Just Add Pee, To The Seeds

In the shadows of ancient pyramids, Egyptian physicians developed an intriguing method of pregnancy testing that would puzzle scientists for millennia. Written in papyrus scrolls dating back to 1350 BCE, this technique directed women to urinate on two bags of seeds: one containing barley, the other wheat. If neither sprouted, the woman wasn't pregnant. But if the seeds germinated, not only was this taken as confirmation of pregnancy, but the type of seed that sprouted first was believed to predict the baby's sex – barley for a boy, wheat for a girl.

What makes this ancient practice particularly fascinating is that modern science has revealed a kernel of truth within it. In the 1960s, researchers decided to put this ancient wisdom to the test, and discovered that the presence of elevated hormones in pregnant women's urine – particularly human chorionic gonadotropin (hCG) – could indeed accelerate seed germination. While the method proved unreliable for gender prediction, it achieved a remarkable 70% accuracy rate in detecting pregnancy, making it one of the earliest known forms of pregnancy testing. This discovery serves as a humbling reminder that our ancestors, though lacking our modern scientific understanding, were keen observers who could identify subtle patterns in the natural world. Their methods, while sometimes wrapped in mystical explanations, often contained surprising elements of scientific validity.

Welcome to the 95th edition of ResusNation!

Nitroglycerin Drip Hack

I've often found that it is difficult to convince nurses at the bedside to start patients on a nitro drip at higher doses. So here's a little hack I learned to get people to understand that it's safe to do so.  A sublingual nitroglycerin at 400mcg doses is often administered every 4-5 minutes for acute angina. The rapid absorption and short half-life of sublingual nitroglycerin actually means we're often delivering significant cumulative doses during repeated sublingual administration. Based on this physiology, it's not unreasonable to start a nitro drip at doses of 80 mics to 100 mics per minute for patients with sympathetic crashing acute pulmonary edema to rapidly reduce the preload as well as a patient's afterload. However, as with all vasodilator therapy, careful hemodynamic monitoring remains essential.

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End Tidal Is More Than Hot Air

In this lecture, Dr. Spiegel explores the often-overlooked power of End-Tidal CO2 monitoring, diving into how it reflects ventilation, perfusion, and metabolism. Learn how to interpret waveforms, optimize CPR performance, and detect complications like right mainstem intubation or poor lung compliance. This session is packed with practical tips to make End-Tidal CO2 your go-to tool in critical care and emergency scenarios.

Check out this lecture from Rory 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. 

ResusNation Unite!

All-Access members of ResusNation are invited to join Haney Mallemat for an online interactive session this Friday 12/20 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 privileges. You'll get access to monthly hangouts, access to our grand rounds library, access to post-grand rounds Q&A with the faculty, 5 monthly videos, and so much more.       

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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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