Richard Byrne, MD

Critical Cases - Deadly Cause of Leg Pain!

A 69 yo male presents with EMS after a friend found the patient confused in bed, covered in feces. The patient's only complaint is leg pain. You quickly think through your differential diagnosis for deadly causes of leg pain as you approach the room. Is this patient hiding one of them???

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Critical Cases - Predicting Failure of NIPPV!

A 76 year old male presents with confusion, cough, and fever. He remains hypoxic in the 80s on nasal canula. Your nurse suggests non-invasive positive pressure ventilation to improve oxygenation. How likely is this strategy to maintain acceptable oxygenation? What are the chance the patient will progress to the need for intubation? 

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Critical Cases - Back pain bounceback!

A 55 year old male presents to the ED with complaints of anterior chest pain radiating through to the thoracic area X 2 mentally run through a check list of the potential "red flag" signs/symptoms for serious back pain before you enter the room. Will this be another benign musculoskeletal pain or something more sinister?

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Critical Cases - Hypertensive Emergency!

A 48 year old male presents with complaints of blurry vision. His triage blood pressure catches your eye: 290/120. "Pretty high," you mutter to yourself "but am I supposed to treat it? If so, with what? How fast should that pressure come down?" Time for a crash review of hypertensive emergency....

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Critical Cases - Anaphylaxis After IV Contrast Administration!

A 79 year old female is sent in by urgent care for a CT scan of the chest after a plain film demonstrates a sternal fracture after MVC. "No problem," you think as you order the CT and go about your shift. A few hours later, however, you hear the dreaded "I need a doctor in here!" from your patient's room....

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Critical Cases: Compartment Syndrome Due to DVT!

A 54 yo male with a recently diagnoised RLE DVT, currently on appropriate oral anticoagulation, presents with severe RLE pain. "Well this is easy...his leg hurts because of his DVT right? RIGHT????" Read on for a relatively rare complication and limb threatening complication of a common diagnosis....

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Critical Cases - Traumatic mydriasis!

 A 34 year old female sustains blunt trauma to the right eye with a fist during an altercation. She complains of eye pain and blurred vision in the affected eye. Summoning up all your opthalmology knowledge, you grap your eye box and approach the room. Does she have a vision threatening injury? Let's find out...

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