The Educational Newsletter From CriticalCareNow!
Welcome to this week's newsletter. We've got a ton of stuff to cover with you, so let's get right to it.
- Get a FREE video package when you register for ResusX:Live in Philly
- Blind nasal intubation isn't a thing still....is it?
- The ECG master, Dr. Amal Mattu talks post-arrest ECG
- A quick video on scalpel-finger-bougie to assist you in crics
- We're talking whole blood transfusion with Dr. Salina Wydo in the ResusNation podcast
- In Chris' corner we're asking whether LR increases potassium in hyperkalemic patients
This is going to be a good one, so let's get ready to get our learn on....it's time for Last Week Now!
A Bonus Gift Just For Our List Members!
You already know that early-Bird registration is open for ResusX:Reset where you can save over 25% for any package that you register for. You already know that you have two options to watch ResusX, attend live in Philadelphia or stream it. You know that you're going to get a t-shirt and some great swag when you attend live...but did you know there's something else? Everyone who registers for the live event will receive the ResusX:Select Volume 1, twenty-five of our most viewed just for you. This is just another thank you for subscribing to the newsletter. This giveaway is only for this week, so if you were planning on registering don't delay. And if you registered already, you'll also be getting access to this bonus retroactively....because that's how we roll.
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ResusX:Reset Live
Come to Philadelphia and watch the rockstars of resuscitation present live, witness debates, participate in hands-on workshops, interact in small group sessions, simulation, and so much more. Stay after 5pm each day and interact with the conference faculty for drinks and food. This is not a conference, it's an experience. A Hilton hotel block has also been arranged for you and is less than 5 minutes away from the venue. Tickets are extremely limited this year to ensure we give you most hands-on, intimate, and exclusive experience. Remember, ResusX is not a conference, it's the ultimate resuscitation experience.
ResusX:Reset Virtual
Virtual attendees can watch all the action, live from the comfort of their own home. And when the live attendees head off to the hands on workshops, virtual attendees will continue to watch their own exclusive lectures online. All virtual attendees will get access to the conference for 30 days after the conference is done!
UltraRounds Pre-Conference
Now is your chance to master point of care ultrasound for your critically-ill patients with UltraRounds. We will go over everything that you need to know about using ultrasound to resuscitate and monitor your patients. This one-day workshop is deeply immersive with a very heavy focus on bedside scanning so you leave ready to scan on your next shift.
Nasal Intubation? In 2023...only in the OR
I love @ICUDoctorofTikTok He is a great educator and an overall amazing person. I stitched a video with him talking about nasal intubations. I didn't think the practice still existed outside of the OR, but it does....this video covers my opinion on that.
Check out the video for more and follow @ICUDoctorofTikTok!
Post-Arrest ECG
In this episode, Dr. Amal Mattu from the University of Maryland School of Medicine discusses the interpretation of Post-Arrest 12-Lead ECGs in critical care and emergency medicine. He begins with a scenario of a patient with chest pain and ventricular fibrillation, emphasizing CPR, defibrillation, and epinephrine. Dr. Mattu then explores key aspects of interpreting the Post-Arrest ECG: identifying ischemia and STEMI for rapid catheterization, reconsidering immediate catheterization for non-ST elevation cases based on recent studies, and cautioning against misdiagnosing wide complex tachycardias as ventricular tachycardia due to potential mimics. He advises repeating the ECG after resuscitation for accuracy and avoiding unnecessary antiarrhythmics. Overall, the talk provides essential insights into navigating these complexities.
Check out his amazing video now!
Scalpel-Finger-Bougie
If you're not coming to ResusX to learn how to perform a cric, then watch this video from Larry Mellick on YouTube. This guy is the G.O.A.T. for online videos and this is no exception from a cadaver lab. Watch, practice, prepare, and repeat.
Click here for the entire video.
Whole Blood in Trauma
In this ResusX podcast episode, Dr. Salina Wydo discusses the history and rationale behind using whole blood transfusions for trauma patients with massive hemorrhage, reviewing existing evidence on its safety and effectiveness compared to component blood products. She explains how whole blood fell out of favor after Vietnam but has seen resurgence based on military experience, and describes the practical aspects of implementing a whole blood program at a civilian trauma center, sharing early results that demonstrate it is a feasible option.
Here are 5 key takeaways:
- Whole blood provides benefits over components like higher oxygen carrying capacity, less breakdown, and more efficient hemostatic factors.
- Evidence shows low-titer type O whole blood carries minimal risk of transfusion reactions or alloimmunization compared to potential benefits.
- Early civilian trauma center experiences demonstrate feasibility of implementing whole blood programs, with protocols expanding eligible recipients.
- Current research is limited by low-quality evidence and bias, but shows no inferiority of whole blood to component therapy for massive transfusion.
- More robust multi-center trials are underway which will provide higher-quality data on the role of whole blood in hemorrhagic shock resuscitation.
Welcome To Chris' Corner
We're excited to announce a new section from contributor Chris Reilly. Chris is a guitar-swinging, song-singing, education-bringing physician from NYC. Follow him at @docreilles on Instagram and TikTok. Let's see what Chris has for us in his post.
For years, normal saline (NS) has been the go-to fluid for resuscitation in emergency departments and ICUs due to its accessibility and compatibility. However, a shift towards balanced crystalloids like Lactated Ringers (LR) has been gaining momentum in recent years, thanks to emerging data showing some clinical benefits over NS (except in a few circumstances, which we’ll get into in a later newsletter). One of the biggest myths surrounding LR: it causes hyperkalemia. However, this argument overlooks the actual physiology of fluid distribution in the body.
When intravenous fluids are given, they distribute across various compartments within the body, not just the EXTRAcellular space (where hyper K can wreak havoc). Therefore, the volume of LR does not stay in the EXTRAcellular space (think of a patient who gets fluid overloaded). The thought is that LR, with a concentration of 4 mEq/L, would tip some of these borderline hyperkalemic patients over the edge. But again, your body is smarter than that (and smarter than a lot of physicians who think it can cause hyperkalemia - burn). In some circumstances, it can even decrease potassium levels closer to LR concentration due to fluid distribution across different compartments. Therefore, it is physiologically not possible to assume that LR would cause a significant increase in extracellular potassium levels. Several studies have even supported the safety of LR and Plasma-Lyte (5 mEq/L) in hyperkalemia and even suggested it as the better choice over normal saline due to higher chloride loads leading to acidosis and causing potassium to shift out of cells. So, next time you have a patient who needs fluids with a diagnosis of hyperkalemia, keep this in mind.
Check out the full blog post on CriticalCareNow by Jon Pickos with illustration by Rahel Gizow.
Join the ResusNation and Get Tons of Content For Less Than a Cup of Coffee
Signup for the ResusNation today and see why over 500 resuscitationists are members. As a ResusNation member you will receive extra content from CriticalCareNow such as live digital teaching sessions, podcasts, free video lectures, a library of grand rounds, and so much more. Check out the memberships options available below and pick the one that is right for you.
There's nothing to think about, you'll be automatically billed monthly and cancel anytime....no questions asked! Looking for a deal? Pay for a yearly pass and get one month free!
ResusNation: Basic Membership (Monthly)
Show your support with our basic membership.
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Access to 2 cutting edge lectures monthly from world-renowned speakers every month
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Unlimited viewing of videos
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Ability to watch on a desktop or mobile video player
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Pay for a monthly or yearly membership
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CEUs available
ResusNation: All-Access Pass (Monthly)
The ULTIMATE membership! In addition to everything in the basic plan, you'll also receive:
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5 cutting-edge lectures monthly from world-renowned speakers
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Exclusive weekly podcasts
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Attend the exclusive Q & A session with Grand Round speakers
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Access our Grand Rounds library and watch previous episodes on replay.
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Watch every Chawk Tawk on replay
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Join our twice-monthly hangouts where you can hang out and ask us anything
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Access the ResusX Community, a forum for questions, post cases, & interact and network with others
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Receive CEU credits for the content that you watch
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Pay for a monthly or yearly membership
ResusNation: Basic Membership (Yearly)
Show your support with our basic membership.
-
Pay for the year and get one month FREE!
-
Access to 2 cutting edge lectures monthly from world-renowned speakers every month
-
Unlimited viewing of videos
-
Ability to watch on a desktop or mobile video player
-
Pay for a monthly or yearly membership
-
CEUs available
ResusNation: All-Access Pass (Monthly)
The ULTIMATE membership! In addition to everything in the basic plan, you'll also receive:
-
Pay for the year and get one month FREE!
-
5 cutting-edge lectures monthly from world-renowned speakers
-
Exclusive weekly podcasts
-
Attend the exclusive Q & A session with Grand Round speakers
-
Access our Grand Rounds library and watch previous episodes on replay.
-
Watch every Chawk Tawk on replay
-
Join our twice-monthly hangouts where you can hang out and ask us anything
-
Access the ResusX Community, a forum for questions, post cases, & interact and network with others
-
Receive CEU credits for the content that you watch
-
Pay for a monthly or yearly membership
