Chairman's Welcome

Brian J. Browne, MD, FACEP, FAAEM, Professor and Chairman
Brian J. Browne, MD, FACEP, FAAEM
Professor and Chairman
 

Welcome to 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 patients and to expand our specialty's contributions to patient care.

Our department's emphasis on education is fundamental. Our 75 full-time, board-certified faculty members include some of the world’s most accomplished clinicians, teachers, researchers, 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 (ED), and the incorporation of simulation into medical education. I am personally committed to our faculty development program, urging faculty members 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. Our faculty provides patient care at 4 hospital EDs in downtown Baltimore: University of Maryland Medical Center (UMMC), Baltimore VA Medical Center, UMMC Midtown Campus, and Mercy Medical Center. In addition, we have a community emergency medicine network at 9 hospitals statewide. These sites provide outstanding clinical education opportunities for our residents and medical students, with ED volumes of:

  • 53,000 at UMMC
  • 32,000 at the VA
  • 31,000 at Midtown
  • 66,000 at Mercy

Our urban location provides a fast-paced and challenging environment for learning and clinical practice. Enriched with the 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

  • July 16th, 2024 - CKD CLOVERS -- Fluid Management in Septic Patients with CKD

    The CLOVERS trial (NEJM 2023) examined one of the eternal questions of critical care, liberal vs restrictive fluid management in sepsis… and found no... (continued)

  • July 15th, 2024 - IVC Pitfalls

    Many may look at the Inferior Vena Cava (IVC) to get a sense of a patient's “fluid responsiveness.” However, there are many pitfalls to using the IVC.... (continued)

  • July 14th, 2024 - BOVA score for PE prediction

    The Bova score has been validated to predict mortality and complications in hemodynamically stable patients with intermediate to high-risk pulmonary embolisms.... (continued)

  • July 13th, 2024 - Radiographically Occult Hip Fractures in the Elderly Population

    Elderly patients with acute hip pain and negative or equivocal findings with initial plain film imaging have a high frequency of occult hip fractures. Strongly... (continued)

  • July 11th, 2024 - Hypertonic Saline for Acute Hyponatremia

    At our institution we have developed a guideline for the use of hypertonic saline in hyponatremia. Administration of 3% sodium chloride for acute or symptomatic hyponatremia Bolus doses are preferred over continuous infusion. Use in patients with rapid decline in serum sodium levels (>= 10 mEq decrease over 24 hours) or symptomatic (e.g. seizures). Do not attempt to normalize the serum sodium level in the first 24 hours. Serum sodium correction should be no more than 8-10 mEq/L in a 24-hour period. 8 mEq/L (or less) should be used in patients at high risk for osmotic demyelination syndrome High risk populations: chronic hyponatremia, hypokalemia, alcoholism, malnutrition, or liver disease Chronic hyponatremia should be corrected over days with a goal of 4-8 mEq/L in 24 hours. Fluid restriction should be considered first-line for chronic hyponatremia. Acute hyponatremia with severe symptoms Bolus 3% sodium chloride 150 mL over 10 minutes. If symptoms persist repeat up to 3 doses over 30 minutes. Acute hyponatremia with moderate symptoms Bolus 3% sodium chloride 150 mL over 20 minutes once. Hyponatremia Fluid Rate Calculations (**Be Careful with Online Calculators**) FYI: 3% Sodium Chloride (1.95 mL/mEq; 513 mEq/1 L); 0.9% Sodium Chloride (6.5 mL/mEq; 154 mEq/1 L) Equations for Calculations Sodium correction for HYPERglycemia Corrected Na=Observed Na + 0.016 x (serum glucose-100) Calculated Sodium Deficit Female: (Desired Na – Observed Na) x 0.5 L/kg x weight (kg) Male: (Desired Na – Observed Na) x 0.6 L/kg x weight (kg) This equation will give you the total mEq of Na needed in 24 hours. Remember: Correction should be no more than 8 mEq/L in 24 hours in most cases. Calculated Infusion Rate for Sodium Correction ___ mEq Na required (from Equation 2) x ___ mL/mEq of fluid = ___ mL of fluid ___ mL of fluid / 24 hours = ___ mL/hr of fluid ***See Visual Diagnosis for an Example with Calculations***... (continued)