REBEL Cast

Annie Duke, a former World Series of Poker champion, details some of the psychology of decision making in the high-risk gambling in her book, Thinking in Bets. In poker, important decisions must be made quickly in the midst of extreme uncertainty and repeated in rapid succession with each new hand. To learn and improve in this environment, these players learn to embrace uncertainty, tease the luck out of their outcomes and avoid common biases when reviewing their prior performance.  As doctors working in Emergency Medicine we often have do the same thing and the wrong decision could potentially be fatal.

In this episode of Rebel Reflections, four Emergency Medicine Physicians, Jacob White, Marco Propersi, Dan Wolf and Will Smith, discuss how thinking in bets while dealing with levels of uncertainty can benefit our performance and learning in the Emergency Department.

• • How does “resulting” or the tendency to equate a decision’s quality with its outcome affect learning in and after residency?
  • How does thinking on the spectrum of more or less right impact our utilization of new research or of implementing a consultant’s recommendations?
  • How do you avoid decision fatigue during a long shift?

We will discuss these topics and many more on this episode of REBEL Reflections!

Thinking in Bets on Amazon.com

Swami chats with Brendan Freeman, Emergency doc and medical education fellow at Staten Island University Hospital about improving our sleep hygiene.

There is a shifting paradigm towards shorter durations of antibiotics in pediatric infections. Conflicting international guidelines recommend treatment of urinary tract infection (UTI) with antibiotic courses ranging from just 3 days to 7–14 days. Antimicrobial resistance is a global health crisis, underscoring the importance of antibiotic stewardship. Investigators in the SCOUT Trial examine the impact of short-course (5 day) antibiotic therapy in UTI, with potentially far reaching implications.

https://rebelem.com/pediatric-utis-short-course-vs-standard-course-antibiotics-is-it-time-for-a-change/

Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. Corticosteroids have excellent anti-inflammatory and immunomodulatory effects that could mitigate some of the inflammation caused by pneumonia. There have been several randomized trials that have shown glucocorticoids have positive effects in patients with CAP. However, except for one trial, none showed a between-group difference regarding mortality.  We now have the Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial.

https://rebelem.com/corticosteroids-in-severe-community-acquired-pneumonia-could-cape-cod-catalyze-a-change-in-critical-care-management/

Should we give oral ibuprofen or intramuscular ketorolac in the ED in patients who can take PO?

This week we discuss some of the serious infectious processes of pregnancy.

This week we discuss the diagnosis and management of Achilles tendon ruptures.

This week we once again borrow audio from the Only in Staten Podcast and feature a discussion on cardiogenic shock with the director of the CCU at SIUH, Dr. Martin Amor.

We've got toxicologist Dr. Sanjay Mohan back on to chat about carbon monoxide toxicity in the ED.

This week, Swami sits down with director of the Staten Island University Hospital cardiac catheterization lab, Dr. Ruben Kandov, to discuss ACS management.

This week we chat with Dr. Danielle Langan, MedEd Fellow and Attending at Staten Island University Hospital, about awareness during paralysis post-RSI.

Simply put, flow is the peak of human performance, maximum focus with maximum responsiveness, an optimal state of consciousness. This state of mind is accessible to anyone under the right circumstances and has huge implications to how we live, work and train. 

In this podcast episode, three Emergency Medicine Physicians, Drs. Marco Propersi, Dan Wolf and Will Smith, discuss flow in relation to working in the ED, how it intersects with medical training, on shift performance and even in daily life outside the hospital. 

• Does the high stakes life or death environment in the ED allow us to access a flow state, even though our own lives are not at risk? 
• How can you set yourself up to achieve flow?
• While on shift how does being ‘in flow’ facilitate mastery of our profession?

We will discuss these topics and many more on this episode of REBEL Reflections!

The Rise of Superman on Amazon.com

From the Only in Staten Podcast - Swami sits down with cardiologist Dr. Samantha Lee to chat about cardiac testing.

This week, Swami shares some pearls from a recent critical care shift.

Toxicologist Sanjay Mohan is back to discuss sodium channel blocker poisoning management.

This week, we discuss angioedema focusing on treatment.

This week we chat about an uncommon, but potentially lethal, cause of back pain.

This week we sit down with Dr. Billy Caputo, Associate Professor of EM and residency director at SIUH to chat about nerve blocks.