The Tale Of The Glowing Hands And The Accidental Ray!
This medical history fact sounds almost too strange to be true. Discover the bizarre moment that revealed the insides of your body for the very first time! It's 1895, and German physicist Wilhelm Röntgen is deep in his laboratory, experimenting with mysterious cathode rays. But things got truly weird when he noticed a screen across the room lighting up with an eerie glow, even though it was shielded. These invisible rays, which he bafflingly called "X-rays," had the astonishing ability to pass through soft tissue but were stopped by bone. His first image? A slightly spooky, yet undeniably amazing, look at his wife's skeletal hand, complete with her wedding ring!
This unexpected discovery, born from pure scientific curiosity and a glowing screen, was far from just a parlor trick; it was a revolution hiding in plain sight. The ability to see inside a living person without surgery was a medical marvel that would go on to form the bedrock of modern diagnostic imaging. Röntgen's X-rays were the accidental spark that led directly to the powerful and precise imaging technologies we rely on every day, like detailed CT scans and intricate MRIs. It just goes to show that sometimes, the most transformative medical innovations begin with a moment of unexpected scientific weirdness!
Welcome to the 115th edition of ResusNation!
Should You Embrace Nebulized Nitro?
Dr. Steve Haywood recounds his experience where there's hesitation surrounding inhaled nitroglycerin, often fueled by concerns about dosing and administration. In this video he suggests a five-milligram dose over 15 minutes, which can feel daunting with varying IV nitroglycerin concentrations available in different emergency departments. For sick pulmonary hypertension patients he talks about taking the formulation you have on hand and administer it continuously via nebulization.
Forget the intricate calculations and the fear of overdose. With the concentrations typically available – whether it's 100, 200, or even 400 micrograms per mL – Steve says that you're unlikely to administer a harmful amount. The focus should be on getting the medication to the patient efficiently. So, when managing pylmoanry hypertension patients, don't let fear paralyze you.
Watch the full video here and leave a comment.
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Registration Is Now Open!
ResusX:2025 is the most anticipated resuscitation conference of 2025 is now open for early-bird registration! Come to historic Philadelphia and spend three-days watching the Rockstars of Resuscitation in action. You'll see short format, high-energy talks, interviews, procedure demoes, and debates. ResusX is not simply a conference, but a resuscitative experience where you are part of the show and spend lots of time after the conference hanging out with the faculty.
Registration will not only give you full-access to the conference but also a swag bag filled with a t-shirt, mug, stickers, and a ton more. Food and snack is on us and you'll also be elibigble to earn up to 20.0 CME or CEU credit. We got your trip covered with on-site parking and an available hotel block.
We will also be offering a selection of post-conference workshops on October 2 & 3 including:
- Amal Mattu's ECG workshop
- UltraRounds: the resuscitative ultrasound workshop
- ResusReady: a procedural workshop for resuscitationists
- The Total Airway Workshop
- The Resuscitationist Guide To The Vent
Today is your opportunity to take your resuscitation skills to the next level and save big with our early-bird discounts. Come to ResusX, learn the skills and save more lives. Click on the link below to register for your early-bird tickets now.
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Morning Report
Welcome to the Morning Report—a new show with unfiltered clinical talk. In this first episode, Dr. Haney Mallemat teams up with legends Dr. Steve Haywood, Dr. Anand Swaminathan, and Mike Carunchio to break down a wild PE case that spirals from EMS to the ED.
Here’s what’s coming in hot:
⚡ Pressor stacking IRL: What, when, how?
⚡ Inhaled nitro… hero move or hype?
⚡ TPA—push it fast or slow roll?
⚡ Why intubating a crashing PE can be deadly (and how to avoid it)
And we don’t stop there—we’re throwing down some 🔥 rapid-fire takes:
- Bougie every time or chill out already?
- Is EMS ready for blood in the field?
- Roc vs. Succ—who you reppin’ for neuro RSI?
- What actually works for intubation training in 2025?
This episode is fast, fun, a little chaotic—in the best way—and packed with legit pearls for your next resus.
🎟️ Want more from these rockstars? Meet us at ResusX this fall → ResusX.com
Severe Pneumonia Treatment: Is Hydrocortisone the Answer?
Severe pneumonia can be a life-threatening condition, often requiring intensive care. Researchers have been exploring various treatments to improve patient outcomes. This new study dives into whether hydrocortisone, a common anti-inflammatory drug, can reduce the risk of death for these critically ill patients. Understanding the effectiveness of available treatments is crucial for patients and their families facing this challenging illness.
The main finding of the study is that hydrocortisone treatment, compared to no hydrocortisone, does not appear to significantly lower the risk of death in patients with severe pneumonia. Although the drug may help shorten the time patients need cardiovascular support, it doesn't seem to have a big impact on overall survival. The researchers point out that while their study was well-conducted, it couldn't rule out smaller benefits or potential harms of hydrocortisone. More research is needed, but these findings will likely influence how doctors approach treatment for severe pneumonia.
Here's my Takeaways:
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Hydrocortisone treatment, compared with no hydrocortisone, appears unlikely to yield a large reduction in mortality in patients with severe CAP.
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Smaller benefits and possible harm of hydrocortisone are not excluded.
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The findings were consistent in sensitivity analyses and across secondary outcomes, regardless of whether patients presented in septic shock or not.
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In exploratory analysis, hydrocortisone may reduce the duration of vasopressor requirement.
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Want to learn more? Read the full study "Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia" by Derek C. Angus et al. in Intensive Care Medicine.
The A.D.D. Approach to Becoming More Productive
Pareto’s Principle states 80% of the impact is achieved by 20% of the effort. But how can you control your time to achieve the greatest impact?
For the past 5 years as an ICU doctor and clinical researcher, I have used the A.D.D. approach every week. With practice, this has truly helped me improve my productivity by over 5 times. Here’s how you can do it (right now). Write down a list of everything you do (personal and professional) in a week. For things that don’t bring you joy, ask yourself, how can I A.D.D. them?
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Automate
Automate repetitive tasks – small time savings add up. Examples: meetings, calendar bookings, email inbox management tools, reference managers etc. -
Delegate
Ask yourself, which of these tasks do I personally need to do? Delegate tasks that don’t require your unique expertise. -
Delete (Deprecate)
Be relentless in removing things that do not generate value or impact. We are good at saying yes, but bad at saying no, and horrible at saying “I am going to stop doing this”.
Applying A.D.D. means reclaiming hours of time each week — time you can spend on actual thinking, achieving an impact, or enjoying your life!
➡️ Want specific examples of how to A.D.D. your life? Check out the full guide on: The A.D.D. Approach
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.
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