REBEL Cast Salim R. Rezaie, MD

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 search for and treat the underlying cause of hypocalcemia REBEL Core Cast 88.0 – Hypocalcemia Click here for Direct Download of the Podcast Definition: A ... Read more

Take Home Points Spontaneous Bacterial Peritonitis (SBP) is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis An ascites PMN count > 250 cells/mm3 is diagnostic of SBP but treatment should be considered in any patient with ascites and abdominal ... Read more

Take Home Points Methemoglobinemia can result from exposure to a number of different medications. The most common are dapsone and topical anesthetic agents (i.e. benzocaine) Consider the diagnosis in any patient with cyanosis and hypoxia that doesn’t respond to oxygen administration Administer methylene blue to any patient with abnormal vital signs, metabolic acidosis, end organ ... Read more

Take Home Points Perichondritis is an infection of the cartilage and connective tissue of the ear Perichondritis can be recognized clinically by erythema, swelling and tenderness of the auricle. The most common organism in perichondritis is P. aeruginosa and antibiotics should be tailored to cover this organism REBEL Core Cast 92.0 – Perichondritis Click here ... Read more

Background Information:  Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. At REBEL EM, we’ve done an extensive write up that details some of ... Read more

Take Home Points Lithium toxicity comes in a three flavors: acute, chronic and acute on chronic. Each form will have a different presentation as well as management. Lithium levels are often unreliable in terms of guiding management and must be taken in context with symptoms and time of ingestion (in acute overdose). IV fluids are ... Read more