Does Mummy Know Best?

Mummy powder, a.k.a. "mumia" or "mummia"...

...was indeed used in European medicine from the Middle Ages through parts of the early modern period. This practice stemmed from a combination of misunderstanding, superstition, and the high regard for ancient Egyptian culture and practices.

The use of mummy powder as medicine was based on several beliefs:

1. The idea that the embalming substances used by ancient Egyptians had medicinal properties.
2. The notion that the preserved bodies contained a life essence that could be transferred to the living.
3. The general belief in the superiority of ancient wisdom and practices.

Mummy powder was prescribed for various ailments, including wounds, headaches, and digestive issues. It was sometimes mixed into drinks or applied directly to the skin.

This practice led to a significant trade in mummies and contributed to the destruction of many ancient Egyptian burial sites. By the 16th and 17th centuries, the demand was so high that there are reports of counterfeit mummies being produced to meet it.

The use of mummy powder declined as medical knowledge advanced and as the ethical implications of the practice became more apparent. By the 18th century, it had largely fallen out of favor in mainstream medicine.

It's a fascinating example of how medical practices can be influenced by cultural beliefs and misunderstandings.  

Okay, it's newsletter time!

An Easy Mnemonic for Beck's Triad

In the world of chaos, mnemonics can be lifesavers - both figuratively and literally. Today, I'm breaking down a clever mnemonic for Beck's Triad, the three classic signs of pericardial tamponade. But before we dive in, let's address the elephant in the room: while these signs are important to know, they're not your go-to diagnostic tool.

The JVD of It All

My mnemonic for Beck's Triad is simple: J.V.D. Here's what it stands for:

• J: Jugular venous distension
• V: Very low blood pressure
• D: Distant heart sounds

A Word of Caution

1. Before you commit this to memory, remember:
   1. These three signs together only show up in about 10% of tamponade cases.
   2. When they do appear together, it's usually in very sick, hypotensive patients.
   3. One or two of these signs alone aren't specific or sensitive enough for diagnosis.

The Ultrasound Ultimatum

Our expert emphasizes: if you even suspect tamponade, get that ultrasound machine in the room ASAP. In fact, I'd argue that in today's medical landscape, not knowing how to use ultrasound is a choice, not a limitation.

The Bottom Line

While Beck's Triad is a classic teaching tool, modern medicine demands more. This mnemonic is a great way to remember these signs, but it's no substitute for bedside ultrasound in diagnosing pericardial tamponade.

Watch the full video here and leave a comment.

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Resuscitative Thoracotomy

In this episode, Dr. Zaf Qasim takes us through the critical and complex procedure of Resuscitative Thoracotomy, as presented at the ResusX: Golden Hour conference. Dr. Qasim discusses the HOTTT algorithm, which includes Hemorrhage control, Oxygenation, Thoracostomy, Transfusion, and Trauma ultrasound, providing a step-by-step guide to managing patients with severe trauma. He offers practical tips on performing thoracotomies, addressing common challenges, and ensuring the best possible outcomes. This episode is packed with life-saving insights and is a must-listen for anyone in emergency medicine or trauma care.

Check out this video now and watch the entire ResusX: Golden Hour conference for more content from Zaf and our other all-star faculty!

 Watch the Video Now!

Quick Review: Cardiogenic Shock

The medical treatment of cardiogenic shock can be complex but don't worry, we got you. This review article discusses the medical treatment of cardiogenic shock (CS), a leading cause of mortality worldwide. The authors outline current approaches, emphasizing the use of inotropes like dobutamine and vasopressors like norepinephrine as first-line treatments. They highlight the importance of restoring cardiac output and maintaining adequate organ perfusion. The article also covers specific considerations for Takotsubo syndrome and hypertrophic cardiomyopathy, where standard treatments may be contraindicated. The authors of this review discuss emerging therapies being explored in clinical trials, including immunomodulation, cardiac myosin activators, and novel inotropic agents.

Key take-home messages:
• Dobutamine and norepinephrine remain the cornerstones of CS treatment
• Tailored approaches are crucial for specific conditions like Takotsubo syndrome
• Despite recent advances, CS treatment hasn't changed significantly in the past decade
• Emerging therapies show promise but require further research
• Medical therapy remains crucial even with the rise of mechanical support devices

Thanks to @CritCareReviews for highligting this article. 

Another Bonus For ResusX Attendees!!! 

If you registered for the ResusX:ReUnion conference you already know about all the great bonuses that we are including with your registration. We're giving you:

• Free registration to the ResusEM7: NeuroCritical Care Symposium on September 18
• Swag bag stuffed with a mug, pens, stickers, and more surprises
• Your sweet, comfortable, offical ResusX conference t-shirt
• Access to all the recorded conference content plus the exclusive virtual lectures not seen by the live audience (Deluxe registration only)
• Watch ResusX:ROSC video conference (Deluxe registration only)
• Watch ResusX:Golden Hour (Deluxe registration only)
• Watch ResusX:Reset conference (Deluxe registration only)
• Get 6 months of the ResusNation membership for FREE (Deluxe registration only)
• Free 3D printed cric trainer (Airway workshop attendees)

But as if these bonuses weren't enough we have one more gift to give you...everyone who attends live will receive a free copy of the Vasopressor and Inotrope Handbook by Eddy Gutierrez!!! You read that correctly...a free copy of this textbook when you attend ResusX live. We're also gifting this book to anyone who registers for the Virtual conference with the DeluXe upgrade (international shipping fees may apply).

If you manage critically ill patients and you are serious about helping patients survive to hospital discharge then do not miss ResusX. You will watch the Rockstars of Resuscitation live on stage, sharpen your procedural skills with hands on workshop, practice ultrasound on live models, listen to pannels, attend one of our four preconference workshops, and socialize with faculty and fellow attendees after the show.   

Don't miss this opportunity to learn, practice, and network with leaders in resuscitation. Register now for ResusX and take your skills to the next level!

Click the button below to secure your spot today. We also have discounts available for residents, fellows, nurses, paramedics and more. 

Get Your Ticket & FREE BOOK NOW!

Needle Vs. Knife for Spontaneous PTX  

The EXPRED study compared simple aspiration to chest tube drainage for primary spontaneous pneumothorax. It found that simple aspiration was non-inferior to chest tube drainage in achieving pulmonary re-expansion within 24 hours, despite a higher failure rate (29% vs 18-19%). The study, conducted across 31 French hospitals with 402 patients, showed similar treatment failure rates at 7 days and lower pain scores in the aspiration group. However, the study's applicability is limited by its design, patient population, and evolving clinical practices.

Key take-home messages:

• Simple aspiration is a viable initial treatment for complete primary spontaneous pneumothorax
• Aspiration offers less pain and fewer complications compared to chest tube drainage
• The study's results are limited to young males with primary pneumothorax
• Further research is needed to compare simple aspiration with newer techniques like pigtail catheters
• The wide non-inferiority margin (25%) raises concerns about the robustness of the findings

For a more detailed analysis and discussion of the study's implications for medical education, check out the full blog post here.

ResusNation Unite!

All-Access members of the ResusNation are invited to join Haney Mallemat for an online interactive session this Thursday, August 15th at 1pmEST. Bring your cases, questions, or just listen in to what other members are talking about. We'll meet on the Kajabi app so we can all talk face to face. And don't worry if you can't make the meeting, it'll be recorded for you to watch after the fact. If you are an All-Access member, you'll receive an email with your private link soon.

Not a member? Then it's time to sign up because membership comes with privledges. You'll get access to monthy hangouts, access to our grand rounds library, access to post-grand rounds Q&A wtih the faculty, 5 monthly videos, and so much more.       

Become a member Now! 

Breaking the RV Death Spiral

In this episode, Dr. Kristen Adorno takes us through the urgent management of acute right heart failure, focusing on the "RV death spiral" caused by massive pulmonary embolism. Recorded at the ResusEM6: The Broken Heart Conference, Dr. Adorno provides a step-by-step guide to resuscitating these critically ill patients, from avoiding common pitfalls like unnecessary intubation to the strategic use of vasopressors and ECMO. Her practical, pathophysiology-driven approach is designed to empower clinicians to handle these challenging cases with confidence. This episode is packed with essential insights for anyone involved in emergency and critical care.

Check out this video now and watch the entire ResusEM6: The Broken Heart Conference conference for more content from Kristen and our other all-star faculty!

Watch the Video Now! 

Watch the August 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

• Amal Mattu on "Modern Management of Acute Pulmonary Edema"
• Zaf Qasim with a discussion on "Trauma"
• Salim Rezaie comparing "DSI v. RSI"
• Terren Trott in the "Airway Hotseat (Part II)"
• Max Hockstein covering "Anti-Dysrhythmics in the ICU"

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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