampules, so several places have had to figure out another solution to work around this issue which is the intention behind this video. Hope that helps
Knowledge is power. If pharmacy hasn't already done this knowing there is a national shortage. Job reviews need to be had. Stay ready and you never have to get ready. It's crazy how many ED nurses don't know this. On the truck, I'd have it premade but typically it's done for me.
Can I aske you I am allways in Hosptial in lot pain I am only 40kg and 32 and I have been on morphine for years I have 7.5 to 10 mills off sun cut or some times iv then go home on codeine so how many mills off codeine do I have take to make up for what I get in hospital so example say I take 7.5 sub cut morphine 4 to 6 times a day then I get home on codeine 30mg how many mill off codeine makes up for 7.5 morphine ? Thanks if u get back to me
Jimmy this is a great question…theoretically this could be a problem but a few things to think about here: 1. Antiarrhythmic drugs have not proven to significantly improve overall survival with good neurological outcomes after out-of-hospital cardiac arrest (OHCA) regardless of route 2. Study in Circulation from 2021 pubmed.ncbi.nlm.nih.gov/31941354/ - No significant effect by drug administration route (IV or IO) for Amiodarone or lidocaine in comparison to placebo during adult OHCA 3. My Opinion: Focus on what matters - High quality CPR, limiting interruptions, defibrillation where appropriate all of which if done well have a much better chance of improving survival with neurological outcomes
I am a patient who on multiple occasions have been awake but paralyzed due to inexperienced doctors and also due to roc being used without proper sedation medications. It is terrifying and you feel like you’re in your coffin. Lifetime of ptsd from it
Had 3 ambulances called to my facility in the course of 2 hours after that word was said. Then phones started ringing off the hook. I still flinch when I hear that word, even when I'm off the clock.
Simply there are more harms than benefits with tramadol for all the reasons listed…yes all medications can be harmful…but the mechanism of action of this medication makes it very unpredictable from person to person
it's a very important question here in Brazil, the majority of EDs don't have any blood products, so, how do you keep your patient alive untill he reaches the surgical center at another hospital? I take we know that 2L of cristalloids is worse than 1L and we don't know if any cristalloid is good, but thinking about a minimum preload, thinking about Frank-Starling and so... we titerate cristalloids and then what is less harmful? starting pressors of giving more cristalloids? i think it's a though call and we should study more, as we won't have blood everywhere in any near future
Agreed...I think vasopressor over crystalloid IMHO...I also work at some centers where blood not available...vasopressors a bridge to buy time until transfer to appropriate facility...we have enough evidence that too much crystalloid is harmful in these patients
Anesthesia & Analgesia 135(6):p 1245-1252, December 2022. | DOI: 10.1213/ANE.0000000000005949, release an article stating: phenylephrine should be used first before norepinephrine if the cause of hypotension is severe TBI.
Hey doc, love the commentary on this one. Thoughts on using a humoral IO for Adenosine rapid push on SVT? For those symptomatic patients who are difficult to cannulate but aren’t unstable enough to sync cardiovert, I’ve always wondered how successful it would be or if it’s ever been attempted. Had this patient not too long ago, best i could get was a 22g on the bicep. Have a good one!
Appreciate...in my mind the algorithm for SVT is... 1. HD Unstable = Electrical Cardioversion 2. HD Stable = Modified Valsalva Maneuver x2 --> CCB/BB --> Adenosine Last Resort Adenosine is such a time sensitive medication that you really need good access that is proximal for it to work. In awake patients Humeral IO is simply not fair in that it is painful. Finally ask anyone who has gotten adenosine and they will tell you that they felt like they were going to die as we are literally stopping their heart. For all these reasons adenosine has fallen way back in my algorithm of managing HD stable SVT...My two cents for what it's worth.
Plus you're trying to get access to a shut down circulation making it much more difficult. Yout IO access is not going to go flat and dissappear on you 🤷♂️
Not sure I understand your point...question one is pre-test probability...if the probability is low then you are considering another diagnosis (i.e. you are not worried about DVT)...if the probability is moderate to high then you are obligated to rule out DVT with an ultrasound.
That is a question for the authors…however they have already performed a dose finding study -> rebelem.com/the-ketaban-trial-nebulized-ketamine-for-analgesia-in-the-ed/
