Richard Byrne, MD

Critical Cases - Alcohol Withdrawal!

A 53 year old reported daily ETOH use presents via EMS for seizure at home. As you approach the stretcher you wrack your brain for the right treatment algorithm, realizing that this patient may die without the correct medications....

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Critical Cases - Torsades de pointes!

A 37 yo female presents with chief complaint of "electric shock" sensations down her arms and intermittent nausea/vomiting over the past week. Her vital signs are unremarkable. Little do you know that this young, well appearing patient has an acute medical emergency which will result in cardiac arrest in a few hours....

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Critical Cases - Boerhaave's Syndrome Emergency!

A patient boarding in the emergency department begins decompensating after a profound fit of retching and vomiting. Blood pressure is dropping and o2 sats are falling...you eyeball the patient from the door and he looks severely ill. No time to page the floor team...time to dive in and resuscitate!

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Critical Cases - Back Pain Nightmare Diagnosis!

A 44 yo male who works as a construction worker presents with 2 days of lower back pain. Having seen literally hundreds of cases of benign musculoskeletal pain in the last year, you are pretty sure you can handle one more. But is there danger lurking behind this well appearing patient with normal vitals? Well, yes of course. Otherwise we wouldn't be covering it on EM Daily....

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Critical Cases - Ankle dislocation!!

It's an ice storm in South Jersey! Thirty-four (34!) patients present within 4 hours with slip and falls and a veritable menagerie of orthopedic injuries. You see a 29 yo male who everted his ankle on the sidewalk. There is an obvious deformity. Should we order an xray and then call the orthopedics resident? No! We're going to reduce, splint, and discharge this patient ourselves....

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Critical cases - Digoxin toxicity!

An elderly female arrives complaining of fatigue and weakness (easy right?) and a casual glance at the MAR shows the she is on digoxin for CHF. You notice she has a HR in the 50s and wonder if digoxin toxicity could be repsonsible for her symptoms. Lucky for you, you brushed up on this basics with this quick case review!

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