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Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department
by Marco Torres
Feb 02, 2023
Background Information:
Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency De...
Tactical Medicine News
How I Educate Series: Tarlan Hedayati, MD
This week’s How I Educate post features Dr. Tarlan Hedayati, the Chair of Education at Cook County Hospital. Dr. Hedayati spends approximately 90% ...
Tactical Medicine News
Intra-articular Lidocaine vs Procedural Sedation and Analgesia for Closed Reduction of Acute Anterior Shoulder Dislocation
Background: Many clinicians have transitioned from procedural sedation and analgesia (PSA) in favor of intra-articular lidocaine (IAL) to manage an...
Tactical Medicine News
REBEL Core Cast 94.0 – SBO
Take Home Points
SBO should be considered in all patients presenting with abdominal pain particularly if they have a prior abdominal surgical hist...
Tactical Medicine News
Cetirizine Vs Diphenhydramine For the Treatment of Acute Urticaria in the ED
Background: Diphenhydramine, a first-generation antihistamine, is the most common pharmacologic agent used to treat acute allergic reactions. Despi...
Tactical Medicine News
The RAMPP Trial: Randomised Ambulatory Management of Primary Pneumothorax
Background: Primary spontaneous pneumothorax, by definition, occurs without trauma or any underlying lung pathology. Often patients are otherwise ...
Tactical Medicine News
REBEL Core Cast 93.0 – Lithium Toxicity
Take Home Points
Lithium toxicity comes in a three flavors: acute, chronic and acute on chronic. Each form will have a different presentation as w...
Tactical Medicine News
How I Educate Series: Christina Shenvi, MD
This week’s How I Educate post features Dr. Christina Shenvi, the Director of the Office of Academic Excellence and former Associate Residency Dire...
Tactical Medicine News
7d vs 14d of Antibiotics in Afebrile Men with UTI
Background: Urinary tract infection (UTI) is one of the most common reasons for anti-microbial use (Tan, 2016). However, the optimal treatment dura...
Tactical Medicine News
Defibrillation Strategies for Refractory Ventricular Fibrillation
Background Information:
Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). T...
Tactical Medicine News
REBEL Core Cast 92.0 – Perichondritis
Take Home Points
Perichondritis is an infection of the cartilage and connective tissue of the ear
Perichondritis can be recognized clinically b...
Tactical Medicine News
Short Course Antibiotics for Peds CAP: A Systematic Review and Meta-Analysis
Background: There is a shifting paradigm with persuasive evidence favoring a shorter duration of antibiotics for outpatient management of community...
Tactical Medicine News
Pigtail Catheter vs Large Bore Chest Tube for Pneumothorax
Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caus...
Tactical Medicine News
REBEL Core Cast 91.0 – Testicular Torsion
Take Home Points
Consider the diagnosis of testicular torsion in all patients with acute testicular pain
Testicular torsion is a surgical emergenc...
Tactical Medicine News
Andexxa Vs 4F-PCC in ICH: An Ongoing Debate
BACKGROUND: Direct oral anticoagulants (DOACs) such as rivaroxaban [Xarelto] and apixaban [Eliquis] have become more prevalent in the aging populat...
Tactical Medicine News
How I Educate Series: Jessie Werner, MD
This week’s How I Educate post features Dr. Jessie Werner, the Clerkship Director and Medical Education Fellowship Director at UCSF Fresno. Dr. W...
Tactical Medicine News
REBEL Core Cast 90.0 – Methemoglobinemia
Take Home Points
Methemoglobinemia can result from exposure to a number of different medications. The most common are dapsone and topical anesthet...
Tactical Medicine News
SAEM Clinical Images Series: An Enlarging Scalp Mass
A 27-day-old female infant born at 34 weeks 4 days with a prenatal history of maternal syphilis treated with penicillin presented with an enlarging...
Tactical Medicine News
Etomidate Vs. Ketamine: A Systematic Review and Meta-Analysis
Background: Rapid sequence intubation (RSI) induction agent selection remains a heavily debated matter. Etomidate causes adrenal suppression in cri...
Tactical Medicine News
REBEL Core Cast 89.0 – Spontaneous Bacterial Peritonitis
Take Home Points
Spontaneous Bacterial Peritonitis (SBP) is a difficult diagnosis to make because presentations are variable. Consider a diagnosti...
Tactical Medicine News
The LOVIT Trial: Orange Crushed
Background: Vitamin C dissociates to ascorbate at physiological pH and is not organically synthesized by the human body. Vitamin C can function as ...
Tactical Medicine News
REBEL Core Cast 88.0 – Hypocalcemia
Take Home Points
Severe hypocalcemia can cause hypotension and QTc prolongation leading to Torsades de Pointes.
Treat moderate to severe symptom...
Tactical Medicine News
REBEL Core Cast 87.0 – Hypercalcemia
Take Home Points
Patients with severe hypercalcemia (> 14 mg/dL) are at risk for severe cardiac dysrhythmias and cardiac collapse
Treatment cen...
Tactical Medicine News
Less is More . . . Again: Speed of IV Fluid Administration in Pancreatitis (WATERFALL Trial)
Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an ...
Tactical Medicine News
How I Educate Series: John Casey, DO
This week’s How I Educate post features Dr. John Casey, the Program Director at OhioHealth Doctors Hospital in Columbus, OH. Dr. Casey spends 100% ...
Tactical Medicine News
TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding
Background: Thromboelastography (TEG) is a reliable, comprehensive non-invasive hemostatic assay that measures the ability of whole blood to form a...
Tactical Medicine News
Another Piece of Equipment with Racial Bias
Background: Medical equipment that gives clinicians vital signs or other objective information must be reliable across populations as this data dri...
Tactical Medicine News
How I Educate Series: Alex Koyfman, MD
This week’s How I Educate post features Dr. Alex Koyfman, who serves as core faculty at UT Southwestern in Dallas, TX. Dr. Koyfman spends approxima...
Tactical Medicine News
Heads Up! There is No Association with Improved Outcomes for Head Up CPR: Why We Must Read Past the Abstract
Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality C...
Tactical Medicine News
The ADVOR Trial: Acetazolamide in Acute Decompensated Heart Failure
Background: Patients presenting with acute exacerbations of congestive heart failure are frequently treated with intravenous loop diuretics. Despi...
Tactical Medicine News
The REVIVED Trial: PCI in Patients with Severe Ischemic Left Ventricular Systolic Dysfunction?
Background: Coronary artery disease can result in hibernating myocardium (chronic myocardial contractile dysfunction) due to ischemia. The theory ...
Tactical Medicine News
REBEL Cast Ep112: The Pre-AeRATE Trial – HFNC vs NC for RSI
Background: Hypoxemia is a commonly encountered adverse event during rapid sequence intubation (RSI) in the ED. Critically ill patients in the ED ...
Tactical Medicine News
The BOX Trial: BP & O2 Targets in Comatose Survivors of Cardiac Arrest
Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC. While hypoxemia (SpO2 <90%) is clearly deleterious, it is...
Tactical Medicine News
COCA Trial Follow-Up: Calcium vs Placebo on Long-Term Outcomes of OHCA
Background: The Calcium for Out-of-Hospital Cardiac Arrest (COCA) trial was a randomized, placebo-controlled, double-blind trial of calcium compare...
Tactical Medicine News
How I Educate: Dr. Graham Snyder, MD
This week’s How I Educate post features Dr. Graham Snyder, the Associate Program Director at the University of North Carolina and Director of Educa...
Tactical Medicine News
The EvK Trial: Ketamine vs Etomidate for Rapid Sequence Intubation
Background: The use of ketamine and etomidate for induction in rapid sequence intubation is heavily debated. The Ketased Trial (Jabre 2009) reporte...
Tactical Medicine News
Non-Sterile Gloves for Suturing Traumatic Lacerations?
Background: Traumatic lacerations presenting to the emergency department are, by definition, contaminated (ie non-sterile). Standard management in...
Tactical Medicine News
The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis
The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis
James C. Fletcher, MD, FACEP and Nicholas...
Tactical Medicine News
Ep 172 Syncope Simplified with David Carr
In this main episode podcast, Dr. David Carr joins Anton to give us his simplified approach to syncope based solely on history, physical and ECG to...
Tactical Medicine News
VTE Recurrence in Subsegmental PE: What’s the Risk?
Background: The overall mortality and case-fatality rate for pulmonary embolism (PE) are decreasing. Yet reporting is increasing, suggesting we are...
Tactical Medicine News
REBEL Cast Ep111: The PREPARE II Trial – Fluid Bolus Prior to Intubation?
Background: Some of the feared complications of endotracheal intubation include hypotension, cardiac arrest, and death (cardiovascular collapse). ...
Tactical Medicine News
Topical TXA in Atraumatic Anterior Epistaxis Yet Again
Background: The use of topical tranexamic acid (TXA) for anterior epistaxis has been studied in many trials with conflicting results. The largest a...
Tactical Medicine News
REBEL Core Cast 85.0 – Superficial Venous Thrombosis
Take Home Points
SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation.
The rate of concurrent DVT and PE in patients wit...
Tactical Medicine News
Classic Journal Club: TXA for Epistaxis
Background: Epistaxis is a common ailment experienced by millions worldwide. While most of these cases can be managed by patients at home, some wil...
Tactical Medicine News
External Validation of Pittsburgh Cardiac Arrest Category (PCAC) Illness Severity Score
Background Information:
Multiple illness severity scores have been developed for use after out-of-hospital cardiac arrest (OHCA) and in-hospital ca...
Tactical Medicine News
Gun Laws and Mass Shootings: A Call to Action
Background: Rob Elementary. Columbine. Sandy Hook. Pulse Night Club. Tops Grocery Store. Irvine Taiwanese Presbyterian Church. Virginia Beach. The...
Tactical Medicine News
The FIRST-ABC Step Up Trial: HFNC vs CPAP for Liberation of Respiratory Support in Children?
Background: Respiratory support is a common intervention in pediatric ICUs and can include HFNC and CPAP/BPAP to avoid invasive mechanical ventilat...
Tactical Medicine News
REBEL Core Cast 84.0 – AVNRT
Take Home Points
AVNRT is a common tachydysrhythmia that results from a reentrant loop within the AV node.
Unstable patients with AVNRT should be ...
Tactical Medicine News
Damping and Arterial Lines
Damping is the influence within a system that is a dissipation of energy during an oscillation. In other words, think of damping like a shock abso...
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