Tactical Medicine News Blog

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 symptoms and any EKG changes with IV calcium salts Always...

Marco Torres | October 19, 2022

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 centers on volume repletion with normal saline with consideration...

Marco Torres | October 5, 2022

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 underlying reversible cause (eg gallstones). Recent evidence has challenged the routine use...

Marco Torres | September 29, 2022

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% of his shifts with learners, including...

John Casey, DO, MA, FACEP | September 28, 2022

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 clot. TEG analyzes the interaction between platelets and the coagulation...

Marco Torres | September 26, 2022

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 drives medical decisions. Many of these tools were not developed...

Marco Torres | September 22, 2022

REBEL Core Cast 86.0 – Hand Nerve Blocks

Marco Torres | September 21, 2022

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 approximately 90% of his shifts with...

Alex Koyfman, MD | September 21, 2022

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 CPR and early defibrillation. Over the years, we as...

Marco Torres | September 19, 2022

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.  Despite being treated with loop diuretics, the problem is many are discharged from...

Marco Torres | September 15, 2022

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 is that there is reduced coronary blood flow and increased myocardial demand...

Marco Torres | September 12, 2022

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 often have a lack of physiologic reserve, decreased...

Marco Torres | September 8, 2022

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 unclear if hyperoxia is beneficial.  Recent studies on patients requiring...

Marco Torres | September 5, 2022