REBEL Cast
REBEL Cast is a medical podcast that focuses on rational, evidence-based evaluation of literature. Hosted by Dr. Salim R. Rezaie, it aims to critically appraise and discuss recent studies and clinical practices in emergency medicine and critical care.
Episodes
REBEL Core Cast—Nitrous Oxide Toxicity: Whippets and Neurologic Injury
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
REBEL MIND – Human Factors: The Hidden Architecture of Emergency & Critical Care Medicine
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: Ef
REBEL MIND – The Mental Jump: Moving from Junior to Senior Leadership in Emergency Care
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 safet
REBEL MIND – Growth vs Fixed Mindset in Medicine
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. Lang
Diastology: Use E/e’ to Estimate Left Atrial Pressure
REBEL Rundown
Key Points
POCUS diastology answers one ED question: Is left atrial pressure (LAP) elevated right now? (not “diagnose diastolic dysfunction”) E/e’ estimates LAP using mitral inflow E (PW Doppler) a
REBEL MIND – How to Sleep When the World Says You Can’t
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
REBEL MIND: Applying Performance Science In and Out of the Emergency Department
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
REBEL Core Cast 150.0: Emergency Medicine Consults: How to Call a Consult + Handle Pushback (With Scripts)
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, n
REBEL CAST – RENOVATE Trial: HFNC vs BPAP in Acute Respiratory Failure
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 subgro
REBEL MIND – Rest Is Not Sleep: The Seven Dimensions of True Recovery
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 div
REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia
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
REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Sara Crager and Ryan Ernst
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 S
REBEL MIND: The Power of Performance Coaching in Medicine
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
REBEL MIND: Performance Under Pressure – What Medicine Can Learn from Elite Teams
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 pe
REBEL Core Cast 148.0–Demystifying Non-Invasive Ventilation & HiFlow
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,
The RSI Trial: Ketamine vs Etomidate in Rapid Sequence Intubation
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
REBEL MIND – The Dunning Kruger Effect: Why Looking Inward Improves Patient Care
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 paci
REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple
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
REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator
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
REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season
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 li
REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley
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 S
REBEL Core Cast 145.0: Understanding QTc Prolongation: Causes, Risks, and Management
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, ondansetr
REBEL Core Cast 144.0: Tourniquet Tips
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 i
REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy
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 str
REBEL Core Cast – DKA: Beyond the Basics Part 2 – SCOPE DKA-Trial
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:
REBEL Core Cast – DKA: Beyond the Basics Part 1 – The SQuID Protocol
REBEL Rundown
Key Points
Fewer ICU AdmissionsOnly 5 patients in the SQuID group required ICU care vs 99 in the traditional insulin drip group. Shorter ED StaysED length of stay dropped by ~3 hours in the SQuID g
REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator
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
REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes
REBEL Rundown
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 an
Incrementum Conference 2026: Revolutionizing Emergency Medicine in Spain
REBEL Rundown
Click here for Direct Download of the Podcast.
Highlights
00:00 Introduction to Rebel Cast00:10 Highlighting the Incrementum Conference 202600:34 Meet the Founders of
REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes
REBEL Rundown
Key Points
Master the 3 Types of BreathsControl, Assist, and Spontaneous — know the difference before tackling ventilator modes. Breath Delivery: Volume vs. PressureVolume-Targeted = fixed volume →
REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine
REBEL Rundown
Key Points
IO Lines Are Life-Saving in Extremis: IO access is fast, reliable, and can deliver nearly any resuscitative medication or fluid during cardiac arrest or hemorrhagic shock. Location Matte
REBEL Core Cast 139.0: Pneumothorax Decompression
REBEL Rundown
Key Points
Think Beyond Trauma: Don’t forget to suspect tension pneumothorax in ventilated patients who suddenly crash or after a central line placement! Confirm with Ultrasound: If the patient is
REBEL Core Cast 138.0: A Simple Bedside Approach to Shock
REBEL Rundown
Key Points
Shock is a Clinical Diagnosis — Not Just a NumberPatients can be in compensated shock with normal BP. Look for signs like AMS, cool extremities, ↓ UOP, and ↑ HR/RR. Start with the 4 L’sL
REBEL Core Cast 137.0: A Simple Approach to Sinus Tachycardia
REBEL Rundown
Key Points
Sinus Tachycardia = Clinical Clue: Don’t just treat the number—it’s a sign of underlying physiologic stress. Oxygen Delivery Equation: HR ↑ may compensate for ↓ hemoglobin, O₂ sat,
REBEL Core Cast 136.0: A Simple Approach to the Tachypneic Patient
REBEL Rundown
Key Points
Short + shallow: Neuromuscular, bronchospasm, or compliance problem → act fast Normal/large tidal volume: Compensation for metabolic/systemic causeUse all tools: Eyes: Chest rise, Hands
REBEL Core Cast 135.0: A Simple Approach to Hypoxemia (vs. Hypoxia)
REBEL Rundown
Key Points
Hypoxemia = low blood oxygen Hypoxia = low tissue oxygen 5 causes of hypoxemia, but most hospital cases are either: Shunt = doesn’t improve with oxygen therapy Dead space = causes tachyp
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, we break down the pathophysiology, clinical course, diagnostic approach, and evidence-based management of APAP
Street Medicine: Compassionate Care for the Unhoused
Introduction: 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 expe
REBEL Core Cast 131.0 – Traumatic Arthrotomy
Take Home points:
Always suspect an open joint if there is a laceration, regardless of size, the lies over joint
CT scan of the affected joint is widely considered to be the standard approach to evaluation but the saline load test may be useful in certain circumstances.
Obtain emergency orthopedics consultation for all open joints and administer antibiotics and update tetanus in all patients
REBEL Core Cast 130.0 – Omphalitis
Take Home Points
Early diagnosis: erythema and warmth of the skin surrounding the umbilicus isn’t normal. Get labs, start abx and get the patient admitted
Consult peds surgery on all of these patients as progression to nec fast, while uncommon, is devastating
If the patient appears toxic or has systemic symptoms, the simply omphalitis has progressed and aggressive treatment including surgery is l
REBEL Core Cast 129.0 – Gastric Lavage
Take Home Points
Orogastric lavage may still play an important role in treatment of the overdose patient. Do not perform lavage if the ingestion has limited toxicity at any dose or the ingested dose is unlikely to cause significant toxicity.
Strongly consider orogastric lavage in a patient who has taken an overdose of drugs that are particularly toxic, suspected extreme doses associated with hig
REBEL Core Cast 128.0 – Toxic Alcohols
Take Home Points
Toxic alcohols generally refer to methanol and ethylene glycol as these substances pose significant metabolic derangement and end-organ damage.
Patient who present shortly after ingestion will simply look inebriated – no different than ethanol intoxication. At this point, patients will have an elevated osmolar gap and little to no anion gap.
Patient who presents in a delaye
REBEL Core Cast 127.0 – Penetrating Neck Injuries
Take Home Points
Anticipate anatomically challenging airways and consider early intubation prior to loss of airway anatomy.
Skip the zones of the neck and focus on hard signs of vascular (Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, Signs of stroke) or aerodigestive (Airway compromise, Bubbling wound, Extensive SubQ air, Stridor, Significant hemoptysis/hemateme
A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI Detection
Background: Cath lab activation based on ST-elevation myocardial infarction (STEMI) criteria is founded on aging data and requires evolution. In the “Occlusive Myocardial Infarction (OMI) Manifesto,” emergency physicians Dr. Steve Smith, Dr. Pendell Meyers, and Dr. Scott Weingart introduced a new paradigm —OMI vs. non-occlusive myocardial infarction (NOMI).
The OMI/NOMI paradigm focuses on the pre
REBEL Core Cast 126.0 – Peds Hem Onc Emergencies
Take Home Points
Early administration of antibiotics (within 60 min) in patients with fever and neutropenia is life saving.
Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well.
Avoid sedation and lying supine and steroids in patients with mediastinal masses.
Red flags in patients with headaches that may suggest a brain tumor include si
REBEL Core Cast 125.0 – Hyperkalemia
Take Home Points
Always obtain an EKG in patients with ESRD upon presentation
Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause
If the patient with hyperkalemia is unstable or has significant EKG changes (wide QRS, sine wave) rapidly administer calcium salts
In patients who are anuric, early mobilization of dialysis resources is critical
REBEL Co
REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy
Take Home Points
Management of severe beta-blocker and calcium-channel blocker toxicity should occur in a stepwise fashion: potential gastric decontamination, multiple lines of access, judicious fluids, calcium, glucagon, and vasopressors as needed.
Initiation of high dose insulin therapy requires a tremendous amount of logistical and cognitive resources as it requires cross-disciplinary collabor
REBEL Core Cast 123.0 – Posterior Epistaxis
Take Home Points:
Posterior epistaxis is a rare, life-threatning presentation.
The key is in identifying and rapidly gaining control with a posterior pack or foley catheter.
These patients often require surgical intervention so get ENT to the bedside and admit to a place with a higher level of monitoring.
REBEL Core Cast 123.0 – Posterior Epistaxis
Click here for Direct Download of th
ANNEXA-1: Andexanet Alfa Associated with Harm in DOAC Reversal
Background: In May of 2018, Andexanet alfa gained accelerated approval by the FDA for the reversal direct oral anticoagulants (DOACs) despite a lack of robust evidence for use. The 2022 AHA/ASA guidelines give the drug a level 2A recommendation and recommend it over the use of 4F-PCC (Greenberg 2022). FDA approval alongside guideline endorsement has led to the drug seeing a remarkable growth in us
REBEL Core Cast 122.0 – Neutropenic Fever
Take Home Points:
There are many causes of neutropenia, chemotherapy being by far the most dangerous.
Febrile neutropenia is a condition conveying high mortality. Early administration of antibiotics is the only factor known to reduce this mortality.
For a patient with neutropenic fever, remember that the body’s own flora is the greatest danger. Isolate, but do not wait to initiate treatment.
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