REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy
Release Date: 10/23/2025
REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple
REBEL Cast
📝 Introduction Learn how to interpret PIP, Pplat, PEEP, and driving pressure on the ventilator. Understand lung compliance, VILI prevention, and ARDS ventilation strategies. 🗝️ Key Points 💨 Peak vs. Plateau Pressures: PIP reflects total airway resistance and compliance, while Pplat isolates alveolar compliance—elevations in both suggest decreased lung compliance (e.g., ARDS, pulmonary edema, pneumothorax). 🧱 PEEP Protects Alveoli: Maintains alveolar recruitment and prevents collapse; typical range 5–8 cmH₂O, but higher levels may benefit moderate–severe ARDS. ⚙️...
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REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator
REBEL Cast
Ventilator management can feel overwhelming—there are so many knobs to turn, numbers to watch, and changes to make. But before adjusting any settings, it’s crucial to understand why the patient is in distress in the first place, because the right strategy depends on the underlying cause. In this episode, we’ll walk through three different cases to see how the approach changes depending on the problem at hand.
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REBEL Core Cast: Pediatric Respiratory Emergencies: Beyond Viral Season
REBEL Cast
Key Tips for Managing Pediatric Respiratory Cases In this episode of the Rebel Core Content Podcast, host Swami and PEM specialist Dr. Elise Perlman dive into critical insights for managing respiratory cases in infants, babies, and toddlers during the viral season. They discuss important pearls such as assessing patients from the doorway, localizing respiratory sounds, and differentiating between upper and lower airway obstructions. They also elaborate on managing common conditions like bronchiolitis, asthma exacerbations, and identifying zebras among routine viral cases. The episode provides...
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REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley
REBEL Cast
📝Introduction Welcome to this special edition of the REBEL Cast, where we unravel key highlights and educational insights from the IncrEMentuM Conference in Spain. This event is a cornerstone for advancing emergency medicine education, drawing esteemed speakers and participants from around the globe. As emergency medicine gains traction in Spain, this conference has become an essential platform for knowledge exchange and professional growth. Today, host Dr. Mark Ramzy shines a spotlight on three distinguished speakers: Dr. Jess Mason, Dr. Tarlan Hedayati, and Dr. Simon Carley, who...
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REBEL Core Cast 145: Understanding QTc Prolongation: Causes, Risks, and Management
REBEL Cast
The QT interval is a vital part of ECG interpretation, reflecting the heart’s electrical recovery after each beat. When prolonged, it can set the stage for torsades de pointes. Understanding how to measure and correct the QT interval, identify high-risk medications, and act quickly when TdP occurs is essential for every clinician. This guide walks you through the physiology, interpretation, common causes, and emergency management of QTc prolongation to keep your patients safe.
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REBEL Core Cast 144: Tourniquet Tips
REBEL Cast
Introduction In this episode of the Rebel Core Content podcast, Swami provides crucial tips on using tourniquets. Highlighting the significance of these life and limb-saving devices, the discussion focuses on the optimal placement of tourniquets, emphasizing placing them 2-3 inches (5-6 cm) above the bleeding source and avoiding joints. Swami also advises on the correct way to tighten the tourniquet using the Velcro strap first, followed by minimal use of the windless. The importance of noting the application time to avoid prolonged arterial flow interruption is also discussed. The episode...
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REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy
REBEL Cast
📝Introduction: In this exciting episode of REBEL Cast, host Dr. Mark Ramzy joins forces with renowned educator and speaker, Dr. George Willis. Broadcasting straight from the ACEP 25 in Salt Lake City, the duo talk about bringing together the international emergency medicine community, as they reflect on their experiences at the Increment Conference in Murcia, Spain, and preview the upcoming event this spring. 🤔What's IncrEMentuM? A new conference and a pivotal gathering for emergency medicine professionals worldwide, has become an essential platform for education, collaboration, and...
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REBEL Cast - DKA Part 2: Beyond the Basics - The SCOPE-DKA Trial
REBEL Cast
🗝️Key Points 💧 Fluid Choice Matters: Plasma-Lyte, a balanced crystalloid, corrected acidosis faster than normal saline in severe DKA patients, with no increase in adverse events. 🧪 Chloride Load Concerns: Normal saline’s high chloride content can worsen acidosis, potentially slowing bicarb recovery even after the anion gap closes. 🔬 Study Design Strengths: The SCOPE-DKA trial was a cluster crossover, open-label RCT, protocolizing all variables except fluid type, enhancing the reliability of its findings. 🧮 Base Excess & Strong Ion Difference: Base excess/deficit and...
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REBEL Cast - DKA Part 1: Beyond the Basics - The SQuID Protocol
REBEL Cast
🔑 Key Points 🛏️ Fewer ICU Admissions Only 5 patients in the SQuID group required ICU care vs 99 in the traditional insulin drip group. ⏱️ Shorter ED Stays ED length of stay dropped by ~3 hours in the SQuID group—an operational win in crowded departments. 💉 No Drop in Nursing Workload Despite using subQ insulin, nurses still performed hourly glucose checks and frequent injections. 🧪 Focus on the Anion Gap DKA resolution = closing the anion gap, not just normalizing blood sugar—critical concept for trainees and nurses alike. 👶 Peds Has the...
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REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator
REBEL Cast
🗝️ Key Points ❌ Don’t chase perfect numbers: Adequate and safe is often better than “perfect but harmful.” 💨 Oxygenation levers: Start with FiO₂ and PEEP, but remember MAP is the true driver. 🫁 Ventilation levers: Adjust RR and TV, tailored to underlying physiology. 🚫 Watch your obstructive patients: Sometimes less RR is more. 📝 Introduction When you take the airway, you take the wheel and you now control the patient’s oxygenation and ventilation. In this REBEL Crit episode, Dr. Lodeserto and Dr. Acker walk through the physiology, ventilator...
info_outline📝Introduction:
In this exciting episode of REBEL Cast, host Dr. Mark Ramzy joins forces with renowned educator and speaker, Dr. George Willis. Broadcasting straight from the ACEP 25 in Salt Lake City, the duo talk about bringing together the international emergency medicine community, as they reflect on their experiences at the Increment Conference in Murcia, Spain, and preview the upcoming event this spring.
🤔What's IncrEMentuM?
A new conference and a pivotal gathering for emergency medicine professionals worldwide, has become an essential platform for education, collaboration, and advocacy, especially in light of emergency medicine's recent recognition as a specialty in Spain. The conference is praised for its outstanding production quality, engaging speakers, and its capacity to foster a global community of emergency care professionals.
🦪Pearls from George's IncrEMentuM 2025 Lectures:Pearls from George's IncrEMentuM 2025 Lectures:
- Sodium Bicarbonate Use:
- Appropriate Use: Focus on specific instances like metabolic acidosis with renal failure or severe metabolic cases with tox patients (e.g., salicylate or TCA overdose).
- Emphasis on Patient-Centric Care: Treat the patient, not the number; avoid harmful overreliance on bicarb based solely on lab results
- Diabetic Ketoacidosis (DKA):
- Balanced Solutions: Preferenced over normal saline to prevent hyperchloremic acidosis.
- Potassium Management: Oral potassium is effective and should be utilized, challenging the myth of impaired gastric absorption in DKA.
- Squid Protocol: Usage of ultra-rapid insulin subcutaneously as an alternative to insulin drips in mild to moderate DKA cases.
- We covered this topic before on REBEL EM. Check out the post here and the podcast here
- Crashing Aortic Dissection:
- Hypotension Insights: Do not attribute sudden hypotension solely to medication; prioritize ruling out tamponade or cardiogenic shock.
- Ultrasound Utilization: Essential tool for detecting complications like tamponade or low EF due to myocardial infarction or aortic valve regurgitation.
- Controlled Pericardial Drainage: Crucial technique to stabilize hemodynamics without increasing mortality, avoiding extensive fluid removal
Here's a helpful algorithmic infographic to reference for aortic dissection patients
Image Courtesy of Dr. Mark Ramzy, DO (@MRamzyDO)
- Hyperkalemia
- Not every patient needs calcium. Dont just give it prophylatically, only those with EKG changes should get it and get enough of it.
- Give an appropriate dose of your other medications. That includes giving 10 units of insulin and 2 amps of dextrose 50. One when they get the 10 units of insulin and the other 30 minutes later
- Patients may be dehydrated, dont give them furosemide or diuretics. Those patients need fluid to help perfuse their kidneys and eliminate potassium
- Here's George Willis' Hyperkalemia Removal Algorith:
- Here's a REBEL REVIEW breaking down the different electrolytes in each of the types of fluids:
🫣Teasers from George's IncrEMentuM 2026 Lectures:
- Severe Thyroid Storm:
- Diagnosis Reminder: Consider thyroid storm in febrile patients with altered mental status; order TSH tests.
- Beta Blocker Administration: Use ultrasound to assess heart function before administering propranolol to prevent low output heart failure.
- Medication Timing: Administer iodine after antithyroid drugs.
- Refractory Hypoglycemia:
- Early Use of Octreotide: Beneficial in sulfonylurea-induced cases; initiate treatment promptly for better efficacy.
- Broadened Perspective: Consider other endocrine disorders as potential causes beyond typical measures.
- Modern Management of SCAPE:
- Bolus Dose Nitroglycerin: A recommended practice for quick patient stabilization and improved outcomes in SCAPE scenarios.
- We covered this topic before on REBEL EM, see Dr. Marco Propersi's post here
✈️See you in Spain!
The upcoming conference aims to gather world-class educators once more and promises an enriching experience for all attendees. George Willis, along with many others, will bring significant discourse to the event. For more information on the IncrEMentuM Conference and to register, visit their website! See you there!