Do Elephants Get Cancer?
Despite their massive size and the sheer number of cells in their bodies, elephants have an astoundingly low rate of cancer. The reason? These gentle giants carry 20 copies of the tumor-suppressing gene TP53, while humans have just one. TP53 acts like the body’s cellular quality control—detecting damaged DNA and triggering cell death before mutations can take hold and turn cancerous.
This natural defense mechanism has sparked major interest in the medical world. Researchers are now diving into elephant genetics to understand how these extra copies of TP53 function and whether we can harness this biological advantage in human cancer prevention or treatment. It’s one of the many ways nature may already hold the blueprint for curing some of our toughest diseases.
Welcome to the 111th edition of ResusNation!
How Emergency Medicine Could Evolve Into A Procedure Subspecialty
As emergency physicians, we've become the default specialists for procedures that others often avoid. From paracenteses to spinal taps, these essential interventions frequently land in our department simply because no one else wants to do them. Despite the changing landscape of emergency medicine, I firmly believe that procedural competency remains a cornerstone of our specialty. My years in the ED have consistently shown that our willingness and ability to perform these procedures defines much of our value in the medical ecosystem. While other specialties may defer these interventions, we embrace them as part of our identity as proceduralists at heart. Looking ahead, I see this procedural expertise potentially evolving into its own subspecialty within emergency medicine, allowing us to further refine and advance these critical skills that so many patients depend on.
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Stop The Madness (In Codes)!
Chaotic codes don’t have to be the norm. In this video, I break down a simple, high-impact approach to managing cardiac arrest with clarity and confidence—focusing on one clear leader, a system-based strategy, and a team-over-heroics mindset. Based on lessons from the RAGE podcast, this is your quick guide to running smoother, more effective resuscitations. Whether you're in emergency medicine, still in training, or leading a Code Blue, these evidence-based tips will help you stay calm, lead well, and save lives.
Check out this video of Dr. Haney Mallemat from ResusX:ReVolved now!
Is Mechanical Thrombectomy Superior to Catheter-Directed Thrombolysis in PE?
The PEERLESS randomized controlled trial provides the first head-to-head comparison of large-bore mechanical thrombectomy (LBMT) versus catheter-directed thrombolysis (CDT) for intermediate-risk pulmonary embolism (PE). This multicenter study of 550 patients with intermediate-risk PE and right ventricular dilatation demonstrated that LBMT significantly outperformed CDT on a composite primary endpoint. LBMT showed a 67% reduction in clinical deterioration/bailout events (1.8% vs. 5.4%) and dramatically reduced post-procedural ICU utilization (41.6% vs. 98.6% admission rates), while maintaining equivalent safety with no differences in mortality or major bleeding rates (both 6.9%).
The evidence showed LBMT patients experienced earlier functional recovery, with significantly fewer patients having moderate-to-severe dyspnea at 24 hours (13.5% vs. 26.4%) and improved right ventricular function. LBMT also resulted in shorter hospital stays (4.5 vs. 5.3 days) and fewer 30-day readmissions (3.2% vs. 7.9%). Importantly, both interventions demonstrated remarkably low 30-day mortality rates (0.4% vs. 0.8%), suggesting that catheter-based interventions for intermediate-risk PE can be performed with high success rates, with LBMT providing additional clinical benefits without increasing bleeding risk.
These findings have immediate implications for pulmonary embolism response teams and interventionalists, supporting LBMT as a first-line approach for intermediate-risk PE patients when intervention is deemed necessary, particularly in patients with elevated bleeding risk or when more rapid recovery and shorter hospitalization are prioritized.
Here's my Takeaways:
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Finding: LBMT reduced clinical deterioration/bailout events by 67% compared to CDT (1.8% vs. 5.4%, p=0.04) with equivalent major bleeding rates (6.9%)
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Practice Impact: LBMT should be considered first-line therapy for intermediate-risk PE requiring intervention, reducing ICU utilization and hospital stays
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Population: Patients with intermediate-risk PE with right ventricular dilatation and additional clinical risk factors, with 94.7% having elevated cardiac troponin
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Limitation: Study did not include anticoagulation-only control arm, and enrolled a lower-than-expected proportion of patients with elevated bleeding risk
Want to learn more? Read the full study "Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial" by Jaber WA, Gonsalves CF, Stortecky S, et al; PEERLESS Committees and Investigators. Epub 2024
Save the Date: ResusX25
Mark your calendars! We're thrilled to announce that ResusX 2025, the premier resuscitation conference of the year, is returning for its seventh spectacular year. Join us September 29 - October 1, 2025, as we take over Philadelphia's iconic Punchline Comedy Club for our most ambitious event yet.
The overwhelming interest we've received through emails and messages has shown just how exited the ResusNation is for this announcement. We're pulling out all the stops to bring you an unforgettable experience featuring the leading voices in resuscitation medicine - live and in person. Don't miss your chance to be part of this landmark event in the City of Brotherly Love. Stay tuned for more details about our world-class speakers, innovative sessions, and more.
We're finalizing an action-packed schedule, including specialized post-conference workshops. Full CME and CEU details will be available on our website shortly.
Given the intimate venue and unprecedented interest in ResusX 2025, we anticipate tickets will sell out rapidly. As a valued newsletter subscriber, we want to ensure you have priority access to registration. So here's how to secure your spot:
If you're committed to attending ResusX 2025, simply complete our priority access form below. You'll receive immediate notification when ticket sales open, giving you first opportunity to register. Based on the overwhelming response we've already received, we expect tickets to be claimed quickly during this priority registration period.
Complete the Priority Access Form
Watch the April's Videos Now!
If you're an All-Access Member, you're in for some great content this month. We have FIVE videos hand-picked by our staff that are high-yield and our most highly watched. We're featuring
- Wright on "The Super Sick SAH"
- Reilly on "CT Head for the Resuscitationist - What is the Approach?"
- Haywood on "NIV Mask Seal"
- Rezaie on "DSI v. RSI"
- Qasim on "Getting to the Heart of the Matter: Breaking Down the Resuscitative Thoracotomy"
Each month we bring you fresh new content from the best of the best in resuscitation. If you're an All-Access member, go watch these videos NOW! If you're not, then sign up here.
Are you a member of ResusNation? For less than a cup of coffee, you can get even more content from CriticalCareNow. Digital teaching sessions, podcasts, free video lectures, grand rounds, and so much more can be your today. Come watch on replay all the content that CriticalCareNow does live. Check out the membership options below and decide the right one for you.
Do you want even more resus content anytime you want? For less than a cup of coffee, you can get even more content from @CriticalCareNow. Digital teaching sessions, free video lectures, grand rounds, and so much more can be your today. Come watch on replay all the content that @CriticalCareNow does live.
Check out the membership options below and decide the right one for you.
Get Access To The ResusNation Today!
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