Richard Byyny

I took a hiatus from Twitter and have now returned greatly diminished. I am just a community EM physician trying to get by.

[Richard Byyny @RByyny]

@J_thanson Sorry cynicism is the language of emergency medicine

[Richard Byyny @RByyny]

@J_thanson

[Richard Byyny @RByyny]

@RealCedricDark @ACEPNow @Danielle_Galian @amyfaithho @TheSGEM @EMCases @medmalreviewer @BorelliCara @LWestafer @HaamidtheMD @vidyaeswaran Mesenteric ischemia

We can use alternate studies for PE and cerebral angio. We have an allowance for dissection so that is less of a concern where I work

By prevalence early appendicitis and diverticulitis would be most likely missed with even a 2-3% reduction in sensitivity

[Richard Byyny @RByyny]

@PCC_PharmD I don’t have data on epi but albuterol decreases serum potassium 1-1.5 mEq. That seems like a solid amount to me. However, it is a moot point regardless. Defibrillation if indicated and high quality chest compressions are what saves lives.

[Richard Byyny @RByyny]

@PCC_PharmD Of course that being said the data in favor of a mortality benefit from epi is essentially non-existent and there is some evidence that it hurts.

[Richard Byyny @RByyny]

@PCC_PharmD I am pretty sure epinephrine does have an effect in hyperkalemia. It is a beta agonist after all.

[Richard Byyny @RByyny]

@PCC_PharmD Also, this list is for PEA. PEA could be grouped as electromechanical dissociation which is depolarization without contraction and depolarization with contraction. This latter group benefits from epi in the form of vasoconstriction and increased cardiac output.

[Richard Byyny @RByyny]

@jeremyfaust @JHowardBrainMD The focus on rare conditions could be a good thing though. You will learn the common diseases as part of your usual practice but you still need to know uncommon conditions if you are ever to hope making their diagnosis.

[Richard Byyny @RByyny]

@reverendofdoubt You could potentially extrapolate that to every intervention except quality chest compressions and defibrillation

[Richard Byyny @RByyny]

@TheSGEM @nursekelsey @GoZwift

[Richard Byyny @RByyny]

@TheSGEM @nursekelsey @GoZwift Me too

[DenverEM @DenverEMed]

Priscilla Reinhart, RN
You will be missed
You picked us up
You taught us
You made us laugh
You spoke truth
You loved us
-36.5 yrs 100s of residents trained infinity of lives impacted
-Rest in Peace
#ThisIsDenverEM

[MFT Libraries @mftlibraries]

Wythenshawe's #BookOfTheWeek is 'Emergency medicine secrets' edited by Katherine Bakes, Jennie Buchanan, Maria Moreira, Richard Byyny & Peter Pons
Available for loan @mftlibraries
#EmergencyMedicine
@EmergencyDepar2 @MRI_ED
@buchana_jab @KatieBakes2
@mmoreiramd @RByyny

[Richard Byyny @RByyny]

@LactatedRingers Fortunately a central line kit works pretty well too though.

[Richard Byyny @RByyny]

@ACEPNow @TheSGEM @CORD_EM @EBMgoneWILD @mcsassymd @DrSuperSalty @MDaware @screamingmd @alimkakeng @movinmeat @lmelville535 @srrezaie @SLuckettG @msmemesha

[Jennie Buchanan @buchana_jab]

Honored to be a part of @Cord County Community of Practice Team on-How we define county EM programs @docteresayvonne @mmoreiramd @TakuTaira @cjangerhofer @MEParsonsMD @GannonSungar @RByyny @zachjarou @SpyderEM @DharaAminMD @MWhiteEMory @LallMichelle Todd A Taylor & David Caro

[Richard Byyny @RByyny]

@amalmattu @UMEmergencyMed I taught Adson's sign too but the sensitivity and specificity for thoracic outlet seems to be less than ideal. Then again what physical exam finding is?

[Richard Byyny @RByyny]

@DrSuperSalty Extra oral technique or syringe technique is so fast and easy.

@ALiEMteam shows how

https://t.co/PkUJhuPkqn

[Jennie Buchanan @buchana_jab]

Finished & to boot w these incredible co-editors @KatieBakes2 @mmoreiramd @RByyny Dr Peter Pons & numerous gifted authors...Thank you!!!

[Richard Byyny @RByyny]

@DrSuperSalty *if you do a good job caring for them