How Our Ancestors Survived Freezing Temps Without Netflix (or Blankets)
Winter wasn't just inconvenient for our prehistoric ancestorsā€”it was a life-or-death battle against freezing temperatures and scarce resources. Yet through remarkable ingenuity, they developed sophisticated survival strategies including constructing intricate shelters and mastering fire. Far from being solitary survivalists, early humans relied on tight-knit community cooperation to ensure everyone made it through the harshest months.
Contrary to popular "caveman" stereotypes, our early ancestors rarely relied solely on naturally occurring caves. Archaeological evidence shows that as far back as 400,000 years ago, species like Homo heidelbergensis were constructing impressive 30-foot wooden shelters on beaches in what is now France. These sophisticated structures, along with hide-covered tents and snow-packed huts, created crucial microclimates that kept communities significantly warmer than the freezing world outside their walls.
Welcome to the 107th edition of ResusNation!
Are You Using Peripheral Vasopressors?
A recent CritBit video addresses a common misconception in critical care - that vasopressors require central line administration. I talked about research supports the safety and effectiveness of peripheral vasopressors when appropriate protocols are followed:
- Properly placed IVs above the elbow (avoid small distal veins)
- Duration less than 24 hours (though longer may be possible)
- Regular monitoring of IV insertion site
- Established institutional protocols for managing potential extravasation
Doing this can reduce unnecessary central line placements while providing timely vasopressor support. Please share below if your institutions has implemented peripheral vasopressor protocols.
Watch the full video here and leave a comment.
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Watch 75 of Our Best Resus Videos!
Have you managed a crash airway, had to resuscitate with refractroy ventricular tachaycardia, or lead your team during a resuscitation? If you answered yes, then ask yourself, "are you treating your patients with the most cutting-edge and evidence based medicine?" Today you can sign up for ResusX:Select Volume 1,2, and 3. In all, you will get lifetime access to 75 of our very best resuscitation videos so you can take your skills to the next level!
Each of these videos is hand picked by our editorial team because they demonstrate mastery in resuscitation. Each of these videos is engaging, entertaining, and jam packed with information. At the completion of the program, you will be able to claim 12.0 AMA PRA Category 1 Credits or CEU contact hours.
Check out all 75 videos that you'll get lifetime access to:
And because you're a newsletter subscriber, I have a super special deal for you. Register for ResusX:Select right now and get 20% off your registration. That's a HUGE savings for 75 videos! Plus, if you are a resident, NP, PA, or nurse, you'll receive an additional 10% off. The only catch is we only have 50 of these discounts codes to giveaway, so it's first come first serve. Use the code "SELECT3" at checkout or just click the link below!
Stop Using Routine Antibiotics in Polytrauma Patients?
Antibiotic prophylaxis has long been considered a potential strategy for preventing complications in polytrauma patients, particularly ventilator-associated pneumonia (VAP). However, a recent systematic review and meta-analysis challenges this conventional approach. Researchers examined three randomized controlled trials involving 256 polytrauma patients to evaluate whether antibiotic prophylaxis improves clinical outcomes compared to placebo or standard care. The findings were revealing: prophylactic antibiotics showed no significant effect on all-cause mortality, duration of mechanical ventilation, or ICU length of stay. While selective decontamination did demonstrate a 70% reduction in VAP incidence in one study, the overall evidence was rated as very low certainty.
The review identified two distinct prophylactic approaches: selective decontamination (of the digestive tract or subglottic area) and systemic antibiotics (penicillin/ampicillin). Neither approach demonstrated mortality benefits, challenging the routine use of prophylactic antibiotics in all polytrauma patients. The researchers emphasized that current evidence is outdated and insufficient, with the included studies dating back to 1976-2002. They call for urgent high-quality research to inform contemporary clinical decision-making, particularly given rising concerns about antibiotic resistance in intensive care settings. Until stronger evidence emerges, clinicians should carefully weigh the potential benefits of targeted decontamination for VAP prevention against the risks of contributing to antibiotic resistance.
KEY TAKEAWAYS
- Antibiotic prophylaxis showed no significant effect on mortality (RR 1.01, 95% CI 0.55-1.85) but may reduce VAP risk by 70% (RR 0.30, 95% CI 0.13-0.72)
- Routine antibiotic prophylaxis for all polytrauma patients cannot be recommended; selective decontamination may be considered for high-risk VAP patients only
- Adult polytrauma patients (mean age 37.4 years, 81.6% male) requiring intensive care and often mechanical ventilation
- Evidence is outdated (1976-2002) and of very low certainty with high risk of bias in all included studies
Want to learn more? Read the full study "Effectiveness of antibiotic prophylaxis in polytrauma patients: a systematic review and meta-analysis" by European Journal of Trauma and Emergency Surgery 2025.
Save the Date: ResusX25
Mark your calendars! We're thrilled to announce that ResusX 2025, the premier resuscitation conference of the year, is returning for its seventh spectacular year. Join us September 29 - October 1, 2025, as we take over Philadelphia's iconic Punchline Comedy Club for our most ambitious event yet.
The overwhelming interest we've received through emails and messages has shown just how exited the ResusNation is for this announcement. We're pulling out all the stops to bring you an unforgettable experience featuring the leading voices in resuscitation medicine - live and in person. Don't miss your chance to be part of this landmark event in the City of Brotherly Love. Stay tuned for more details about our world-class speakers, innovative sessions, and more.
We're finalizing an action-packed schedule, including specialized post-conference workshops. Full CME and CEU details will be available on our website shortly.
Given the intimate venue and unprecedented interest in ResusX 2025, we anticipate tickets will sell out rapidly. As a valued newsletter subscriber, we want to ensure you have priority access to registration. So here's how to secure your spot:
If you're committed to attending ResusX 2025, simply complete our priority access form below. You'll receive immediate notification when ticket sales open, giving you first opportunity to register. Based on the overwhelming response we've already received, we expect tickets to be claimed quickly during this priority registration period.
Complete the Priority Access Form
Watch the March 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
- Propersi on "Capecod Trial"
- Schauer on "Trauma Contributions from the Military"
- Fornari on "Cerebral Edema in Pediatric DKA"
- Kim on "Everything You Wanted to Know About Thoracotomies"
- Weingart on "Trauma Team Leader"
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!
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