REBEL Cast
Welcome to REBEL Cast, and for those of you who have not checked out the main website already, REBEL EM stands for Rational Evidence Based Evaluation of Literature in Emergency Medicine. The format of the show will be a critical review of current literature going through some of the pertinent results and limitations. At the end of the show we will give our clinical take home points and how and if you should apply this research to your clinical practice
info_outline
REBEL MIND Ep2: Performance Under Pressure - What Medicine Can Learn from Elite Teams
01/21/2026
REBEL MIND Ep2: Performance Under Pressure - What Medicine Can Learn from Elite Teams
🗝️Key Points 🎯Partnership Focus: New collaboration with Arena Labs aimed at enhancing healthcare worker wellness. 🏃🏽♂️➡️Personalized Coaching: Tools and coaching programs designed for stress management and performance improvement. 📊Data-Driven Insights: Utilizing wearable sensor data to tackle burnout effectively. 🌄Broad Impact: Offers a unique opportunity to contribute to large-scale healthcare improvements. 📝 Introduction Welcome back to Rebel MIND, the podcast series where we dive into crucial aspects of healthcare worker well-being. In this episode, hosted by Mark and Marco, we're excited to introduce a collaboration with Arena Labs. Arena Labs is helping us measure healthcare performance through innovative programs designed to combat burnout and enhance personal wellness using data-driven strategies. 🤔 Why This is Important Burnout among healthcare workers is a growing concern, especially in such high-pressure environments as emergency and intensive care units. The collaboration with Arena Labs brings forth a vital focus on using data and coaching to build resilience among medical professionals. By prioritizing their personal wellness, healthcare workers can provide more effective patient care, making this initiative crucial for the entire healthcare ecosystem. 🌟Be Brilliant at the Basics Ask yourself — “What is it on your time off that gives you a deep sense of fulfillment?” On your time off are you doing things that fill your bucket and add to your recovery? ❓What is Allostasis and Allostatic Load Allostasis: Our body’s ability to adapt over time to stress. It’s relevant to the phase you are in during this particular season in your life. Ex. You are a first year medical student freaking out about your very first exam. Over time as you do more exams, they are still stressful, but by now you have developed modified study habits to succeed and get used to the frequent exams In the context of emergency medicine, you may be nervous or stressed about your first shift at a new hospital but overtime you learn the staff, the location of equipment, the acuity of that particular site, the patient population so over time you get used to the stress of a shift at that new hospital Allostatic Load: The wear and tear on the body from chronic stress due to maladaptation or poor recovery methods. This refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. Ex. You are an emergency medicine physician at a very busy, high acuity center and have never prioritized taking care of yourself on/during a shift. As a result, external factors add to not being able to fully recover when you get home or are off shift (ie. Admin work, teaching obligations, family/friends) and so you never fully recover before you have to go back on shift to the same stressors you just exposed yourself to. So the cycle continues 🏥 Relevance to the Emergency Department and ICU Healthcare workers in emergency departments (ED) and intensive care units (ICU) are often under enormous stress due to the nature of their work. Arena Labs' program offers tailored solutions, helping ED and ICU staff manage their unique challenges through effective recovery techniques and performance tools. This approach caters specifically to the demanding schedules and the unpredictability inherent in these environments. 👀 Where to Learn More Intrigued by the possibilities this partnership offers? You can explore more by visiting . Also, check out the comprehensive coaching program available, designed specifically for healthcare providers looking to enhance their well-being and performance. 💬 Conclusion In an era where burnout is pervasive, our collaboration with Arena Labs offers a beacon of hope for healthcare workers. By leveraging cutting-edge data insights and practical coaching, this partnership aims to redefine healthcare wellness, fostering a sustainable, resilient workforce that's equipped to navigate the pressures of modern medicine. Join us in this journey towards enhanced well-being and workforce empowerment, ensuring that those who care for us are also cared for. 📚References Guidi J, et al. Allostatic Load and Its Impact on Health: A Systematic Review. Psychother Psychosom. 2021; Epub 2020 Aug 14. PMID: Frueh BC, et al. "Operator syndrome": A unique constellation of medical and behavioral health-care needs of military special operation forces. Int J Psychiatry Med. Epub 2020 Feb 13. PMID:
/episode/index/show/rebelcast/id/39800005
info_outline
REBEL Core Cast 148.0–Demystifying Non-Invasive Ventilation & HiFlow
01/12/2026
REBEL Core Cast 148.0–Demystifying Non-Invasive Ventilation & HiFlow
🗝️ Key Points 💨 NIV = Support without a tube: CPAP, BiPAP, and HFNC improve oxygenation and reduce the work of breathing. 🫁 CPAP = Continuous pressure: Best for hypoxemic patients (e.g., pulmonary edema, OSA). ⚖️ BiPAP = Two pressures (IPAP/EPAP): Great for hypercapnic failure (e.g., COPD, obesity hypoventilation). 🌬️ HFNC = Heated, humidified high flow: Reduces effort, improves comfort, and enhances oxygen delivery. 🩺 Supportive, not definitive: NIV stabilizes patients while the underlying cause is treated. 📝 Introduction Non-invasive ventilation (NIV) refers to respiratory support provided without endotracheal intubation. The most common modalities include continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), and high-flow nasal cannula (HFNC). These therapies aim to improve oxygenation, reduce the work of breathing, and potentially prevent invasive mechanical ventilation.
/episode/index/show/rebelcast/id/38627470
info_outline
REBEL MIND: The Dunning Kruger Effect - Why Looking Inward Improves Patient Care
01/07/2026
REBEL MIND: The Dunning Kruger Effect - Why Looking Inward Improves Patient Care
Welcome to REBEL MIND—Mastering Internal Negativity during Difficulty. In this series, we turn the same critical lens REBEL EM uses for literature inward—into mindset, leadership, and psychological safety—so we can deliver better care outward to patients and teams. In this episode and blog post, host Mark Ramzy and co-host Kim Bambach (Assistant Professor of Emergency Medicine, The Ohio State University) explore a deceptively simple question: How accurately can we assess our own performance? The answer hinges on a classic cognitive bias that touches all of us in emergency medicine. 🗝️Key Points 🧠 We don’t know what we don’t know: Low experience can inflate confidence; true expertise usually brings humble certainty. 🏥 ED relevance is universal: From central lines to transvenous pacing, over- or under-confidence shows up at every level—intern to seasoned attending. 🧩 Metacognition matters: Accurate self-assessment is a clinical skill; reflection + feedback loops keep us calibrated. 🛠️ Practice beats bravado: Skill decay is real; deliberate practice and HALO (high-acuity, low-occurrence) refreshers protect patients. 🤝 Psychological safety ≠ niceties: “Confident humility” enables questions, feedback, and better resuscitation decisions—especially under uncertainty. 💬Conclusion The Dunning–Kruger Effect isn’t a moral failing; it’s a predictable human pattern that every clinician rides—often multiple times per day in the ED. The antidote is metacognition: routine reflection, explicit debiasing, deliberate practice, and feedback within a psychologically safe culture. 🚨Clinical Bottom Line Competence is quiet and curious. The more we know, the more we recognize what we don’t—and the better we become at caring for patients and each other.
/episode/index/show/rebelcast/id/38529710
info_outline
REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple
12/22/2025
REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple
📝 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. ⚙️ Driving Pressure (ΔP = Pplat − PEEP): Lower ΔP reduces atelectrauma and improves outcomes; optimize by adjusting PEEP thoughtfully. 💥 Prevent VILI: Keep Pplat < 30 cmH₂O, use low tidal volumes (6 mL/kg IBW), and monitor for barotrauma, volutrauma, atelectrauma, and biotrauma. 📚 Evidence-Based Practice: ARDSNet and subsequent trials confirm that lung-protective ventilation—low Vt, limited pressures, and individualized PEEP—improves survival in ARDS.
/episode/index/show/rebelcast/id/38627290
info_outline
REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator
12/08/2025
REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator
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.
/episode/index/show/rebelcast/id/38626685
info_outline
REBEL Core Cast: Pediatric Respiratory Emergencies: Beyond Viral Season
12/04/2025
REBEL Core Cast: Pediatric Respiratory Emergencies: Beyond Viral Season
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 valuable tips for emergency medical professionals to enhance patient care and avoid missing serious conditions. 00:00 Introduction and Guest Welcome 00:13 Diving into Viral Season in Pediatrics 01:15 Pearl 1: Observing Respiratory Patterns 03:17 Pearl 2: Localizing Respiratory Sounds 06:32 Treating Different Respiratory Conditions 10:57 Managing Severe Asthma Exacerbations 15:32 Identifying the Zebras: Uncommon but Critical Diagnoses 20:01 Conclusion and Final Thoughts
/episode/index/show/rebelcast/id/39237755
info_outline
REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley
11/20/2025
REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley
📝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 shared their expertise and experiences at this transformative gathering last 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 Their IncrEMentuM 2025 Lectures Think about alternative diagnoses that could be driving the patient’s atrial fibrillation Maybe the atrial fibrillation is an adaptive response and slowing them down (whether chemically or electrically) may cause more harm than good Get in the mental space before having to perform a High Acuity Low Occurrence (HALO) procedure and walk through each of the parts step by step (Subscription required to watch) Like many things in critical care, a patient with a severe head injury requires you to do many little things very well (ie. reducing ICP increases by taking off the C-collar if able, positioning the patient appropriately, knowing when to use certain medications) ✈️See you in Spain! The upcoming conference aims to gather world-class educators once more and promises an enriching experience for all attendees. Drs. Tarlan Hedayati, Jess Mason and Simon Carley, along with many others, will be there at the event. See you there!
/episode/index/show/rebelcast/id/39034905
info_outline
REBEL Core Cast 145: Understanding QTc Prolongation: Causes, Risks, and Management
11/18/2025
REBEL Core Cast 145: Understanding QTc Prolongation: Causes, Risks, and Management
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.
/episode/index/show/rebelcast/id/38357430
info_outline
REBEL Core Cast 144: Tourniquet Tips
11/03/2025
REBEL Core Cast 144: Tourniquet Tips
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 concludes with a reminder to visit the podcast's website for more valuable content. Key Times: 00:00 Introduction to Tourniquets 00:40 Optimal Placement of Tourniquets 01:21 Proper Tightening Techniques 01:57 Importance of Timing and Application 02:36 Summary and Conclusion
/episode/index/show/rebelcast/id/38355945
info_outline
REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy
10/23/2025
REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy
📝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 and the 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 (@) 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 ✈️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. See you there!
/episode/index/show/rebelcast/id/38620385
info_outline
REBEL Cast - DKA Part 2: Beyond the Basics - The SCOPE-DKA Trial
10/21/2025
REBEL Cast - DKA Part 2: Beyond the Basics - The SCOPE-DKA Trial
🗝️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 strong ion difference are valuable but underutilized tools for assessing acid-base status—don’t rely solely on pH or bicarb. ⚠️ Limitations & Next Steps: The study did not include lactated Ringer’s, and fluid rates were left to clinical discretion. More research, including three-arm trials, is needed for definitive guidance. 📝 Introduction Managing diabetic ketoacidosis (DKA) requires careful consideration of fluid therapy, especially in severe cases. In part two of our REBEL Cast DKA series, we shifted from insulin strategies to fluid choice in severe DKA, diving into the SCOPE-DKA trial—a cluster, crossover, open-label RCT from Australia. While normal saline (NS) is commonly used, concerns about its high chloride content and impact on acidosis have sparked growing interest in balanced solutions like Plasma-Lyte. 🚨 Clinical Bottom Line Plasma-Lyte showed a modest but meaningful benefit over normal saline in resolving metabolic acidosis in patients with severe DKA. Though safety profiles were similar, the more balanced electrolyte composition of Plasma-Lyte helped normalize acid-base status slightly faster—without worsening ketosis. While this won’t revolutionize care overnight, it’s one more step toward physiologic resuscitation in DKA. Understanding fluid composition and its impact on acid-base balance is crucial for optimal patient care.
/episode/index/show/rebelcast/id/36657535
info_outline
REBEL Cast - DKA Part 1: Beyond the Basics - The SQuID Protocol
10/06/2025
REBEL Cast - DKA Part 1: Beyond the Basics - The SQuID Protocol
🔑 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 Edge Pediatric ICUs routinely use a 2-bag system (D10 + electrolytes vs electrolytes alone) to safely continue insulin while managing glucose—adult medicine should take note. 📝Introduction In this episode of REBEL Cast, we dive into part one of our Diabetic Ketoacidosis (DKA) series with a twist—subcutaneous insulin instead of the traditional IV drip. We explore the SQuID Protocol (Subcutaneous Insulin in DKA), which could potentially shift how we manage mild to moderate DKA—from the ICU to the general floor. With ICU bed shortages, ED boarding, and nursing resource challenges, it's time to ask: Do all DKA patients really need a drip and an ICU bed? We reviewed a quasi-experimental study comparing traditional insulin drips versus subcutaneous insulin (lispro q4h + glargine at time zero) in a busy urban ED. The results? Promising—but not without caveats.
/episode/index/show/rebelcast/id/36657480
info_outline
REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator
10/02/2025
REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator
🗝️ 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 strategies, and clinical curveballs that separate calm control from chaos at the bedside.
/episode/index/show/rebelcast/id/38354425
info_outline
REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes
09/22/2025
REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes
🗝️ Key Points 💨 Start with Breath Types: Controlled, assisted, and supported breaths are the foundation of all modes. 🛌 Comfort Over “Best Mode”: No mode improves mortality — focus on patient synchrony and comfort. ✅ Know the Big 5 Modes: AC: All controlled or assisted (volume or pressure). PS: Fully spontaneous, great for SBTs. PRVC: Pressure-delivered, volume-targeted hybrid. SIMV: Mixed mode, less favored in adults. VS: Spontaneous mode with adaptive pressure. ⚠️ Watch for Pitfalls: PRVC may under-ventilate in agitation. SIMV often causes dyssynchrony. 🎯 Bottom Line: Master mode mechanics and match the vent to the patient — not the other way around. 📝 Introduction Mechanical ventilation can feel overwhelming, especially when faced with a sea of ventilator modes and unfamiliar terminology. In Part 2 of the series, we go beyond breath types and delivery mechanics to explore the most used modes in the ICU. We will break down each one; explaining how it works, when to use it, and why the goal isn’t the “best mode” but the most comfortable one for the patient.
/episode/index/show/rebelcast/id/37717865
info_outline
Incrementum Conference 2026: Revolutionizing Emergency Medicine in Spain
09/18/2025
Incrementum Conference 2026: Revolutionizing Emergency Medicine in Spain
⏰ Highlights 00:00 Introduction to Rebel Cast 00:10 Highlighting the Incrementum Conference 2026 00:34 Meet the Founders of Incrementum 01:21 The Journey to Incrementum 04:27 The Recognition of Emergency Medicine in Spain 06:04 What is Incrementum? 08:14 Bringing Together Top Emergency Medicine Experts 11:38 Exciting Sessions to Look Forward To 15:54 Conclusion and Invitation to Increment 2026 📝 Introduction In this special episode of Rebel Cast, we spotlight the Incrementum Conference in Spain, a significant event in emergency medicine. Hosts welcome Dr. Francisco ‘Paco’ Campillo Palma and Dr. Carmen Maria Cano, founders of Incrementum, to discuss the recognition of emergency medicine as a specialty in Spain. They share their journey of creating the conference, emphasizing the importance of education, collaboration, and growth. The discussion also touches on this year’s conference highlights, including sessions on mental health and evidence-based medicine, and the exceptional lineup of speakers. Listeners are encouraged to attend the conference in April 2026 for an enriching experience. 📌 Bottom Line Join us in Spain this April for the Increment Conference! 👉 Register now at
/episode/index/show/rebelcast/id/38213885
info_outline
REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes
09/15/2025
REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes
Key Points: 💨 Master the 3 Types of Breaths Control, Assist, and Spontaneous — know the difference before tackling ventilator modes. 📦 Breath Delivery: Volume vs. Pressure Volume-Targeted = fixed volume → monitor pressure 📈 Pressure-Targeted = fixed pressure → monitor volume 🫁 Lung Compliance = Pressure-Volume Relationship Volume mode: ↑ pressure = ↓ compliance (stiff lungs) Pressure mode: ↓ tidal volume = ↓ compliance 🏋️♂️ Use Analogies to Simplify The pull-up analogy makes complex concepts easier to grasp and remember. 🧱 Build the Foundation First Before diving into complex ventilator modes, get solid on breath types, delivery methods, and lung mechanics. Introduction: For many medical residents, the ICU can feel like stepping into a pressure cooker. At the heart of that stress often lies one intimidating machine: the ventilator. Rather than diving headfirst into complex ventilator modes, this episode lays a critical foundation by breaking down the basic building blocks of mechanical ventilation, something every clinician should master before moving on to more advanced concepts. Once you know the 3 types of breaths and how those breaths are delivered, you can more easily understand most of the mechanical ventilator modes.
/episode/index/show/rebelcast/id/37717185
info_outline
REBEL Core Cast 140: The Power and Limitations of Intraosseous Lines in Emergency Medicine
09/01/2025
REBEL Core Cast 140: The Power and Limitations of Intraosseous Lines in Emergency Medicine
Limitations of IO access include: Placing an IO in a bone with a proximal fracture, a previous IO placement attempt or any circulatory compromise proximal to the site is contraindicated Blood work drawn from an IO are generally not accurate, so once the patient has been resuscitated with the IO, intravenous blood draws are recommended Dislodgement is common; it is best to use the stabilizer that comes with the IO kit; if the kit does not have a stabilizer, stack lots of gauze on both sides of the IO needle and tape it down Best site for IO? While proximal humerus site portents faster infusion rates than proximal tibia site, the main limitation of the proximal humerus site is that the arm must be held in internal rotation to avoid dislodgement of the IO Proximal tibia may be easier to landmark than proximal humerus Other sites include distal tibia, distal femur and sternum but are uncommonly employed in EDs
/episode/index/show/rebelcast/id/37630220
info_outline
REBEL Core Cast 139.0: Pneumothorax Decompression
08/18/2025
REBEL Core Cast 139.0: Pneumothorax Decompression
Show Notes: On this episode of the Rebel Cast, Swami takes a deep dive into pneumothorax decompression, focusing on the need for improvements beyond the classic teachings. Covering scenarios where immediate decompression is critical, particularly in tension pneumothorax, Swami discusses the limitations of needle decompression, especially in the second intercostal space at the midclavicular line. He highlights the importance of using POCUS for diagnosis and recommends skipping needle decompression in favor of finger thoracostomy for a more reliable and effective treatment. Key takeaways emphasize recognizing tension pneumothorax in various clinical situations and the advantages of finger thoracostomy over traditional techniques. Take Home Points: Suspect tension ptx not just in trauma but also in mechanically ventilated patients who become unstable and after central line placement Confirm with US if time allows Needle decompression is a suboptimal approach to decompression. Finger thoracostomy is more likely to be successful Highlights: 00:00 Introduction to Pneumothorax Decompression 00:17 Recognizing Tension Pneumothorax 01:00 Common Scenarios for Pneumothorax 01:34 Confirming Diagnosis with POCUS 01:50 Issues with Needle Decompression 03:21 Advantages of Finger Thoracostomy 04:11 Key Takeaways and Conclusion
/episode/index/show/rebelcast/id/37239220
info_outline
REBEL Core Cast 138.0: A Simple Bedside Approach to Shock
08/04/2025
REBEL Core Cast 138.0: A Simple Bedside Approach to Shock
In this episode, we will dive into a simple yet effective bedside approach to a patient in shock. By using quick physical exam findings and bedside vitals (particularly pulse pressure), you can form a quick assessment of the likely underlying etiology of a critically ill patient.
/episode/index/show/rebelcast/id/36836040
info_outline
REBEL Core Cast 137.0: A Simple Approach to Sinus Tachycardia
07/21/2025
REBEL Core Cast 137.0: A Simple Approach to Sinus Tachycardia
Sinus tachycardia is the most prevalent cardiac dysrhythmia in critically ill patients, yet it often receives less attention than it warrants. While the rhythm itself is not inherently dangerous, it serves as a crucial indicator of underlying physiological disturbances that require prompt evaluation and management.
/episode/index/show/rebelcast/id/36957675
info_outline
REBEL Core Cast 136.0: A Simple Approach to the Tachypneic Patient
07/07/2025
REBEL Core Cast 136.0: A Simple Approach to the Tachypneic Patient
In this episode, we focus on the bedside evaluation of the tachypneic patient. Tachypnea (increased respiratory rate) can be an early indicator of serious illness, but not every tachypneic patient is on the verge of arrest. The key is honing your bedside assessment to recognize who is at risk for rapid deterioration and why. We break down a practical approach you can use immediately at the bedside.
/episode/index/show/rebelcast/id/36802440
info_outline
REBEL Core Cast 135.0: A Simple Approach to Hypoxemia (vs. Hypoxia)
06/16/2025
REBEL Core Cast 135.0: A Simple Approach to Hypoxemia (vs. Hypoxia)
In this episode, we break down a practical bedside approach to hypoxemia. We clarify the difference between hypoxemia (low oxygen in the blood) and hypoxia (low oxygen at the tissue level), and walk through the major causes of hypoxemia that you need to recognize quickly at the bedside.
/episode/index/show/rebelcast/id/36791520
info_outline
REBEL Core Cast 134.0 - Acetaminophen Toxicity
06/02/2025
REBEL Core Cast 134.0 - Acetaminophen Toxicity
Acetaminophen (APAP) overdose remains one of the most common causes of acute liver failure in the United States. While its therapeutic use is widespread and generally safe, unintentional overdoses and delayed presentations can lead to devastating outcomes. In this episode of REBEL Cast, Swami breaks down the pathophysiology, clinical course, diagnostic approach, and evidence-based management of APAP toxicity—including when to initiate NAC, how to apply the Rumack-Matthew nomogram, and the evolving role of adjunctive therapies like fomepizole. Whether you're in the ED or elsewhere , this is core content every clinician should know.
/episode/index/show/rebelcast/id/36535780
info_outline
REBEL Cast - Street Medicine: Compassionate Care for the Unhoused
04/02/2025
REBEL Cast - Street Medicine: Compassionate Care for the Unhoused
In this episode of Rebel Cast, host Marco Propersi, along with co-hosts Steve Hochman and Kim Baldino, delve into the practice and importance of street medicine—the direct delivery of healthcare to homeless and unsheltered individuals. Special guests Dr. Jim O'Connell, a pioneer of street medicine, and Dr. Ed Egan, a recent street medicine fellowship graduate, share their experiences and insights on serving this vulnerable population. They discuss the origins, scope, and challenges of street medicine, the ethical dilemmas faced, and the profound impact of building trust and community with patients. The conversation underscores the necessity of integrating street medicine with mainstream healthcare systems and emphasizes that small acts of kindness and persistence can significantly improve the lives of those experiencing homelessness. 00:00 Introduction to Rebel Cast 00:18 Meet the Hosts and Guests 00:47 Understanding Street Medicine 02:22 Origins and Early Challenges 07:23 Street Medicine in Practice 20:11 Barriers to Care 22:23 Housing First Experiment 26:56 Ethical Dilemmas in Street Medicine 27:52 Challenges of Providing Care on the Streets 29:56 The Role of Street Medicine Teams 31:17 The Importance of Building Trust 33:55 Limitations and Realities of Street Medicine 37:37 The Future of Street Medicine 41:42 Integrating Street Medicine with Emergency Medicine 43:36 Personal Reflections and Lessons Learned 48:56 Advice for Aspiring Street Medicine Practitioners 53:03 Final Thoughts and Encouragement
/episode/index/show/rebelcast/id/35958315
info_outline
REBEL Cast - Is Pip-Tazo Harming Sepsis Patients?
01/14/2025
REBEL Cast - Is Pip-Tazo Harming Sepsis Patients?
In this episode of RebelCast, host Dr. Marco Propersi and guest Dr. Lynnsey Moss discuss the comparative study of piperacillin-tazobactam versus cefepime in the treatment of undifferentiated sepsis. They discuss a recent retrospective cohort study which examines 90-day mortality rates is sepsis patients treated with these antibiotics. The researchers explore the role of anti-anaerobic coverage and its potential for disrupting the gut microbiome. Key points discussed include the method of instrumental variable analysis, the validity of study findings, and a comparison with the ACORN trial. The episode concludes with a cautious stance on changing clinical practice based on these findings. 00:00 Introduction and Welcome 00:14 Meet Lindsey Moss 00:37 Discussion on Piptazo vs Cefepime 01:55 Research Background and ACORN Trial 03:03 Study Methodology 05:20 Study Results and Analysis 08:52 Instrumental Variable Analysis Explained 12:11 Critical Evaluation of the Study 17:44 Conclusion and Takeaways 18:36 Closing Remarks
/episode/index/show/rebelcast/id/34852890
info_outline
REBEL Core Cast 133.0 - TMJ Dislocation
12/18/2024
REBEL Core Cast 133.0 - TMJ Dislocation
/episode/index/show/rebelcast/id/33995572
info_outline
REBEL Cast - A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI Detection
12/08/2024
REBEL Cast - A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI Detection
In this episode of Rebelcast, hosts Dr. Marco Propersi and Dr. Joe Bove discuss the Queen of Hearts, a groundbreaking AI tool changing the game in EKG interpretation for detecting occlusive myocardial infarctions. Joined by experts Dr. Pendell Meyers and Dr. Steve Smith, they delve into the nuances of OMI classification and highlight the advanced capabilities of this AI model. The conversation covers the development, validation, and implementation of the Queen of Hearts AI model, its potential impact on emergency medicine, and its future implications for medical education and practice.
/episode/index/show/rebelcast/id/34336160
info_outline
REBEL Core Cast 132.0 - Recent Onset AFib
12/04/2024
REBEL Core Cast 132.0 - Recent Onset AFib
/episode/index/show/rebelcast/id/33548642
info_outline
REBEL Core Cast 131.0 - Post-Dural Puncture Headache
11/13/2024
REBEL Core Cast 131.0 - Post-Dural Puncture Headache
/episode/index/show/rebelcast/id/33409467
info_outline
REBEL Core Cast 130.0 - Omphalitis
10/30/2024
REBEL Core Cast 130.0 - Omphalitis
/episode/index/show/rebelcast/id/33298467