REBEL Cast

REBEL Rundown Key Points Mastery Learning: A unique educational framework focusing on achieving high competence with minimal variability among learners. Deliberate Practice: Involves learner-driven improvement, guided by expert feedback and breaking skills down into micro steps.   Psychological Safety: Essential in mastery learning, allowing open feedback without fear or shame, enhancing growth. E...

REBEL Rundown Click here for Direct Download of the Podcast . What Is Nitrous Oxide? Nitrous Oxide (N2O) is a colorless, odorless inhaled anesthetic that has been used for centuries, particularly in the surgical world. Mechanistically, it can induce euphoria, anxiolysis, and intoxication via NMDA receptor antagonism. During the late twentieth century, nitrous oxide was increasingly used recreation...

REBEL Rundown Key Points Human Factors: The unseen behaviors, distractions and considerations critical in emergency medicine and the ICU, influencing patient care beyond just medical knowledge. System Design : Effective system design directly impacts team performance by creating environments that facilitate optimal decision-making. Real-world Application : The application of human factors in healt...

REBEL Rundown Key Points Parallel Tasking: Transitioning from junior to senior roles in medicine involves both personal growth and the development of leadership skills, often simultaneously. Psychological safety: Creating this within teams is critical for fostering an environment where all members feel empowered to speak up and share insights. Big and Small Picture View: Effective leadership requi...

REBEL Rundown Key Points Growth mindset transforms learning – Residents and students who believe skills can be developed are more open to feedback, more resilient after failure, and more engaged in practice. Language matters in feedback – Simple reframes such as “You’re developing procedural skills” instead of “You’re not strong at procedures” encourage persistence and normalize the learning curve...

REBEL Rundown Key Points Try the coffee nap! Where you combine caffeine and a 30-minute nap to then have that boost energy and alertness by the time it kicks in. Sleep isn’t optional—it’s crucial for memory, mood regulation, and physical recovery. It is fundamentally different from rest Replacing sleep with caffeine isn’t effective and can have negative health impacts. Make getti...

REBEL Rundown Key Points Understanding the Why: The significance of understanding underlying causes, beyond initial diagnoses, in both sports and emergency medicine is explored. Recovery Focus : Emphasizing the importance of recovery time and small daily choices in optimizing performance for both athletes and emergency physicians. Data-Driven Insights: The Arena Labs approach uses personalized dat...

REBEL Rundown Key Points The 4 Steps of an ED Consult: Introduce yourself and your role Lead with the outcome (the ask) Give a focused case summary (why it’s theirs + what you’ve done) Close the loop (timeline, next steps, contingencies) Click here for Direct Download of the Podcast . Introduction Today we’re tackling one of the most important (and most under-taught) skills in emergency medicine:...

REBEL Rundown Key Points HFNC met criteria for non-inferiority to BPAP for preventing intubation or death within 7 days in four of the five ARF subgroups. Bayesian dynamic borrowing increased power across subgroups but created variable certainty, especially in smaller groups such as COPD. The immunocompromised hypoxemia subgroup did not meet non-inferiority, leading to early trial stopping for fut...

REBEL Rundown Key Points Rest isn’t a luxury; it’s a necessity and differs significantly from sleep in terms of mental and physical recovery needs. Uncovering the seven types of rest can highlight diverse needs: physical, mental, sensory, creative, emotional, social, and spiritual. Rest from high-stress environments such as the ED is crucial for reducing exhaustion, enhancing decision-...

REBEL Rundown Key Points Hydrocortisone Saves Lives: The 2023 Cape Cod Trial (NEJM) showed a clear mortality benefit and reduced need for intubation in severe CAP patients treated with hydrocortisone. Guidelines Are Catching Up: The SCCM (2024) and ERS now recommend steroids for severe CAP, while ATS/IDSA updates are still pending. Redefining “Severe”: Patients requiring high FiO₂ (>50%), nonin...

REBEL Rundown 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 essentia...

REBEL Rundown Key Points Building Resilience: Rebel MIND, in partnership with Arena Labs, introduces a science-based performance coaching platform specifically tailored for healthcare professionals, focusing on stress management and burnout prevention. Personal Insights: Jackie Penn shares her journey from exercise science to digital coaching, highlighting the importance of tailored coaching in hi...

REBEL Rundown 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 healt...

REBEL Rundown 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 enha...

REBEL Rundown Key Points Mortality: No statistically significant difference in 28-day mortality between ketamine vs etomidate for intubation in critically ill patients, though there was a ~1% absolute difference favoring ketamine. Hemodynamics: Ketamine induction was associated with more cardiovascular collapse , mainly driven by new/increased vasopressor use (dose escalation or addition of a vaso...

REBEL Rundown 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...

REBEL Rundown 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. D...

REBEL Rundown 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 . Click here for Direct Download of the Podcast . Introduction Ventil...

REBEL Rundown Introduction Welcome to the Rebel Core Content Blog, where we delve into crucial knowledge for emergency medicine. Today, we share insightful tips from PEM specialist Dr. Elise Perelman, shedding light on respiratory challenges in infants, toddlers, and young children during the viral season. Understanding that most cases involve typical viruses, we aim to equip you with diagnostic p...

REBEL Rundown 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 essentia...

REBEL Rundown Key Points Prolonged QTc raises risk of torsades de pointes Correct for heart rate: QTc > 440 ms (men) or > 460 ms (women); > 500 ms = high TdP risk . Common culprits: Methadone, ondansetron, macrolides, fluoroquinolones, antipsychotics. Prevention: Check & replete K, Mg, Ca and avoid QT-prolonging meds when possible. If TdP develops: Defibrillate + IV magnesium and stop...

REBEL Rundown Key Points Tourniquets save lives and limbs: Apply immediately when you’ve got arterial bleeding. Placement matters: Position the tourniquet 5–6 cm proximal to the arterial bleed, or if you can’t identify the exact source, place it as high up on the limb as possible . Windlass technique: The windlass provides only a small amount of extra pressure. Tighten the velcro first , then twis...

REBEL Rundown 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 upc...

REBEL Rundown 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 c...