Richard Byrne, MD

Advanced Practice: "Signs and Symptoms You Would Like to be Sued for Malpractice"

Read on for a summary of a lecture from Dr. Richard Byrne on common themes in ED malpractice. Knowledge of the high risk patients and diagnoses is the first and best defense against diagnostic error!

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Advanced Practice: Debate! Thrombolytics in Cardiac Arrest

The Cooper EM Residency recently hosted a spirited debate on the topic of administering thromblytic therapy during cardiac arrest. Drs. Byrne and Roberts faced off in a duel for the ages! Read on to see the results of the largest randomized controlled trial the "TROICA" study and to see the winner (and loser)!

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Advanced Practice - Calcific Tendonitis Can Mimic Septic Arthritis!

A 63 yo male presents complaining of severe pain to the right shoulder. He has markedly restricted range of motion in the shoulder, without any overlying erythema, edema, or warmth. You take a cursory glance at the xray as you gather supplies to perform an arthrocentesis for suspected septic arthritis...

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Advanced Practice - My Patient Hearing Opera Singer in Right Ear

An 82 yo male presents to the ED complaining of several months of progressive hearing loss in the right ear. For the past 3 days, he can hear a male voice singing opera in the right ear only,  24/7. Read on for a brief discussion of this fascinating phenomenon and how we cured him in 5 minutes!

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Advanced Practice - Missed Orthopedic Injuries in the ED!

Check out this lateral film of the wrist. See the fracture? Look again! Surprise...there is no fracture, but this patient has sustained a serious wrist injury with the potential for long term disability. This week we highlight some of the most common missed orthopedic injuries in the ED and suggest a few strategies to minimize the errors.

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Advanced Practice: Thoracic Central Venous Obstruction!

A 25 yo male with a hx of ESRD due to membranoproliferative glomerulonephritis (MPGN) presents to the ED with complaints of swelling to his LUE, face, and neck progressive over 5 days. He was seen at another ED 2 days prior and had an ultrasound of his LUE fistula as well as a duplex of his LUE which were unremarkable.  A CT scan of the chest was ordered, revealing bilateral occluded brachiocephalic veins, which were treated in the interventional radiology suite with balloon venoplasty with resultant resolution of edema.

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Advanced Practice: ACEP Guidelines Advocate for Discharge of Low Risk Chest Pain Patients!

For decades, Emergency Medicine Providers have struggled to come to a consensus on the management of patients with chest pain with non-ischemic ECGs and negative biomarker testing. Both cardiology and emergency medicine guidelines failed to provide a clear recommendation on which patients should be discharged from the ED. The American College of Emergency Physicians has taken a bold step with their latest guidelines for the management of low risk chest pain patients which will dramatically change standard practice in the care of possible ACS patients.  

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