iiinova — where your digital self keeps evolving

🚨Our new MIND Post on the One Minute Preceptor is out! 🎙️Listen to the Full Podcast Episode By Drs. Kim Bambach and Doris Ilic Here: loom.ly/z1cO3zE #FOAMed

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REBEL EM @rebel-em.bsky.social · 02/10/2026

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

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REBEL EM @rebel-em.bsky.social · 01/10/2026

🫁 Confused about hypoxia vs hypoxemia? We’ve got a simple bedside approach‼️ 🚫 Shunt ≠ Dead space 💡 Know when FiO₂ fails & PPV saves 🔗 loom.ly/hJFaydE #FOAMed #MedSky #EMIMCC

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REBEL EM @rebel-em.bsky.social · 30/09/2026

🛌🏽Rest is NOT Sleep! 🧠 Uncovering the seven types of rest can highlight diverse needs: physical, mental, sensory, creative, emotional, social, and spiritual 👀Check out our latest MIND Episode on the 7 Dimensions of Rest: loom.ly/IZcGTlQ #FOAMed #MedED @MRamzyDO @Marco_Propersi @EMSwami

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REBEL EM @rebel-em.bsky.social · 29/09/2026

⁉️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: loom.ly/aND5tTw #FOAMed #Meded @MRamzyDO @marco_propersi @srrezaie

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REBEL EM @rebel-em.bsky.social · 26/09/2026

🆕 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. 🔗 loom.ly/083PigU 🧠 By Christopher Karnicki #FOAMed

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REBEL EM @rebel-em.bsky.social · 25/09/2026

Status epilepticus: what’s the move after midaz? 🚑 Data suggest ketamine ↑ seizure cessation (esp in adults) without more arrests/intubations ⚠️ not ready to rewrite protocols. Benzos first. Ketamine for true refractory cases. 🔗 loom.ly/Fv09Jgk #FOAMed #EMS #Neuro

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REBEL EM @rebel-em.bsky.social · 24/09/2026

🚨Do We Need a CT for Every Renal Colic? 🪨 🧍‍♂️ Young w/ classic sx? No CT 🧓 Older or unclear dx? CT w/ contrast. 🔍 Use POCUS to guide imaging Stop the scan-everyone approach. 👉 Read more: loom.ly/AMw_hY0 Written by: Dr. Abbas Husain #FOAMed #EMIMCC #MedSky

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REBEL EM @rebel-em.bsky.social · 23/09/2026

💧How much fluid should be giving in Pancreatits? 🌊Check out the WATERFALL Trial: loom.ly/dBJbgl8 by @emswami.bsky.social #FOAMed @marco-propersi.bsky.social @mramzydo.bsky.social

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REBEL EM @rebel-em.bsky.social · 22/09/2026

🚨 New Post Alert! 🔥 Pancreatitis Severity Made Simple: Ranson’s Criteria vs BISAP Score — which predicts mortality better? 🩸 Compare the classic 48-hr model with the bedside-friendly BISAP. ➡️ wp.me/pdrP8b-5rG #MedSky #FOAMed #EMIMCC

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REBEL EM @rebel-em.bsky.social · 21/09/2026

🚨New Post: A2B Trial - Are Alpha-2 Agonists Better than Propofol for ICU Sedation? 💊 Neither dexmedetomidine nor clonidine reduced the time to successful extubation compared to propofol 👀Check out the full post here: loom.ly/H3A95RM by Dr. Dorian Alexander from UTHealth #FOAMed

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REBEL EM @rebel-em.bsky.social · 19/09/2026

🚨 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! loom.ly/voSxpiI #REBELEM #EMIMCC #FOAMed

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REBEL EM @rebel-em.bsky.social · 18/09/2026

🚨 New REBEL Core Cast! Ep 138: A Simple Bedside Approach to Shock💥 Start with the 4 L’s: Lucid, Limbs, Leak, Lactate Pulse pressure = your shock type cheat code 🎧 Listen now: loom.ly/ntey1VU #FOAMed #EMIMCC #MedSky

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REBEL EM @rebel-em.bsky.social · 17/09/2026

🚨 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 🔗 wp.me/pdrP8b-5tG

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REBEL EM @rebel-em.bsky.social · 16/09/2026

🤔How smooth is the transition from junior to senior in your emergency department? 🔍Effective leadership requires zooming in on specific tasks & zooming out to manage the big picture 🗣️Talk the Talk with clear, structured communication 👀Check out the blog post here: loom.ly/lz9YUQU

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REBEL EM @rebel-em.bsky.social · 15/09/2026

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 👉 wp.me/pdrP8b-5sU #FOAMed

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REBEL EM @rebel-em.bsky.social · 14/09/2026

⁉️Should we keep giving Antibiotics in Cirrhotic Patient's with Upper GI Bleeding? 🚨Find out in our latest post: loom.ly/Kw24Bx4 🎯 Shorter antibiotic courses demonstrated a 97.3% probability of non-inferiority for mortality vs standard 5–7 day regimens #FOAMed

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REBEL EM @rebel-em.bsky.social · 12/09/2026

🚨 Check it out on REBEL EM: Size Matters! Are you using the right cuff? New RCT shows the wrong cuff size skews SBP/DBP. 📉 Too Small cuff = High BP 📈 Too Large cuff = Low BP 📌 Details: wp.me/pdrP8b-5k6 @marco_propersi @EMSwami @srrezaie @MRamzyDO

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REBEL EM @rebel-em.bsky.social · 11/09/2026

🚨 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: wp.me/pdrP8b-5pF #FOAMed #EMIMCC #MedSky

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REBEL EM @rebel-em.bsky.social · 10/09/2026

🦠 Sepsis antibiotics: Is 7 days enough? The BALANCE Trial says yes ⚠️ But watch for spectrum & selection bias 💡 7d may work for most, but not all 📖Read full post here: loom.ly/rnrHxg8 #FOAMed #MedSky #EMIMCC

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REBEL EM @rebel-em.bsky.social · 09/09/2026

🧠New REBEL MIND Post on Mastery Learning 🦺 Psychological Safety allows open feedback w/o fear or shame, enhancing growth. Embrace the productive struggle! 🎙️Listen to the full episode here: loom.ly/BRJSgOQ by Drs. Kim Bambach and Jennifer Yee from The Ohio State University! #FOAMed

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REBEL EM @rebel-em.bsky.social · 07/09/2026

🧠Latest REBEL MIND Post is out about 🥬NATURE! 🌿 Nature gives directed attention a chance to recover. 🛠️ Nature is a tool but not a treatment for broken systems 🎙️Listen to the full podcast episode here: loom.ly/WpEKNd4 #FOAMed #MedED #Nature #Wellness #MINDset

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REBEL EM @rebel-em.bsky.social · 05/09/2026

🚺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: loom.ly/iKgOlDQ #FOAMed

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REBEL EM @rebel-em.bsky.social · 04/09/2026

🧠💥 1 month of intractable headache. Tried NSAIDs, antiemetics, steroids, nerve blocks, Topamax, ubrogepant—nothing worked. Then 💉 2.5 mg IV Haldol = near-total relief. Old drug, new role? 🔗 loom.ly/ic39bnw #FOAMed #EMIMCC #MedSky

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REBEL EM @rebel-em.bsky.social · 02/09/2026

POCUS diastology in the ED = 1 question: Is LAP elevated now? Measure E/e’ (mitral inflow E ÷ annular e’). ≥14 suggests elevated LAP/cardiogenic edema; ≤8 argues against; 8–14 indeterminate. loom.ly/DbZddQc #FOAMed

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REBEL EM @rebel-em.bsky.social · 01/09/2026

🫀Norepi or Epi after Cardiac Arrest? 🤔Was there a lower rate of recurrent cardiac arrest when using one over the other? 👀Check out the full post by Drs. Elizabeth Smith & Dorian Alexander from UTHealth Houston (@uthoustonemres): loom.ly/u-sENPg

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REBEL EM @rebel-em.bsky.social · 31/08/2026

🚨New MDCalc Wars Post on Pediatric Appendicitis! 3️⃣Three Score for One Diagnosis 👌🏽Alvarado, PAS vs pARC (see the Prep Sheets and Tables Below) 🚸Which performs better for acute appendicitis in the ED or clinic? 👀Check out full post: loom.ly/j00Be_I #FOAMed #EmergencyMedicine

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REBEL EM @rebel-em.bsky.social · 29/08/2026

🚨 Vasopressor Extravasation? Act fast. 💉 Phentolamine 🧴 Nitro ointment 💨 SC Terbutaline Quick-reference REBEL REVIEW 👇 📸 PMID: 28890646 #FOAMed #EM #CriticalCare #PharmTips

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REBEL EM @rebel-em.bsky.social · 28/08/2026

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REBEL EM @rebel-em.bsky.social · 27/08/2026

💡 New REBEL Core Cast Drop Demystifying Non-Invasive Ventilation & HiFlow 🫁 CPAP: Best for hypoxemia ⚖️ BiPAP: Go-to for hypercapnia 🌬️ HFNC: Comfy + effective NIV ≠ cure NIV = bridge 📲 Listen now: wp.me/pdrP8b-5ru 🧠 Written by: Drs. Frank Lodeserto & Eric Acker #FOAMed

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REBEL EM @rebel-em.bsky.social · 26/08/2026

🚨 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: wp.me/pdrP8b-5oN #FOAMed #EMIMCC #MEDSky

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REBEL EM @rebel-em.bsky.social · 25/08/2026

🧪The lab differences between TTP and DIC can be confusing! 🩸Heres REBEL REVIEW highlighting the differences! #FOAMed @mramzydo.bsky.social @emswami.bsky.social @marco-propersi.bsky.social

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REBEL EM @rebel-em.bsky.social · 24/08/2026

🚨Does Compliance and Implementation of the Sepsis Bundle (SEP1) improve mortality? 👀Find out in our latest post: loom.ly/tx2PVP4 by Drs. Melissa Smith & Maren Leibowitz from Northwestern University in Chicago, IL #FOAMed

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REBEL EM @rebel-em.bsky.social · 21/08/2026

💉How effective is haloperidol for delirium in the ICU? Find out here with the AID-ICU Trial: loom.ly/WJ487I8 🌀Check out the CAM-ICU Algorithm below! #FOAMed @mramzydo.bsky.social @marco-propersi.bsky.social

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REBEL EM @rebel-em.bsky.social · 20/08/2026

🚨The HOPE Trial out now on REBEL EM: 🧠 Late-window benefit: Alteplase improved outcomes in pts treated 4.5–24 hrs after stroke onset depending on imaging 🕒Supports a “tissue over time” approach ⚠️ Benefit–risk tradeoff 👀Check out the full post here: loom.ly/yNSrnJg #FOAMed

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REBEL EM @rebel-em.bsky.social · 19/08/2026

How great is the Canadian Syncope Score? Find out in this clinical decision tool's external validation: loom.ly/yuSj7_0 Here's one of our REBEL REVIEWS summarizing the tool #FOAMed #EMIMCC #MedSky #Medicine #Syncope

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REBEL EM @rebel-em.bsky.social · 17/08/2026

🚨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

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REBEL EM @rebel-em.bsky.social · 16/08/2026

🎙️ 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: wp.me/pdrP8b-5ph #EMIMCC #FOAMed #MedSky

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REBEL EM @rebel-em.bsky.social · 14/08/2026

📣 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. 🔗 wp.me/pdrP8b-5qZ

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REBEL EM @rebel-em.bsky.social · 13/08/2026

🚨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

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REBEL EM @rebel-em.bsky.social · 12/08/2026

🚨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: loom.ly/93Gd3_Y #FOAMed #MedEd @MRamzyDO @marco_propersi @EMSwami

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REBEL EM @rebel-em.bsky.social · 11/08/2026

🚫 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. 📖 wp.me/pdrP8b-5nC #FOAMed #EmergencyMedicine

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REBEL EM @rebel-em.bsky.social · 10/08/2026

🚨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

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REBEL EM @rebel-em.bsky.social · 09/08/2026

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REBEL EM @rebel-em.bsky.social · 07/08/2026

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

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REBEL EM @rebel-em.bsky.social · 06/08/2026

🫀 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: wp.me/pdrP8b-5se #FOAMed

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REBEL EM @rebel-em.bsky.social · 05/08/2026

💤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

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REBEL EM @rebel-em.bsky.social · 04/08/2026

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

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REBEL EM @rebel-em.bsky.social · 03/08/2026

🚨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: loom.ly/WlIhC6Y 🎮Check out Rapid Sequence: loom.ly/5onuPdY #FOAMed

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REBEL EM @rebel-em.bsky.social · 01/08/2026

🚨 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. 👉 wp.me/pdrP8b-5om #EMIMCC #FOAMed #MedSky

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