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

REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple 12/22/2025

REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator 12/08/2025

REBEL Core Cast: Pediatric Respiratory Emergencies: Beyond Viral Season 12/04/2025

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

REBEL Core Cast 145: Understanding QTc Prolongation: Causes, Risks, and Management 11/18/2025

REBEL Core Cast 144: Tourniquet Tips 11/03/2025

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

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