A Deadly Fashion Craze 

From The 1950's

Imagine walking into a shoe store and casually sticking your feet into what was essentially a radioactive fun house mirror. That's exactly what people did for several decades after World War I, when shoe-fitting fluoroscopes became all the rage. These wooden or metal cabinets, complete with three peepholes for the whole family to gather 'round and watch your skeleton wiggle its toes, were marketed as the latest in shoe-fitting technology. It was like a front-row ticket to your own personal X-ray show, minus any of those pesky safety protocols you might find at a doctor's office.

As it turns out, getting a blast of unregulated radiation every time you went shoe shopping wasn't exactly a great idea (shocking, right?). After World War II, when people finally started catching on to the whole "radiation can be dangerous" concept, states began cracking down on these glowing foot-viewers. While we'll never know exactly how many people's toes got an unwanted tan from these machines, Pennsylvania finally pulled the plug in 1957, becoming the first state to ban them. The rest of the country quickly followed suit, deciding that maybe, just maybe, buying shoes didn't need to involve seeing your own skeleton.

Well...that's your fun fact for the week, now it's time for the newsletter!!!

Welcome to the 98th edition of ResusNation!

Stop Torturing Your Patients with Unnecessary ABGs

I recently shared some controversial thoughts about ABGs (arterial blood gases) that might ruffle some feathers in the medical community. After over a decade of critical care experience since completing my fellowship in 2010, I've come to a firm conclusion: ABGs shouldn't be used to determine whether a patient needs intubation. While this isn't backed by any specific PubMed studies, my extensive experience across emergency rooms, hospital floors, and ICUs has shown me that intubation is purely a clinical decision. When a patient is somnolent and not protecting their airway, or in respiratory distress and hypoxemic, the decision to intubate should be based on what we see, not what an ABG tells us.

The truth is, ABGs are painful procedures that we often order more out of uncertainty than necessity. I've never met anyone who's had an ABG and eagerly asked for another one. The greatest irony is that we're causing significant pain to patients who are already struggling to breathe, all for information that rarely impacts our clinical decision-making. In my experience, the only legitimate reason I've seen for ordering an ABG is to buy time when the medical team is unsure about the next steps in patient care. For patients with low oxygen saturations who otherwise look comfortable and are breathing well, we might need to improve their oxygenation through other means, but an ABG won't help us make that decision.

Watch the full video here and leave a comment.

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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. 

Watch the January 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

• Byrne on "Intubation of the Neurologically Injured Patient"
• Fornari discussing "Cerebral Edema in Pediatric DKA"
• Spiegel exploring "Finding One MAP for Everyone"
• Kaswer presenting "Partial REBOA: The Future of Trauma Care?"
• Torres on "Lethal Diamond in Trauma"

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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