A Message From Haney
Puff, Puff, Gasp! When Smoking Was a 'Cure' for Asthma
For centuries, doctors prescribed all sorts of bizarre things, and one of the strangest has to be recommending smoking as a treatment for asthma. Picture this: a patient walks into a doctor's office, gasping for air. The doctor, in a wise and knowing tone, says, "Ah, yes, a classic case. You need more smoke in your life." And then, they would hand over what were literally called "asthma cigarettes," which were basically a mix of tobacco and herbs. It wasn't a joke, it was the accepted medical advice! If a time-traveler from today were to go back and witness this, they'd probably have an asthma attack just from the irony of it all.
This went on for a surprisingly long time, with people puffing away on their prescribed smokes, all in the name of feeling better. Thankfully, we've come a long way since then. Our modern doctors now recommend much more sensible things, like life-saving inhalers and, you know, not inhaling anything that's actively on fire. So the next time you see a commercial for a fancy new asthma inhaler, just remember that its ancestors were a bunch of herbs rolled up in paper, and be thankful for the wild and wonderful progress of modern medicine.
Welcome to the 131st edition of ResusNation!
Know How do Do THIS!
In emergency medicine, the ability to perform a cricothyroidotomy isn't just a niche skill—it's a fundamental part of managing a difficult airway, and this case proves exactly that. I’ve been in situations where a patient presents with a rapidly deteriorating airway, and there’s no time to waste with alternative methods. In this video Dr. Rich Byrne recalls a case where a patient, who'd had a neck embolization just the day before, walked into the ED with a swelling neck. Within minutes, the patient became cyanotic and went into cardiac arrest right in front of us. An initial attempt at oral intubation was made, but it was clear that the airway was compromised from external compression, and a surgical approach was our only option. This patient would not have survived if we hadn't been ready to perform a cricothyroidotomy.
The reality is, in a "can't intubate, can't ventilate" scenario, many of the tools we rely on daily, like video laryngoscopes or even LMAs, become useless. There's no time to wait for a surgeon or another specialty team to arrive; you have to act immediately. This is why I stress that every emergency medicine professional needs to master the skill of a cricothyroidotomy. It’s a life-saving procedure that, in a situation like this, is the only thing that stands between a patient and certain death. The ability to perform this procedure is non-negotiable and essential for anyone who manages airways.
Watch the full video here and leave a comment.
Don't forget to like and follow my IG, TikTok, YT, Facebook or Linkedin accounts.
Tickets Are Almost Sold-Out !
ResusX:2025 is the most anticipated resuscitation conference of 2025 is almost sold-out! 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, 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.
GET SHESE BONUSES!
- Lifetime access to ResusX:2024 + CME / CEUs
- Lifetime access to ResusX:2023 + CME / CEUs
- FREE Ticket to ResusEM Live in Philly on October 9th. Attend Live or Virtually
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
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.
Is High-Flow Nasal Oxygen is a Viable Alternative to NIV?
When a patient arrives at the emergency room struggling to breathe due to pulmonary edema from heart failure, a common and uncomfortable device called non-invasive ventilation (NIV) is often used. This mask is a powerful tool, but many patients find it difficult to tolerate. What if there was a more comfortable option that was just as effective? A new study published in the American Journal of Emergency Medicine investigated this exact question, comparing the standard NIV treatment with a different method: the high-flow nasal cannula (HFNC). The good news is that both methods were found to be equally effective in helping patients breathe easier.
The study found no significant difference between the two treatments in reducing respiratory distress. Patients on both HFNC and NIV showed similar improvements in their breathing rate, oxygen levels, and overall comfort after two hours. The HFNC device, which delivers heated and humidified oxygen through a soft nasal tube, was just as good at reducing the symptoms of fluid in the lungs as the NIV mask. The most important implication is that since HFNC is generally better tolerated by patients, it can be a great alternative to the standard NIV therapy. While this single study doesn't tell us about long-term outcomes like hospital stay or survival, it's a promising step toward making emergency care for heart failure more comfortable and effective.
Here's my Takeaways:
- Finding: No statistically significant difference was found between high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) in reducing respiratory rate and other signs of respiratory failure in patients with acute cardiogenic pulmonary edema.
- Practice Impact: HFNC, which is often better tolerated and more comfortable for patients, may be considered a viable alternative to NIV for patients with acute cardiogenic pulmonary edema.
- Population: The study focused on adult patients (18 years or older) with acute cardiogenic pulmonary edema who required ventilatory support. It was conducted at a single academic emergency department in Turkey.
- Limitation: The study was a single-center trial, which may limit the generalizability of the findings. It did not assess long-term outcomes like intubation rates, hospital length of stay, or mortality. Due to the nature of the interventions, treating clinicians and patients could not be blinded, which introduces a risk of bias.
 |
Want to learn more? Read the full study "Is high-flow nasal oxygen as effective as non-invasive ventilation in acute cardiogenic pulmonary Edema?" by Erhan Altunbas et al. in the American Journal of Emergency Medicine.
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.
Get Access To The ResusNation Today!
Responses