A Message From Haney
Why George Clooney Yelled This Word at Everyone in the 90s
We’ve all watched enough Grey’s Anatomy to know that "STAT" is the magic word that makes nurses sprint and dramatic music swell. But contrary to that rumor your aunt forwarded you, it isn’t a fancy acronym for "Sooner Than Already There." It’s actually the great-grandchild of the Latin word statim, which translates to "immediately" or "while standing." Basically, ancient doctors were saying, "Do this before you even move your feet to walk away, or so help me Jupiter, I will lose it."
Why do we still use it? Because back in the 19th century, Latin was the universal language of medicine, ensuring a doctor in London and a doctor in Berlin could both agree on exactly how much to panic. Today, it remains the ultimate trump card for urgency. So, the next time your coffee order is taking too long, try telling the barista you need that double-shot espresso statim. We can’t promise it will speed things up, but it will definitely make you feel like a TV surgeon for a solid three seconds.
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Is Ketamine Actually Safe for Traumatic Brain Injury?
For decades, a persistent medical dogma has warned clinicians against using ketamine for patients with traumatic brain injury (TBI), fearing it would dangerously spike the pressure inside the skull (intracranial pressure or ICP). In emergency situations where every second counts, this belief has often limited sedation options for patients requiring immediate breathing support. However, a comprehensive new systematic review and meta-analysis of 15 studies—covering over 6,000 patients—is challenging this "old myth". The researchers found that, contrary to historical concerns, ketamine does not appear to increase hospital death rates or worsen brain pressure in TBI patients.
The results of this analysis have significant real-world implications for emergency care. The data showed that ketamine use was not associated with elevated intracranial pressure; in fact, some evidence even hinted it might help reduce it. This gives healthcare providers a green light to utilize ketamine's beneficial properties—such as maintaining respiratory reflexes—without the fear of causing secondary brain damage. However, the study did identify one critical limitation: patients receiving ketamine had a higher risk of hypotension (low blood pressure). While the fear of raising brain pressure may be unfounded, this new evidence suggests that clinicians should feel confident using ketamine for TBI, provided they remain vigilant in monitoring and managing the patient's blood pressure.
Here's my Takeaways:
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Finding: Ketamine administration did not statistically increase hospital mortality (RR=1.18) or intracranial pressure (RR=0.67) in patients with traumatic brain injury.
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Practice Impact: Clinicians can consider ketamine a safe option for TBI sedation and intubation, moving away from historical avoidance due to ICP concerns.
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Population: A diverse group of over 6,000 adult and pediatric patients with mild to severe traumatic brain injury analyzed across 15 studies.
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Limitation: The study identified a significant association between ketamine use and hypotension episodes (RR=1.47), requiring careful hemodynamic monitoring during administration.
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Want to learn more? Read the full study: Is ketamine safe for traumatic brain injury? A systematic review and meta-analysis by Sciorilli et al. in Journal of Critical Care.
Watch the December'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.
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