The Blog

Thanks for dropping by! We have curated an incredible collection of the best articles from the leading Emergency Medicine, Tactical Medicine, Prehospitial Medicine, Austere & Remote Medicine authors, as well as Survival Medicine gurus and many others!

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Tactical Medicine News

The ED-AWARENESS Study: Awareness with Paralysis

by Marco Torres
Jun 30, 2022
‘He remembered waking up with someone pulling very hard on his injured leg, which caused severe pain. He thinks he was in the ED. The patient said ...
Tactical Medicine News

Antibiotics in COPD Exacerbations – 2 days vs 7 days

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are commonly seen in the ED. AECOPD is characterized by a change ...
Tactical Medicine News

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of ...
Tactical Medicine News

REBEL Core Cast 83.0 – Post-LP Headache

Take Home Points Post dural-puncture headache affects up to 30% of patients after lumbar puncture. Suspect PDPH in all patients who recently under...
Tactical Medicine News

REBEL Cast Ep110: The COVI-PRONE Trial – Awake Prone Positioning and COVID-19

Background: Early in the COVID-19 pandemic, clinicians were looking for practical, widely available, and low-cost interventions to help patients wi...
Tactical Medicine News

Tenecteplase vs Alteplase in Acute Ischemic Stroke

Background: At my shop we have changed wholesale to the use of tenecteplase over alteplase for acute ischemic stroke meeting criteria for thromboly...
Tactical Medicine News

EPIC Trial: Electrode Positioning in Cardioverting Atrial Fibrillation

Background Information: Electrical cardioversion of atrial fibrillation is regularly performed by emergency physicians, intensivists, and cardiolog...
Tactical Medicine News

Traumatic Hemothorax: Pigtail vs Chest Tube

Background: Optimal management of pneumothorax and hemothorax with chest thoracostomy has been widely debated over the last decade.  We no longer ...
Tactical Medicine News

REBEL Core Cast 82.0 – Abdominal Aortic Aneurysm

Take Home Points Consider AAA in patients with acute onset of back or abdominal pain particularly in patients > 50 and in those with a history ...
Tactical Medicine News

Impella Devices 101

Now that I am working up in the ICU, one of the devices that I am frequently coming across is the Impella device.  This is not something we get muc...
Tactical Medicine News

The Dirty Epi Drip and IV Flow Rates

Recently, I put out a video on the dirty epi drip (YouTube and TikTok) and in that video I discuss the use of this modality when in a pinch (i.e. c...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Mega Summary – Part 2

Take Home Points Emergency medicine revolves around the differential diagnosis History and physical exam should significantly narrow your differen...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Mega Summary – Part 1

Take Home Points Emergency medicine revolves around the differential diagnosis History and physical exam should significantly narrow your differen...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Syncope

Take Home Points Break the differentials down into bad & painless, bad & painful, and other causes – WOMAN-PE Cardiac causes – mechanical ...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Weakness

Take Home Points Be prepared to do everything with these cases, if they can’t provide information, dive into their medication list, history, conta...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Dizziness

Take Home Points Key point is to discern between central and peripheral causes – become familiar with the nuances of one and concentrate on that A...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Rash

Take Home Points Examine all parts of the body, even inside the mouth – this can be the difference between benign and life threatening rashes Trul...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Fever

Take Home Points Look for the red flags – hypotension, environmental exposures, medications (SS, NMS), SIRS/qSOFA criteria Be on the lookout for n...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Ankle and Foot Injuries

Take Home Points Sprains need more support than just an ace wrap – place them in an aircast or a splint Perform a thorough physical exam – take of...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Leg Pain

Take Home Points Approach leg pain with the seconds, minutes, hours mindset – think about acute limb ischemia, compartment syndrome, and necrotizi...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Lacerations

Take Home Points Don’t make bite width to small – look at the curvature of the needle – start the bite at half the curvature of the needle Don’t p...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Back Pain

Take Home Points Ask about the red flags: cancer, fever, IVDA, FND, point tenderness, saddle/perianal anesthesia, trauma, urinary retention, bowel...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Vaginal Bleeding

Take Home Points Get a upreg on any childbearing age female with vaginal bleeding – this is an ectopic pregnancy until proven otherwise Confirm va...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Lower Abdominal Pain

Take Home Points Get a upreg on every female patient of child bearing age with lower abdominal pain – this is an ectopic pregnancy until proven ot...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Diffuse and Flank Abdominal Pain

Take Home Points Diffuse abdominal pain can be anything – keep a broad differential and work from there Old patient and flank pain = aortic catast...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Epigastric Pain

Take Home Points Patients don’t necessarily know what’s important – ask lots of questions, find out if they’ve been taking a ton of NSAID’s or Tyl...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Introduction to Abdominal Pain

Take Home Points Go in thinking sick vs not sick – this can take time to develop and that’s ok, this skill will come as you see more patients If y...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Vomiting

Take Home Points Think about causes – is it the head, the belly, or something else leading to the vomiting Get a upreg on all females of childbear...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Chest Pain

Take Home Points Take chest pain seriously – ACS and PE patients don’t always appear ill – look for the silent killer cases Remember 4-2-1 approac...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Asthma

Take Home Points Wheezing can be absent when severe – be wary of the silent chest = impending respiratory failure Not everything that wheezes is a...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Shortness of Breath

Take Home Points Keep a wide differential Think of the airway, lungs, heart, blood, kidneys, acid/base, brain Use Wells & PERC consecutively t...
Tactical Medicine News

REBEL Core Cast – Basics of EM – COVID-19

Take Home Points Constantly evolving disease with various presentations Identify those that are hypoxic are deliver appropriate oxygen therapy Giv...
Tactical Medicine News

REBEL Cast – Basics of EM – Cough

Take Home Points Be aware of the red flags – fever, HIV, hemoptysis, TB risk factors Is the onset acute or chronic Characterize sputum production ...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Sore Throat

Take Home Points Look for the red flags – fever, drooling, neck stiffness, toxic ingestion, uvula deviation, voice changes Steroids help with swel...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Intoxication

Take Home Message Do not ignore abnormal vital signs – they can be the harbinger of badness Watch out for developing withdrawal, treat early and a...
Tactical Medicine News

REBEL Core Cast – Basics of EM – AMS

Take Home Points Walk in – decide sick/not sick Do I need help now? If so, call in the troops Stable – start asking questions – A LOT OF THEM Inve...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Eye Complaints

Take Home Points Always check the vital signs of the eye – visual acuities, field of vision, ocular pressure Go in thinking whether you have to ca...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Head Injury

Take Home Points Patients >65 or suspected of intoxication are at high risk for bleeds – scan them!! Epidural has a lucent period – be wary of ...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Headache

Take Home Points Hypertension rarely causes headache, it’s usually the other way around. Patients with headaches are in pain, and in turn, may hav...
Tactical Medicine News

REBEL Core Cast – Basics of EM – Introduction

REBEL Core Cast – Basics of Emergency Medicine Podcast Welcome to the EMRA Basics of Emergency Medicine Podcast. I am your host EJ Wright, and the ...
Tactical Medicine News

Massive Acetaminophen Overdose: Are We Giving Enough N-acetyl-cysteine?

Introduction: Acetaminophen, N-acetyl-p-aminophenol, or APAP, is one of the most commonly used medications worldwide. While it is generally safely ...
Tactical Medicine News

Monkeypox…The Basics

Background: Monkeypox is a poxviridae virus closely related to smallpox (variola).  It was first described in humans in 1970 and has since become e...
Tactical Medicine News

REBEL Core Cast 81.0 – Priapism

Take Home Points Priapism is compartment syndrome of the penis. Ischemia and infarction can occur with prolonged priapism and rapid treatment and ...
Tactical Medicine News

Embedding Fonts into Your PowerPoint on Macs

It’s no secret or surprise that I love presentation design.  I love to nerd out on it like I do dissecting recent clinical literature.  What is sur...
Tactical Medicine News

REBEL Cast Ep109: The RePHILL Trial

Background: Currently, trauma resuscitation focuses on immediate hemorrhage control, resuscitation with blood products (i.e. PRBCs, plasma) and ear...
Tactical Medicine News

Intermittent Fasting and PLEASE Don’t Just Read the Abstract

Background: There are many lifestyle modification strategies available as a way to aid in weight management.  Two in particular include calorie res...
Tactical Medicine News

Race Multiplier in the eGFR Equation: What’s the impact for African-Americans?

Kidneys icon – vector web illustration, easy paste to any background Background: Race is a sociological construct that affects how clinicians deliv...
Tactical Medicine News

RESCUE-Japan LIMIT Trial

Background: The publication of the MR CLEAN trial in January 2015 changed the face of ischemic stroke care. This was the first study demonstrating ...
Tactical Medicine News

REBEL Core Cast 80.0 – Compartment Syndrome

Take Home Points Compartment syndrome is a life and limb threatening emergency that requires early recognition, prompt diagnosis and immediate man...
Tactical Medicine News

Using the Word “Quiet“ in the ED

Background: For those who believe in superstition, the superstitious belief that saying the word “quiet” while working in the ED will result in a c...
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