A Message From Haney
Welcome to the 129th edition
of ResusNation!
A Tongue That Weighs
More Than an Elephant?
It’s hard to imagine the sheer size of a blue whale, the largest animal on Earth. To give you some perspective, consider this: a single blue whale's tongue can weigh as much as an adult elephant. That's a staggering 4,000 to 8,000 pounds! This massive organ is just one part of the whale's enormous body, which can stretch up to 98 feet long and weigh as much as 200 tons. The immense scale of these gentle giants is truly breathtaking.
The incredible size of the blue whale is a testament to the wonders of our oceans. Their immense tongues are perfectly adapted for their unique feeding style. They are filter feeders, meaning they gulp down enormous amounts of water filled with tiny krill. Their powerful tongues then help to push all that water back out through their baleen plates, trapping the krill inside for a delicious meal. It’s a fascinating and efficient process that highlights the amazing evolutionary adaptations found in the animal kingdom.
Welcome to the 129th edition of ResusNation!
The Ultimate MedEd Challenge
(and a Free Conference Ticket)
I am a big believer in the power of medical education, and I've found that the best educators are those who can distill complex topics into concise, high-impact lessons. That's why I'm personally running a video education contest with a specific challenge: create a video using only 20 slides, with each slide lasting exactly 20 seconds. This may seem simple, but believe me—it's not. I've tried this format myself, and it requires incredible discipline and a deep understanding of your subject matter to deliver a powerful message in just 6.6 minutes. This isn't for everyone; it's a true test for those who are passionate about teaching and ready to push their skills to the limit.
This 20x20 format forces us to cut out the fluff and focus on what's truly essential. It's about being an expert who can communicate clearly and efficiently, because in our field, time is always a critical factor. I believe this type of focused educational content is the future of medical training, and I'm excited to see the innovative ways you all rise to the occasion. The winner will receive a free, live ticket to my conference in Philadelphia. I'm personally reviewing every submission, and I can't wait to see the incredible content that comes out of this challenge.
Watch the full video here and leave a comment.
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Norepinephrine vs. Ephedrine & Post-Op Complications
When patients undergo major surgery, one of the biggest risks is a sudden drop in blood pressure, or hypotension, especially right after anesthesia is administered. This can happen because of the medications used and is a known contributor to organ dysfunction after surgery. For years, the go-to solution has been to treat these drops as they happen, often using a drug called ephedrine. But what if we could prevent them from happening in the first place? A recent study challenges this reactive approach, finding that a proactive strategy using a different drug might significantly improve patient safety and recovery.
The new research found that continuously giving patients a low dose of norepinephrine from the very start of anesthesia induction was much more effective at maintaining stable blood pressure. This preventative approach resulted in a 14% lower risk of any medical or surgical complication within 30 days after surgery compared to the standard method of giving ephedrine as needed. Notably, the biggest difference was seen in the reduction of postoperative pulmonary (lung-related) complications. While this was a single-center trial and needs to be confirmed by larger studies, it provides a compelling case for changing how we manage blood pressure during this critical phase of surgery. This new approach could lead to a shift in clinical practice, offering a safer path forward for vulnerable patients undergoing major procedures.
Here's my Takeaways:
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Finding: Prophylactic use of norepinephrine reduced the risk of medico-surgical complications within 30 days by 14% (44% vs. 58%) and significantly lowered postoperative pulmonary complications (17% vs. 31%) compared to reactive ephedrine treatment.
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Practice Impact: Starting a continuous norepinephrine infusion early to prevent hypotension (low blood pressure) may be a more effective strategy than giving ephedrine boluses only after blood pressure has already dropped.
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Population: The study focused on high-risk patients, specifically adults over 50 years old with an ASA score of ≥2, who were undergoing major abdominal surgery.
- Limitation: The study was conducted at a single center, which means the results may not be generalizable to other hospitals and could have overestimated the treatment effect.
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Want to learn more? Read the full study "Early Use of Norepinephrine in High-Risk Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Trial" by Trocheris-Fumery et al. in Anesthesiology (2025).
Watch the August'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
- Kim on "Cricothyroidotomies & Emergency Airways"
- Marolini on "When Should We Neuro-Prognosticate"
- Hedayati on "Dual Defib Strategies"
- Goldstein on "The Agitated Patient"
- Haywood on "Vent Dyssynchronies"
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.
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