Dr. Nick Ghionni (@PulmToilet)
Pulmonologist and critical care physician known online as @PulmToilet; appears to discuss evidence and clinical reasoning around SCAPE and high‑dose nitroglycerin.
Best podcasts with Dr. Nick Ghionni (@PulmToilet)
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Sep 24, 2025 • 49min
@PulmToilet's Crusade Against SCAPE and High-Dose Nitroglycerin
Dr. Nick Ghionni, a pulmonologist known as @PulmToilet, dives into the controversial diagnosis of SCAPE, questioning its validity and origins. He clarifies that SCAPE is often a hypertensive emergency with pulmonary edema rather than a unique condition. Discussing the dangers of high-dose nitroglycerin, he highlights misconceptions and recommends safer alternatives like CPAP and sublingual nitro. Dr. Ghionni calls for better evidence in EMS protocols and shares insights on the common misidentification of conditions in prehospital care.
