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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Advanced Practice: sPESI vs Hestia Criteria for Discharge of Low Risk PE Patients

With the rise in popularity of the NOAC class of anticoagulants, more and more patients with a new diagnosis of pulmonary embolism are being discharged from the emergency department.  Multiple risk classifications tools have been developed to help identify patients at low risk of short term mortality. Read on to see if this new study determined which tool is the winner!

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Direct Measurement of Compartment Pressure Using a Stryker Device

Acute compartment syndrome is a surgical emergency.  Measurements of compartment pressures are an important adjunct to making the diagnosis. Check out this post for a video demonstration on how to operate the Stryker Device

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