Tactical Medicine News Blog

Rosh Review EM Scholar Monthly Question

You are working in a rural ED, and an older woman from a local assisted care facility arrives via ambulance in obvious respiratory distress. EMS is able to tell you...

Marco Torres | May 15, 2023

Ep182 STIs: Vulvovaginitis, Cervicitis, Urethritis Recognition and Management (BACKUP)

STIs are on the rise and underrecognized in the ED. Certain STIs such as syphilis can have a mortality rate of up to 58%. When recognized and treated early ED...

Anton Helman | May 12, 2023

Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines.1, 2 Phenobarbital has been...

Marco Torres | May 11, 2023

REBEL Core Cast 101.0 – Imaging in Renal Colic

Take Home Points Many patients with renal colic require a CT scan. Diagnostic imaging should focus on eliminating concerning mimics; not on clinching the diagnosis of renal colic. POCUS and...

Marco Torres | May 10, 2023

Shifting the Paradigm: Can We Manage Mechanically Ventilated Patients with Occult Traumatic Pneumothorax Conservatively?

Background: Clinically significant pneumothoraces in patients on mechanical ventilation can be dangerous as positive pressure ventilation can cause an increase in intrapleural pressure and trigger tension physiology. Occult pneumothoraces are...

Marco Torres | May 8, 2023

REBEL Core Cast 100.0 – Alcoholic Ketoacidosis

Take Home Points Alcoholic Ketoacidosis (AKA) can present with significant acidemia (pH < 7.00). Despite the significant acidemia, patients with AKA can remain alert and lucid despite their severe metabolic...

Marco Torres | April 26, 2023

How Good is Ultrasound at Diagnosing PTA?

Background: The increased utility and accessibility of point-of-care ultrasound (POCUS) has allowed clinicians the freedom to rethink their diagnostic approach for many common diseases, including peritonsillar abscess (PTA). Clinical evaluation may...

Marco Torres | April 17, 2023

REBEL Core Cast 99.0 – Bundle Branch Blocks

Marco Torres | April 5, 2023

The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable...

Marco Torres | March 30, 2023

Impact of Emergency Department Crowding on Lung Protective Ventilation

Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Traditionally patients were managed on the ventilator with lung volumes of 10...

Marco Torres | March 27, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal

Background information: Alcohol has potentiating effects on the inhibitory GABA neurotransmission system and inhibitory effects on the excitatory glutamate neurotransmission system. Chronic alcohol use causes changes to preserve homeostasis, and...

Marco Torres | March 23, 2023

REBEL Core Cast 98.0 – 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 considered for immediate synchronized electrical cardioversion....

Marco Torres | March 22, 2023

Prehospital Traumatic Cardiac Arrest: A Systematic Review and Meta-analysis

Background: Traumatic cardiac arrest in the prehospital setting carries an extremely high mortality rate. Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the...

Marco Torres | March 13, 2023