University of Maryland School of Medicine

Department of Emergency Medicine

University of Maryland School of Medicine Department of Emergency Medicine

Chairman's Welcome

Brian Browne, MD, Chairman
 
Welcome to the website of the Department of Emergency Medicine at the University of Maryland School of Medicine.

We train tomorrow's leaders in emergency medicine to positively affect the lives of our patients and to expand our specialty's contributions to patient care.

We are proud to boast of a faculty of more than 75 board-certified or board-eligible physicians, including some of the nation’s most accomplished clinicians, teachers, and leaders in emergency medicine. Our faculty's interests are wide-ranging: emergency care, cardiopulmonary and brain resuscitation, clinical toxicology, prehospital care, emergency medical services, disaster preparedness and response, international medicine, use of ultrasound in the emergency department, and the incorporation of simulation into medical education. I am personally committed to our faculty development program, urging the faculty to explore their academic interests by promoting collaborative efforts on interdepartmental projects and initiatives.

The Department of Emergency Medicine has a proud history of serving communities in the Baltimore metropolitan area. In addition to providing patient care at the University of Maryland Medical Center, our faculty staffs the emergency departments at four hospitals in downtown Baltimore. These sites provide outstanding clinical education opportunities for our residents and medical students. Collectively, our physicians oversee the care of approximately 182,000 patients per year. Patient volume at the University of Maryland Medical Center is approximately 46,000 per year.

Our urban location provides a fast-paced and challenging environment for learning and clinical practice. Coupled with state-of-the art technology and cutting-edge academic resources available to us as part of the University of Maryland School of Medicine, we offer comprehensive training in emergency medicine. Our educational responsibilities have our highest commitment. We are shaping the future of emergency medicine in the United States and abroad. 

I welcome your interest in our department, and I invite you to explore our website to learn more about our dynamic clinical and educational programs.

 

Department Blog

Educational Pearls

  • April 22nd, 2014 - Considering "The Lethal Duo" when Intubating the patient with TBI

    Hypoxia and hypotension are considered the "lethal duo" in patients with traumatic brain injury.  In a recent randomized control trial (by our own... (continued)
  • April 21st, 2014 - Subcutaneous Defibrillator

    - The implantable cardioverter-defibrillator (ICD) has evolved from devices through epicardial patch electrodes introduced by thoracotomy to transvenous... (continued)
  • April 18th, 2014 - Scabies diagnosis in kids

    Scabies is considered by the WHO to be one of the main neglected diseases with approximately 300 million cases worldwide each year. One third... (continued)
  • April 17th, 2014 - Predictors of esophageal injury in caustic ingestion?

    Caustic ingestion can potentially cause significant esophageal and/or gastric injury that can lead to significant morbidity, including death.   Endoscopy is often performed: ·      To determine the presence of caustic injury. ·      To determine the severity of caustic injury (grade: I to III).   Grade Tissue finding Sequela I •  Erythema or edema of mucosa •  No ulceration No adverse sequela IIa •  Submucosal ulceration and exudates •  NOT circumferential No adverse sequela IIB •  Submucosal ulceration and exudates •  Near or circumferential Stricture > 70% IIII •  Deep ulcers/necrosis •  Periesophageal tissue involvement Acute Perforation and death Chronic Strictures and increased cancer risk   ·      Placement of orogastric or nasograstic tube for nutritional support if needed (grade IIb and III)   Evidence for predictor of esophageal injury (frequently cited) comes from mostly studies involving pediatric population and unintentional ingestion: 1.     Gaudreault et al. Pediatrics 1983;71:767-770. o   Studied signs/symptoms: nausea, vomiting, dysphagia, refusal to drink, abdominal pain, drooling or oropharyngeal burn o   Presence of symptoms: Grade 0/I lesion: 82%; Grade II: 18% o   Absence of symptoms: Grade 0/I: 88%; Grade II: 12% 2.     Crain et al. Am J Dis Child. 1984;138(9):863-865 o   Presence of 2 or more (vomiting, drooling and stridor) identified all (n=7) grade II and III lesion. o   Presence of 1 or no symptoms: no grade II/III lesions o   Stridor alone associated with grade II/III lesions (n=2) o   10% of patients without oropharyngeal burns had grade II/III lesions. 3.     Gorman et al. Am J Emerge Med 1990;10(3):189-194. o   Two or more symptoms: vomiting, dysphagia, abdominal pain or oral burns o   Sensitivity: 94%; specificity 49% o   Positive predictive value 43% ; negative predictive value: 96% o   Stridor alone (n=3): grade II or greater lesion 4.     Previtera et al. Pediatric Emerg Care 1990;6(3):176-178. o   Esopheal injury in 37.5% of patients without oropharyngeal burn o   Grade II/III injury: 8 patients   Available data suggests that there are no “good” or reliable predictors for esophageal injury.   However, high suspicion for gastrointestinal injury should be considered with GI consultation for endoscopy in the presence of ·      Stridor alone ·      Two or more sx: vomiting, drooling or stridor (Crain et al) ·      Intentional suicide attempt... (continued)
  • April 16th, 2014 - The Overlooked Epidemic

    Mental disorders account for 7.4% of the world’s burden of disease in terms of disability-adjusted life years and nearly 25% of all years lived... (continued)