The History Of Epi In Arrest

Ever wonder why...

...we give exactly 1mg of epinephrine during cardiac arrest? The story begins in the 1960s, when researchers working with dog models of asphyxia discovered that epinephrine improved survival. The drug's effects were compelling: through alpha-adrenergic stimulation, it constricted peripheral blood vessels, effectively pushing more blood to critical organs like the heart and brain. Through beta-adrenergic effects, it made the heart beat stronger and faster. The medical community quickly embraced this intervention, and epinephrine became the standard of care in cardiac arrest management.

But here's the fascinating part - the 1mg dose we still use today wasn't established through careful dose-finding studies or extensive human trials. Instead, it became standardized more through tradition and convention than scientific validation. For decades, this dose went largely unquestioned, passed down through generations of medical training and codified in resuscitation protocols worldwide. It wasn't until recent years that researchers began to seriously examine whether this historical dose was actually optimal. The story of epinephrine in cardiac arrest serves as a remarkable example of how medical practices can become deeply entrenched without rigorous scientific validation, reminding us that even our most basic medical assumptions deserve periodic reexamination.

Welcome to the 93rd edition of ResusNation!

Stop That Seizure, NOW!

Everyone in resuscitaiton knows that status epilepticus is medical emergency, but what makes this condition particularly alarming is its sobering 30-day mortality rate of 10%; one in ten patients with status might not survive the month. However, there's hope in swift action: research consistently shows that rapid intervention significantly improves patient outcomes. The key principle in managing status epilepticus is simple yet crucial: the faster we control the seizures, the better chance we have at saving lives. This time-sensitive nature of treatment underscores the importance of healthcare providers recognizing and responding to status epilepticus with urgency and precision.

Watch the full video from Dr. Danya Khoujah here and leave a comment.

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The Big Intubation MicroSkills (Part I)

In this episode, Dr. Salim Rezaie dives into the "micro-skills" that form the foundation of successful intubation. Recorded at ResusX: ReUnion, Dr. Rezaie walks through practical techniques like flush-rate oxygenation, the use of PEEP valves, and positioning strategies to optimize oxygenation and reduce complications. He also shares his preferred medications and workflows to tackle challenging airways. If you're looking to refine your intubation preparation and improve patient outcomes, this episode is packed with evidence-based pearls you can start using today!

Check out this lecture from Salim at ResusX: ReUnion and explore over 60 life-changing talks from our world-class faculty, available on replay forever. Get 20% off with this link.

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Watch ResusX:ReUnion on Replay!

Tomorrow, October 8th, we are launching the replay for ResusX:ReUnion. If you weren't there live for ResusX:ReUnion then you missed an amazing experience with 3 days of education and over 50 faculty members. Fortunately for you, we got the whole incredible event captured on video and you can start watching tomorrow. 

These videos were recorded in high-definition and have remastered audio. When you register you'll also have access to high-yield summaries that you can download to take with you on the go. You'll also be able to earn CME or CEU credits as you watch.

And because I'm grateful that you are a newsletter subscriber, I'm giving you early-bird access with a coupon to save over 20% off the registration price. Starting tomorrow, use code "SAVE20" at checkout to get your discount. Please note, we only have a limited number of these coupons so don't wait too long to register. 

Crush Injuries

In this episode, Dr. Jenn Repanshek takes a deep dive into the management of crush injuries, highlighting the critical complications that can rapidly escalate if not treated properly. She discusses hyperkalemia, rhabdomyolysis, compartment syndrome, and the essential steps for fluid resuscitation and hemodynamic support. If you’re looking to sharpen your trauma management skills and improve outcomes for critically injured patients, this episode is packed with actionable insights you can apply immediately.

Check out this lecture from Jenn at ResusX: ReUnion and explore over 60 life-changing talks from our world-class faculty, available on replay forever. Get 20% off with this link.

Watch the December Videos Right 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

• Fornari on "Cerebral Edema in Pediatric DKA"
• Hockstein with a deep dive into "Echo Your ECMO!"
• Qasim presenting "REBOA – Why Are We Letting a Killer Out on the Streets?"
• Hicks on managing the "Massive Hemorrhage Protocol"
• Trott delivering insights on "Heads Up CPR"

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.

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