Richard Byrne, MD

Advanced Practice: Balanced Electrolyte Soluton vs Normal Saline in the Critically Ill

You are resuscitating a septic patient in the emergency department and are about to click on the order for a fluid bolus. You are confronted with several options for isotonic crystalloid including normal saline, lactated ringer's, and something called "Plasma-Lyte A." A New England Journal article, hot off of the presses, will almost certainly influence this decision in the coming months and years. Read on for a synopsis of this certain-to-be controversial paper.

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#EMConf: Inflammatory Bowel Disease in the ED!

Last week the Cooper EM residents received a primer on the approach to the patient with IBD in the ED from our own GI fellow Krysta Contino. This week will focus on the basic approach, and next week we will take a deeper dive into specific complications that every ED doc needs to know about!

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#EMconf #FlyEaglesFly: FFP for ACE-I induced angioedema

While the Cooper EM residents and faculty not on duty flock to the Eagles Super Bowl celebration parade in Philadelphia, EMDaily presents a brief review by our own Dr. Reid Phillips of two articles examining the efficacy of fresh-frozen plasma for the treatment of ACE-I induced angioedema. Can this simple therapy help prevent an airway disaster? Read on to find out!

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Advanced Practice: Neutropenic Fever in the ED

The cancer population is at an increased risk for morbidity and mortality from common infections due to their impaired immunity. Knowledge on how to approach the febrile neutropenic patient can have a huge impact on an otherwise horrific mortality rate in this vulnerable population.

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Advanced practice: Bariatric surgery complications

roux en y

Obesity is a problem in the United States. More and more patients are receiving bariatric surgery, resulting in a predictably higher volume of patients seeking care in the ED for complications of surgery. Read on to learn more about some of the potentially devastating complications of the most common bariatric procedure: the roux-en-y bypass.

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Advanced Practice: Use of Ultrasound for Infant Lumbar Punctures

Modern immunizations in conjunction with better CT imaging has likely led to declining need for lumbar puncture in the emergency department to evaluate for meningitis and subarachnoid hemorrhage. This may contribute to physician discomfort with the procedure and lower likelihood of first attempt success. This study evaluated whether the addition of ultrasound guidance could increase first attempt success on infant lumbar puncture in the Emergency Department.

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Advanced Practice Airway Mastery Series: Predicting Cardiac Arrest After Intubation

Intubation is a potentially dangerous procedure which may result in rapid hemodynamic collapse and cardiac arrest in the critically ill. This week we summarize the results of a large retrospective study to determine the clinical factors associated with cardiac arrest after intubation.

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