🚨New Post: SPICE III Trial 📉 Using dexmedetomidine as the primary early sedative for mechanically ventilated ICU patients did not improve 90-day all-cause mortality compared to usual care. #FOAMed #EmergencyMedicine #CriticalCare #Sedation #Ventilation #Propofol #Precedex #Emergency #Medicine

🎙️ New Podcast! 💉 IO lines: Power & Pitfalls in the ED ⚡ Fast, reliable access in arrest & shock 🧭 Site matters: Sternum > Humerus > Tibia ⚠️ Labs unreliable, dislodgement common 👉 Listen now: https://wp.me/pdrP8b-5ph #EMIMCC #FOAMed #MedSky

📣 A new REBEL Crit dives into the Ket-Mid RCT. Ketamine + midazolam significantly outperformed midazolam alone in pediatric status epilepticus. ✅ More seizure cessation ✅ Fewer intubations ✅ No increased harms 👀 Promising? Yes. 📊 Practice changing? Not yet. 🔗 https://wp.me/pdrP8b-5qZ

🚨NEW REBEL EM POST: HI-PEITHO Trial 🚨 🏆 First RCT showing catheter-directed fibrinolysis plus anticoagulation reduces short-term hemodynamic decompensation vs anticoagulation alone in intermediate-high risk PE 🚑 Identify Early, Anti-coagulate First 💉 Is the Catheter Even Necessary? #FOAMed

🚨Our REBEL MIND Post on the Dunning-Kruger Effect! 🧠MIND = Mastering Internal Negativity During Difficulty 🏁How accurately can we assess our own performance? 🎙️Listen to the episode & check out the post here: https://loom.ly/93Gd3_Y #FOAMed #MedEd @MRamzyDO @marco_propersi @EMSwami

🚫 Routine casting for all snuffbox tenderness? 🩹 The SUSPECT Trial says… maybe not. Bandaging was noninferior for occult scaphoid fx w/ better ROM + satisfaction. 🧠 Re-think your reflexes. 📖 https://wp.me/pdrP8b-5nC #FOAMed #EmergencyMedicine

🚨New Post on Toddler Fractures! Is a cast or a removable boot better? 🥾 For uncomplicated, radiographically confirmed toddler’s fractures, use a walking boot instead of routine casting 🧒 Boot treatment was noninferior to casting for pain at 4 wks 🏃 Kids recovered function faster #FOAMed

🚨 REBEL EM Gear Available! 🚨 Show your love with our I Love EBM—REBEL EM Heart Logo collection! 🎉 T-shirts, hoodies, mugs, and stickers—perfect for the EBM community! 🫁💥 👉 Shop now and wear your passion! https://loom.ly/voSxpiI #REBELEM #EMIMCC #FOAMed

📉 Does trending biomarkers help stop antibiotics sooner safely in sepsis? 👀 More here: https://wp.me/pdrP8b-5mL #FOAMed #EMIMCC #MedSky

🫀 Is Abelacimab the future of AFib anticoagulation? 🧬 Novel Factor XI inhibitor 📉 >60% less bleeding vs rivaroxaban ❓Stroke protection still uncertain 🔄 Needs Phase 3 trials vs apixaban 📖 Read more: https://wp.me/pdrP8b-5se #FOAMed

💤Not sure HOW sedated to keep your patient? 💉The Richmond Agitation-Sedation Scale (RASS) is a good place to start! 🛌🏽Heres a REBEL Review outlining each value! #FOAMed @mramzydo.bsky.social @marco-propersi.bsky.social

🚨NEW BLOG POST🚨 ⁉️Does a restrictive vs liberal O2 strategy in trauma patients reduce mortality and/or major respiratory complications? 👀Find out here: https://loom.ly/fDJK4vw by @nyulangoneEM Drs. Ali and Aiad (@Maureen_NYUdoc) #FOAMed @EMSwami @MRamzyDO @Marco_propersi #EmergencyMedicine

🚨New MIND episode on Gamification in Medical Education! 🕹️ Rapid Sequence alternates between game blocks, where learners act in clinical scenarios, and teaching blocks 🎙️Listen to the full episode here: https://loom.ly/WlIhC6Y 🎮Check out Rapid Sequence: https://loom.ly/5onuPdY #FOAMed

🚨 New on REBEL EM! 💨💉 Nebulized TXA for Hemoptysis ⚡ 72% stopped bleeding in 30 min (vs 51% w IV) 📉 Fewer procedures: 25% vs 48% BAE 🌬️ Easy, cheap, non-invasive ✅ Bottom Line: Neb TXA is safe, accessible & effective—but needs more validation. 👉 https://wp.me/pdrP8b-5om #EMIMCC #FOAMed #MedSky

🚨 TXA for Hemoptysis: We Put That $#!t on Everything (That Bleeds) Pt 2 🫁💨 Neb TXA worked faster & needed fewer procedures than IV in a small RCT PMID: 36410494 🌬️ Cheap, no IV, and maybe better ⚠️ Mostly TB patients, but results? 🔥 📖 www.rebelem.com #FOAMed #MedEd #EMIMCC #MedSky

🚺What Is the Role of TXA in Dysfunctional Uterine Bleeding? ♀️We explore this in our latest clinical conundrum post by @EMSwami 💉Tranexamic acid (TXA) is a safe and effective treatment for dysfunctional uterine bleeding. 👀Read more about it here: https://loom.ly/iKgOlDQ #FOAMed

🫁 New Core Cast: The Tachypneic Patient Short + shallow = BIG problem ⚠️ 👁 Watch chest rise ✋ Palpate abdomen 👂 Listen 🧠 Synthesize 🎧 Full episode: [https://wp.me/pdrP8b-5ng] #FOAMed #EmergencyMedicine #PulmPearls #Tachypnea #MedEd

🚨 New Post Alert! Syncope is common in the ED—but which decision rule do you trust? ⚡ San Francisco Syncope Rule = fast but fallible 🧩 Canadian Syncope Risk Score = comprehensive but complex 🩺 Neither replaces clinical judgment 👉 Read here: https://wp.me/pdrP8b-5pF #FOAMed #EMIMCC #MedSky

🚨EVERDAC Trial Post is out! 🚨 💉Is non-invasive BP an acceptable alternative to arterial lines in critically ill patients? 🟰 NIBP monitoring is noninferior to a-line when comparing 28 day mortality rates. #FOAMed

🚨 PEERLESS Trial: intermediate-risk PE (selected for catheter therapy) — FlowTriever LBMT vs CDT. LBMT “wins” the 5-part win ratio mainly via ICU use; remove ICU metrics and it’s NS. Mortality/ICH/bleeding similar. #FOAMed 🔗 https://wp.me/pdrP8b-5tG

RENOVATE Trial: HFNC vs BPAP in ARF 📊 Did HFNC match BPAP in 5 respiratory failure subgroups? ✅ Non-inferior in 4/5 🧪 Bayesian dynamic borrowing = statistical edge 🚫 Futility in immunocompromised patients Read more 👉 https://wp.me/pdrP8b-5sU #FOAMed

🆕 New REBEL EM Post Can #POCUS improve outcomes in shock resuscitation? ✅ ↓ Mortality ✅ ↓ Vasoactive days ✅ ↑ Lactate clearance 💥 Bedside ultrasound isn’t just diagnostic—it’s therapeutic. 🔗 https://loom.ly/083PigU 🧠 By Christopher Karnicki #FOAMed

🚨New Post: HFNC vs. NIV in Acute Cardiogenic Pulmonary Edema: 🫁 HFNC vs. NIV: High-flow nasal cannula (HFNC) performed similarly to non-invasive ventilation (NIV) in reducing respiratory rates at 120 minutes in patients w/ACPE #FOAMed #CriticalCare #Pulmonary #EmergencyMedicine

⁉️Does continuous suctioning during RSI lead to rapid deoxygenation? 🙅🏽‍♂️NOPE - it did not cause more rapid deoxygenation when compared to a PRN approach 👀Check out the full blog post by @EMSwami here: https://loom.ly/aND5tTw #FOAMed #Meded @MRamzyDO @marco_propersi @srrezaie

🫀Norepi or Epi after Cardiac Arrest? 🤔Was there a lower rate of recurrent cardiac arrest when using one over the other? 📚This meta-analysis & systematic review sought to answer that! 👀Check out the full post by Drs. Elizabeth Smith & Dorian Alexander from UTHealth Houston (@uthoustonemres)

🥇What does performance under pressure in medicine look like? 🏃🏽‍♂️‍➡️What if we had the same tools as professional sports teams and elite athletes? 🧠 We've partnered with Arena Labs for data driven insights! 👀https://loom.ly/YvLC3F8 @Arena_Labs @MRamzyDO @Marco_propersi @EMSwami

🚨 NEW POST: MDCalc Wars 🛑💥 Are you using PERC and Wells correctly? ✅ Start with Wells to guide next steps 🚫 Don’t use PERC in moderate/high-risk 🧪 Use high-sensitivity D-dimer! 👉 Read now: https://wp.me/pdrP8b-5oN #FOAMed #EMIMCC #MEDSky

🚨New Post: The TASC Trial: Therapeutic vs Prophylactic Anticoagulation for Acute Chest Syndrome 🫁First phase 3 RCT to demonstrate that a pharmacologic intervention can shorten the duration of acute chest syndrome in sickle cell disease #FOAMed #EmergencyMedicine #CriticalCare #SickleCell

🫀 Is Abelacimab the future of AFib anticoagulation? 🧬 Novel Factor XI inhibitor 📉 >60% less bleeding vs rivaroxaban ❓Stroke protection still uncertain 🔄 Needs Phase 3 trials vs apixaban 📖 Read more: https://wp.me/pdrP8b-5se #FOAMed

📉 Does trending biomarkers help stop antibiotics sooner safely in sepsis? 👀 More here: https://wp.me/pdrP8b-5mL #FOAMed #EMIMCC #MedSky