Journal of Emergency Medicine最新文献

{"title":"A Change of Pace: Modifying Pacemaker Settings in the Emergency Department as Emergency Physicians, A Case Report","authors":"Maritza Kelesis MD,&nbsp;Martin Huecker MD, FAAEM, FACEP,&nbsp;Robert Whitford MD, FAAEM","doi":"10.1016/j.jemermed.2024.10.012","DOIUrl":"10.1016/j.jemermed.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Pacemakers are implantable or external devices that send electrical impulses, allowing the heart to contract. Some common indications for permanent pacemaker placement include symptomatic bradycardia due to high-grade atrioventricular (AV) block, sick sinus syndrome, chronic bifascicular block, and postcardiac transplantation. Like all devices, pacemakers can malfunction or stop working entirely. We present a patient with an implantable pacemaker/cardioverter and defibrillator (ICD) displaying symptomatic failure to capture, and settings were adjusted in the emergency department (ED). Adjustment in the ED resolved the patient's symptoms and required no further interventions.</div></div><div><h3>Case Report</h3><div>An 82-year-old woman with atrial fibrillation, heart failure, and a Medtronic dual chamber pacer/ICD (Medtronic, Minneapolis, Minnesota) presented to the ED for complaints of weakness and lightheadedness. Emergency medical services noted intermittent bradycardia, hypotension, and decreased responsiveness. Electrocardiogram (ECG) revealed failure to capture. The Medtronic application was used to interrogate and reprogram the device. The settings were DDD at a rate of 60 beats/min with ventricular output of 4.5 millivolts (mV) and atrial output of 4.5 mV, which were changed to ventricular lead outputs from 4.5 mV to 8.0 mV and rate from 60 to 80 for additional cardiac output. After this adjustment, the bradycardia resolved, and ECG showed a successful AV-paced rhythm. Transcutaneous pacing was never required.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>Adjustment of pacer settings in the ED to stabilize the critically ill patient is within the scope of the emergency physician. We can reduce stress to the patient and prevent hospitalizations. Pacemakers can become a tool to optimize treatment plans for an aging population in whom pacemakers are becoming more common.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"71 ","pages":"Pages 82-87"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a 90-Minute Gonorrhea/Chlamydia Test Decreases Antibiotic Under- and Overtreatment in Female Emergency Department Patients.","authors":"Brian Chinnock, Gilbert Ramirez, Christopher Teran, Gayle Kouklis","doi":"10.1016/j.jemermed.2025.03.004","DOIUrl":"10.1016/j.jemermed.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>Nucleic acid amplification testing (NAAT) of Chlamydia trachomatis and Neisseria gonorrhoeae (CT/NG) in emergency departments (EDs) with prolonged turnaround time (TAT) has resulted in high rates of under- and overtreatment in female patients.</p><p><strong>Objective: </strong>The aim of this study was to determine whether under- and overtreatment rates in an ED using a newer NAAT with a 90-min TAT would be decreased compared with an ED not using this test.</p><p><strong>Methods: </strong>We conducted a retrospective study examining female patients tested for CT/NG in the ED and compared under- and overtreatment rates during two different 70-week time periods before and after transition to the 90-min TAT in the intervention ED (ED-I) and no transition in the control ED (ED-C). We used an interrupted time series analysis of the data to determine the intervention effect.</p><p><strong>Results: </strong>There were 10,064 and 1990 CT/NG tests, respectively, in the ED-I and ED-C during the study period. Preintervention to postintervention, undertreatment went from 37% to 19% (18% decrease; 95% CI -17% to -20%) in ED-I, and from 42% to 40% (2% decrease; 95% CI -7% to 2%) in ED-C, respectively. Overtreatment rates changed from 27% to 17% (10% decrease; 95% CI -8% to -11%) in ED-I and from 37% to 33% (4% decrease; 95% CI -8% to 1%) in ED-C, respectively.</p><p><strong>Conclusions: </strong>Results of this real-world ED study showed that a 90-min TAT decreased under- and overtreatment rates for female patients tested for CT/NG. Future innovations that decrease TAT and process changes that decrease time to collection may improve these rates even further.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caffeine Overdose Resulting in Seizure-like Activity and Rhabdomyolysis in a Child: A Case Report.","authors":"Kathleen Stephanos, Bryan D Hayes","doi":"10.1016/j.jemermed.2025.03.006","DOIUrl":"10.1016/j.jemermed.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Caffeine is a commonly used medication throughout pediatrics for its medicinal effects and recreation. While multiple reports have shown concern for overdoses in adolescents and adults, there is little reported on caffeine's effects on younger children.</p><p><strong>Case report: </strong>We present the case of a 4-year-old female with developmental delay with associated seizures, who presented with unexplained tachycardia, and concern for increased seizure activity. After EEG showed no evidence of epileptiform changes, further investigation showed rhabdomyolysis, hypokalemia, tachycardia and ultimately elevated caffeine levels. This resulted in a diagnosis of factitious disorder by proxy.</p><p><strong>Why should an emergency physician be aware of this: </strong>This is a rare case of caffeine overdose in a child resulting in rhabdomyolysis. While other stimulants are commonly considered in patients with such symptoms, and are included in standard drug screens, caffeine should also be evaluated as a cause of unexplained hyperactive behaviors, particularly in the non-verbal patient.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breakthrough Fever in Cardiac Arrest Patients Without the Use of a Cooling Device","authors":"Grigory Ostrovskiy MD ,&nbsp;Sarah E. Nelson MD,MPH","doi":"10.1016/j.jemermed.2025.03.009","DOIUrl":"10.1016/j.jemermed.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Fever avoidance after cardiac arrest is recommended but cooling devices may not be used even if targeting normothermia.</div></div><div><h3>Objectives</h3><div>We sought to establish the incidence of postarrest fever and association with clinical outcomes depending on whether a cooling device was used.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of adult cardiac arrest survivors admitted to intensive care units (ICUs) in our health system in 2021. Our primary outcome was discharged alive. Univariate and multivariable statistics were computed, and additional outcomes included cooling device use, Tmax of ≥38°C within 48 h of admission, and Glasgow Coma Scale (GCS) ≥8 at discharge.</div></div><div><h3>Results</h3><div>364 patients were screened and 194 ultimately analyzed. Seventy-eight (40.2%) were female, median (IQR) age was 63 (54.0–72.8) years old, 96 (49.7%) were provided a cooling device, and 49 (25.3%) reached a temperature ≥38°C within 48 h of admission. Patients without a cooling device more often reached Tmax ≥38°C (37.1% vs. 13.5%, <em>p</em> &lt; 0.001). Greater GCS on day 3 was a consistent independent predictor of being discharged alive and of GCS ≥8 at discharge while failure to use a cooling device was the strongest independent predictor of postarrest fever.</div></div><div><h3>Conclusions</h3><div>Cooling devices were associated with fever prevention but used in patients who ultimately did poorly. Moreso than use of a cooling device, achieving fever avoidance may be more important for prognosis.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"75 ","pages":"Pages 14-23"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Controlled Trial of HIV Pre-Exposure Prophylaxis Provision in the Emergency Department (PrEPPED).","authors":"Ethan Cowan, Erick Eiting, Clare O'Brien-Lambert, Jacqueline Ryder, Yvette Calderon","doi":"10.1016/j.jemermed.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jemermed.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>Oral human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) effectively reduces HIV transmission. However, PrEP remains underutilized due to structural, provider, and individual-level barriers, with significant disparities in access. Emergency departments (EDs) serve high-risk populations often disconnected from primary care, offering a strategic setting for initiating PrEP services. In spite of the potential, ED-based PrEP programs face challenges, and the feasibility of initiating PrEP in this setting is unclear.</p><p><strong>Objectives: </strong>This pilot randomized controlled trial (RCT) aimed to evaluate the impact of immediate PrEP initiation (iPrEP) in the ED on PrEP usage at 90 days.</p><p><strong>Methods: </strong>The trial randomized eligible ED patients 1:1 to iPrEP in the ED with a 28-day starter pack given at discharge vs. referral for outpatient PrEP initiation. Participants were followed for 90 days, with the primary outcome being PrEP usage. Secondary outcomes were PrEP usage at 30 and 60 days, retention in care at 30, 60, and 90 days, HIV risk, and satisfaction.</p><p><strong>Results: </strong>Of 1455 patients screened, 169 were eligible, 27 were randomized, and 26 received their assigned intervention. At 90 days, only 3 participants were taking PrEP (2 iPrEP, 1 referral). Follow-up at 30, 60, and 90 days revealed no significant differences between the groups for any secondary outcome.</p><p><strong>Conclusions: </strong>PrEP initiation in the ED did not improve PrEP usage or retention in care compared with referral alone. Despite high satisfaction with the screening process, barriers to ED-based PrEP initiation, including low interest and awareness, persisted.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Introduction of Flow Facilitators: A Targeted Wellness Initiative in the Emergency Department","authors":"Rachna Subramony MD ,&nbsp;Josh Gieschen BS ,&nbsp;Allyson Kreshak MD ,&nbsp;Vaishal Tolia MD ,&nbsp;Alicia Minns MD","doi":"10.1016/j.jemermed.2025.03.008","DOIUrl":"10.1016/j.jemermed.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Given that the 2020s have seen record levels of physician burnout, there is a pressing need to develop solutions to combat this trend.</div></div><div><h3>Objectives</h3><div>In this study we aimed to assess the efficacy of flow facilitators as an intervention to improve physician well-being in the emergency department (ED). A novel position in the ED was established and its impact on physician well-being assessed.</div></div><div><h3>Methods</h3><div>Emergency physicians at a large academic hospital were surveyed anonymously and met to discuss the factors affecting well-being and job satisfaction. Based on this meeting and survey results, the hospital system hired three full-time employees to function as “flow facilitators,” with their primary task to streamline logistical challenges in the ED, with the goal of decreasing wait times and increasing physician satisfaction. Emergency physicians were then surveyed to evaluate the changes in their self-reported satisfaction after implementation of an ED flow facilitator. Objective metrics of patient satisfaction and favorable outcomes (left-without-being-seen rates/wait times) were also assessed, as well as identifying specific areas for further improvement by the existing flow facilitators.</div></div><div><h3>Results</h3><div>Physicians overwhelmingly responded positively to the program, with the most consistent positive responses directed toward perceived improvement in logistical challenges over clinical challenges. Over 85% of physicians agreed that the program had improved their overall well-being. The specific throughput metrics showed that for computed tomography, ultrasound, and X-ray study, the time for order placed to results obtained decreased significantly. There was also an increase in average ED census and, based on increasing number of patients, the time to admission from ED triage decreased. The ED time to discharge and left without being seen did not significantly change.</div></div><div><h3>Conclusions</h3><div>Physician well-being and ED overcrowding are important issues with high financial, as well as emotional, costs. The introduction of flow facilitators to the ED seems to be an effective, targeted intervention to address physician well-being and improve radiology result times.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"74 ","pages":"Pages 134-141"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal Sedation Use for Laceration Repair in the Pediatric Emergency Department","authors":"A.E. Mulcrone MD ,&nbsp;E.A. Camp PhD ,&nbsp;E. Frierson MD ,&nbsp;Y. Koukaz MD ,&nbsp;C.E. Chumpitazi MD,MS","doi":"10.1016/j.jemermed.2025.03.007","DOIUrl":"10.1016/j.jemermed.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Minimal sedation agents assist pediatric laceration repair, but few studies compare their efficacy and safety in the emergency department (ED). They can be preferred agents by mildly impairing cognitive function and physical coordination while maintaining important airway, ventilatory, and cardiovascular functions.</div></div><div><h3>Objectives</h3><div>To determine procedure completion and reported adverse events (AEs) between minimal sedation agents for facial laceration repair in the ED.</div></div><div><h3>Methods</h3><div>This retrospective study included children 1–8 years of age who received minimal sedation (oral [PO] or intranasal [IN] midazolam, IN dexmedetomidine, or PO hydrocodone-acetaminophen) for sutured facial laceration repair. The primary outcome was procedure completion, with secondary outcomes of reported AEs and time metrics.</div></div><div><h3>Results</h3><div>1309 eligible patients met inclusion criteria with procedural completion achieved in 95.5% (1250/1309). AEs were documented in 21 patients (1.6%) without significant difference by medication. Hydrocodone-acetaminophen had a shorter ED length of stay by an average of approximately 40 min compared to the other three medications combined after adjustment (aβ = −38.86 (−48.31 to −29.41). The use of IN midazolam reduced time from medication administration to ED disposition by approximately 20 min (aβ = −20.16 (95% CI −25.17 to −15.14).</div></div><div><h3>Conclusion</h3><div>Minimal sedation agents allow for successful facial laceration repair in children and AEs were rarely reported. The quality of sedation with these agents was not studied but would be beneficial for future studies.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"75 ","pages":"Pages 1-13"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifying Trauma Team Activation Criteria to Increase Rates of Appropriate Triage: A Retrospective Study.","authors":"Megan E Knapp, Jacob Smith, Katie L Bower, Pamela A Boremski, Bryan R Collier, Jacob R Gillen","doi":"10.1016/j.jemermed.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.jemermed.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>The American College of Surgeons has designated six minimum criteria for a full trauma team activation, to which many Trauma Centers add criteria to reduce rates of mistriage. However, there is no consensus on what the optimal trauma team activation criteria should be. At our institution, suboptimal rates of overtriage were detected, so the trauma team activation criteria were modified to improve overtriage.</p><p><strong>Study objectives: </strong>The objective was to retrospectively evaluate triage patterns before and after implementation of modified trauma team activation criteria. The hypothesis was that rates of appropriate triage and overtriage would improve following criteria modification without a significant increase in undertriaged patients.</p><p><strong>Methods: </strong>Rates of appropriate triage, overtriage, and undertriage were assessed before and after the implementation of the modified criteria. Triage patterns were evaluated using the Standardized Trauma Assessment Tool. Statistical analyses were conducted with an alpha level of 0.05.</p><p><strong>Results: </strong>The modified criteria were associated with increased appropriate triage (74.7-79.4%, p < 0.01) due to a decrease in overtriage from 57.0% to 45.7% (p < 0.001). There was no change in undertriage (3.2-4.9%, p = 0.05).</p><p><strong>Conclusion: </strong>This study assessed triage patterns associated with simplified, modified trauma team activation criteria at a Level 1 Trauma Center. The modified criteria were associated with decreased overtriage without increasing undertriage. These findings support simplifying trauma team activation criteria as an approach to improving rates of appropriate triage.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coma as the Sole Initial Manifestation of Levothyroxine Intoxication: A Case Report.","authors":"Christina-Chrysanthi Theocharidou, Maria Pavlidou, Melanthi Endiaroglou, Anastasia Dimaki, Fotini Ampatzidou","doi":"10.1016/j.jemermed.2025.03.005","DOIUrl":"10.1016/j.jemermed.2025.03.005","url":null,"abstract":"<p><strong>Background: </strong>Levothyroxine overdose rarely causes severe symptoms in adults. We present an unusual case of isolated coma after massive levothyroxine ingestion.</p><p><strong>Case report: </strong>A 33-year-old woman presented to the Emergency Department comatose (Glasgow Coma Scale score 3/15) but hemodynamically stable. Computed tomography of the brain was normal. History revealed ingestion of 10.5 mg levothyroxine 2 h prior in a suicide attempt. Gastric lavage and activated charcoal were administered. The patient was intubated and admitted to the intensive care unit (ICU). Treatment included cholestyramine for enhanced thyroxine elimination. Thyroid function tests showed elevated free T4 and T3 with initially normal, but later suppressed, thyroid-stimulating hormone. The patient developed fever at 20 h, attributed to aspiration pneumonia rather than thyroid storm. She regained consciousness and was extubated at 28 h. Total ICU stay was 72 h. She was discharged after 10 days, with no complications. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case is notable for isolated coma without typical thyrotoxicosis symptoms, in spite of massive levothyroxine ingestion. Although altered mental status has been reported in levothyroxine overdose, coma as the sole presenting symptom is extremely rare. Emergency physicians should consider levothyroxine toxicity in cases of unexplained coma, even without other thyrotoxicosis signs. Prompt supportive care and gastrointestinal decontamination can lead to favorable outcomes in severe overdose.</p>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Laceration From Posterior Rib Fractures After a Ground-Level Fall: A Case Report","authors":"Benjamin Travers MD,&nbsp;Laura Murphy MD","doi":"10.1016/j.jemermed.2024.09.020","DOIUrl":"10.1016/j.jemermed.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Rib fractures represent a common injury after blunt chest wall trauma with known complications including pneumothorax, hemothorax, pulmonary contusion, and pneumonia. This case report describes an emergency department patient with acute decompensation from aortic laceration as a rare complication of rib fractures. There are rare documented cases of this complication occurring in admitted patients with rib fractures, but this is one of the only cases that describes this complication occurring in a patient presenting to the emergency department.</div></div><div><h3>Case Report</h3><div>This case describes a patient who was found down at her home and presented to the emergency department in acute distress. She was found to have three left-sided posterior rib fractures, which had lacerated her thoracic aorta causing a large left hemothorax and acute decompensation. The patient was resuscitated in the emergency department followed by thoracic endovascular aortic repair in the operating room. The patient did well after surgical repair and was discharged from the hospital at her baseline mental and functional status.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>It remains important to resuscitate an acutely ill patient based on history, physical examination, and vital signs. The key takeaway from this case report is that, although rare, aortic laceration remains a possible complication of posterior rib fractures in a patient who acutely decompensates.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"70 ","pages":"Pages 139-141"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}