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!

We hope you find something of interested to you, please use the search bar on top to narrow down what you are looking for.

As always, all credit is given to the original author and origin publication.

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Tactical Medicine News

Andexxa Vs 4F-PCC in ICH: An Ongoing Debate

by Marco Torres
Nov 28, 2022
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...
Tactical Medicine News

The ED-AWARENESS Study: Awareness with Paralysis

‘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 ...
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