JEM reports最新文献_第3页

Erratum regarding missing statements in previously published articles 关于先前发表的文章中缺失陈述的勘误

JEM reports Pub Date : 2026-03-01 Epub Date: 2026-02-16 DOI: 10.1016/j.jemrpt.2026.100217

引用次数: 0

Teaching pediatric emergency department agitation management using a clinical pathway combined with simulation scenarios 运用临床路径结合模拟情景教学儿科急诊科躁动管理

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-08-21 DOI: 10.1016/j.jemrpt.2025.100191

Neehar Kundurti , Rachel Tuuri , Lynne Fullerton , Priya Gupta , Brittany Ebbing , Sara Skarbek-Borowska

{"title":"Teaching pediatric emergency department agitation management using a clinical pathway combined with simulation scenarios","authors":"Neehar Kundurti , Rachel Tuuri , Lynne Fullerton , Priya Gupta , Brittany Ebbing , Sara Skarbek-Borowska","doi":"10.1016/j.jemrpt.2025.100191","DOIUrl":"10.1016/j.jemrpt.2025.100191","url":null,"abstract":"<div><h3>Background</h3><div>Agitation is a common cause for pediatric emergency department (ED) visits. Despite consensus guidelines and recent educational toolkits, opportunities exist to improve provider knowledge and patient care by utilizing novel teaching modules.</div></div><div><h3>Objectives</h3><div>This study aimed to develop and test a teaching module (intervention) using two clinical case simulations and a pediatric agitation pathway (decision aid). We hypothesized that the module would improve provider knowledge and comfort in managing acutely agitated pediatric patients.</div></div><div><h3>Methods/Design</h3><div>This single-center, pre-post intervention study used a multidisciplinary-developed pathway based on consensus guidelines and two simulation case scenarios.</div></div><div><h3>Subjects and Setting</h3><div>Participants, all trainees in emergency medicine, completed a knowledge test and comfort survey prior to the training. They then attended a brief teaching session on the pathway, participated in two simulation case scenarios, and subsequently repeated the test and survey. Outcome measures were the difference between knowledge and comfort scores before and after the training.</div></div><div><h3>Results</h3><div>Sixteen participants completed the module. Knowledge improved significantly, with mean test scores increasing from 4.5 out of 10 (IQR 3–5) to 8 out of 10 (IQR 7–9) (P < .001). Comfort improved with using chemical (P = .002) and physical (P = .001) restraints.</div></div><div><h3>Conclusion</h3><div>The findings suggest that a teaching module for pediatric agitation which uses a decision aid in simulation scenarios is feasible and effective in improving overall knowledge and comfort associated with pediatric chemical and physical restraint use. It fills a well-known gap in pediatric agitation training and has the potential to be replicated in teaching programs for other emergent conditions.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral anterior shoulder dislocations after ground-level fall 地面坠落后双侧前肩脱位

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-09-15 DOI: 10.1016/j.jemrpt.2025.100192

Priya Shil, Courtney Mariner, Scott Gutovitz

{"title":"Bilateral anterior shoulder dislocations after ground-level fall","authors":"Priya Shil, Courtney Mariner, Scott Gutovitz","doi":"10.1016/j.jemrpt.2025.100192","DOIUrl":"10.1016/j.jemrpt.2025.100192","url":null,"abstract":"<div><h3>Background</h3><div>Despite being the most routinely encountered joint dislocation, bilateral anterior shoulder dislocation is a rare finding in a common Emergency Department complaint of mechanical ground level fall. High energy mechanisms of injury such as trauma, seizures, and electrocution are the most common causes of bilateral shoulder dislocation.</div></div><div><h3>Case report</h3><div>A 72-year-old male presents with simultaneous anterior dislocations of both shoulders after a fall while walking his dog. He arrived in the Emergency Department with arms above his head and xray imaging identified bilateral shoulder dislocations. After procedural sedation, the shoulders were successfully reduced without any evidence of neurovascular injuries and later discharged.</div></div><div><h3>Why should an emergency physician be aware of this</h3><div>?This mechanism of injury is rare among those who are diagnosed with bilateral shoulder dislocation and therefore, more likely to be missed. Where symmetry generally represents a person's normal anatomy, the apparent symmetric appearance in bilateral shoulder dislocation is misleading. Due to the infrequent occurrence, there is low clinical suspicion among emergency physicians leading to delayed diagnosis and associated complications.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retropharyngeal abscess in a patient with Crohn's disease treated with risankizumab: A case report 利桑单抗治疗克罗恩病患者咽后脓肿1例

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-10-11 DOI: 10.1016/j.jemrpt.2025.100195

Nathan Rasmussen , Lauren Meloche , Mohamed Awadalla , Chris Dion , Douglas Rappaport

{"title":"Retropharyngeal abscess in a patient with Crohn's disease treated with risankizumab: A case report","authors":"Nathan Rasmussen , Lauren Meloche , Mohamed Awadalla , Chris Dion , Douglas Rappaport","doi":"10.1016/j.jemrpt.2025.100195","DOIUrl":"10.1016/j.jemrpt.2025.100195","url":null,"abstract":"<div><h3>Background</h3><div>Retropharyngeal abscesses are rare but potentially life-threatening infections in adults. Early symptoms may mimic benign musculoskeletal complaints, delaying diagnosis. Patients on immunosuppressive biologics, such as Interleukin-23 inhibitors, may present more indolently and with atypical features.</div></div><div><h3>Case report</h3><div>A 69-year-old man with a history of Crohn's disease on risankizumab presented to the emergency department (ED) with persistent neck pain after lifting a heavy object. Initial evaluation included computed tomography (CT) without contrast, which was negative, and he was discharged twice with symptomatic treatment. He later returned with worsening pain and new-onset dysphagia. Repeat CT and magnetic resonance imaging (MRI) were suspicious for inflammation or infection. Although initially afebrile, he developed sepsis with Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia during his hospitalization. Repeat MRI ultimately revealed a retropharyngeal abscess involving the longus colli muscles. He was treated with intravenous antibiotics and underwent surgical drainage. The postoperative course was uncomplicated, and he was discharged in a stable condition.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>This case underscores the diagnostic challenge of deep space neck infections in adults, particularly in those receiving immunosuppressive therapies. The patient's immunomodulated state likely contributed both to the development of the abscess and the delayed appearance of imaging. Emergency physicians should maintain a high index of suspicion for deep space neck infections in immunosuppressed patients, even when early imaging is negative and symptoms appear musculoskeletal in origin. Awareness of biologics like risankizumab and their infection risks is critical as their use becomes more common in the ED population.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Not shooting blanks: A case of foreign body urinary retention 非空白弹：一例异物尿潴留

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-09-25 DOI: 10.1016/j.jemrpt.2025.100193

Sarah Spelsberg, Benjamin McMichael, Brianna Crosby, Katherine Fredlund

{"title":"Not shooting blanks: A case of foreign body urinary retention","authors":"Sarah Spelsberg, Benjamin McMichael, Brianna Crosby, Katherine Fredlund","doi":"10.1016/j.jemrpt.2025.100193","DOIUrl":"10.1016/j.jemrpt.2025.100193","url":null,"abstract":"<div><h3>Background</h3><div>Bullet and other foreign body migration after penetrating trauma is rare. There is potential for delayed movement and migration over time. A migrating retained foreign body can cause serious complications.</div></div><div><h3>Case report</h3><div>A 51-year-old male sustained a gunshot wound to the abdomen and pelvis. The bullet initially lodged in the abdomen. Trauma imaging identified cancer and the patient required surveillance scans. The position of the bullet remained unchanged for 11 months. From 11 to 15 months, imaging showed the bullet migrating across the abdomen, into the bladder, and through the prostate, ultimately causing acute urinary retention in the urethra. The patient presented with severe pain and was found to have bladder distention and the bullet 5 mm from the urethral meatus. It was successfully removed under sedation using alligator forceps followed by Foley catheter placement.</div></div><div><h3>Why should an emergency physician be aware of this</h3><div>This case illustrates the rare but significant risk of delayed bullet migration and the need for long-term monitoring in penetrating trauma with retained foreign body.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare but life-threatening Emergency: Orolingual angioedema with tenectaplase therapy 罕见但危及生命的紧急情况：舌部血管性水肿与替纳普酶治疗

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.jemrpt.2025.100194

Kevin Koetters, Keri Furci, Marisa Van Buskirk, Kelly Mari, Alessandro Iliceto

{"title":"A rare but life-threatening Emergency: Orolingual angioedema with tenectaplase therapy","authors":"Kevin Koetters, Keri Furci, Marisa Van Buskirk, Kelly Mari, Alessandro Iliceto","doi":"10.1016/j.jemrpt.2025.100194","DOIUrl":"10.1016/j.jemrpt.2025.100194","url":null,"abstract":"<div><h3>Background</h3><div>Orolingual angioedema is a rare but potentially life-threatening complication of intravenous thrombolytic therapy for acute ischemic stroke (AIS). While it is a well reported side effect of alteplase, reports involving Tenecteplase (TNK) are limited. Risk factors include concurrent use of angiotensin-converting enzyme (ACE) inhibitors and infarction involving the insular or frontal cortex.</div></div><div><h3>Case report</h3><div>A 58-year-old woman with history of hypertension on antihypertensive therapy with benazepril presented to the Emergency Department (ED) with acute aphasia and right-sided hemiplegia. Non-contrast head CT excluded hemorrhage, and she was treated with TNK. Shortly after administration, she developed right-sided upper lip and tongue swelling. Orolingual angioedema was promptly identified, and the patient was treated with intravenous methylprednisolone, diphenhydramine, and famotidine. She was monitored in the neurocritical care unit, and her symptoms gradually resolved without the need for intubation.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>TNK is increasingly being used as a preferred thrombolytic agent for AIS across many stroke centers in the United States. Though angioedema is a well-defined clinical entity and a known complication of alteplase, particularly for patients taking ACE inhibitors, there is limited literature describing its incidence in patients treated with TNK. ED providers should recognize that orolingual angioedema can occur with TNK. The condition, although often mild, can progress rapidly and become life threatening if the airway is compromised. Prompt identification, risk stratification, and early medical intervention are critical to mitigate the risk of life-threatening deterioration and potentially avoid challenging intubations and airway compromise.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When retrograde menstruation becomes dangerous: A case of hemodynamic instability from a necrotic leiomyoma 当月经逆行变得危险：坏死性平滑肌瘤引起的血流动力学不稳定1例

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-10-11 DOI: 10.1016/j.jemrpt.2025.100196

Shreya Suresh, Eric Shipley

{"title":"When retrograde menstruation becomes dangerous: A case of hemodynamic instability from a necrotic leiomyoma","authors":"Shreya Suresh, Eric Shipley","doi":"10.1016/j.jemrpt.2025.100196","DOIUrl":"10.1016/j.jemrpt.2025.100196","url":null,"abstract":"<div><h3>Background</h3><div>Retrograde menstruation is a common gynecologic occurrence that is typically associated with development of extrauterine endometriosis. However, in rare cases, it may result in life-threatening complications, particularly when compounded by underlying pathology. Case Report: We report a rare and severe presentation of retrograde menstruation due to a necrotic submucosal leiomyoma, resulting in profound anemia and hemoperitoneum in a 29-year-old female. The patient presented with vaginal bleeding, persistent suprapubic and left lower quadrant abdominal tenderness, and an episode of syncope in the emergency department (ED). Imaging results revealed hemoperitoneum and a necrotic intracavitary fibroid. Laboratory findings showed a rapidly declining hematocrit from vaginal and intra abdominal bleeding, that ultimately necessitated emergent surgical intervention. Initial stabilization included blood transfusions, tranexamic acid administration, and pain control. Then, a laparoscopy and hysteroscopic myomectomy was performed that showed retrograde menstruation with copious amounts of old and fresh blood in the anterior and posterior cul de sacs. Blood was seen in the upper abdomen where the blood had tracked around the liver. Why Should an Emergency Physician Be Aware of This? This case underscores the diagnostic challenge when retrograde menstruation occurs in atypical presentations involving necrotic fibroids and hemorrhagic complications. The unusual severity of this case, marked by active paradoxical abdominal bleeding and hemodynamic instability highlights the importance of timely, multidisciplinary intervention to prevent life-threatening complications. This report contributes to the limited literature on complications involving retrograde menstruation and emphasizes the importance of a high suspicion in similar clinical scenarios.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Undifferentiated shock in the elderly: Hemorrhagic shock from a bleeding epiploic appendage varix 老年未分化性休克：由出血性大网膜附件静脉曲张引起的失血性休克

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.jemrpt.2025.100198

Daniel T. Secor , Max Watchmaker , Jordan R. Pollock , James S. Komara , Douglas E. Rappaport

{"title":"Undifferentiated shock in the elderly: Hemorrhagic shock from a bleeding epiploic appendage varix","authors":"Daniel T. Secor , Max Watchmaker , Jordan R. Pollock , James S. Komara , Douglas E. Rappaport","doi":"10.1016/j.jemrpt.2025.100198","DOIUrl":"10.1016/j.jemrpt.2025.100198","url":null,"abstract":"<div><h3>Background</h3><div>Undifferentiated hypotension with altered mental status in elderly patients poses a diagnostic challenge in the emergency department. Although fluid resuscitation may yield transient hemodynamic improvement, this response can obscure life-threatening pathology. Rarely, bleeding from an epiploic appendage can cause intra-abdominal hemorrhage and lead to sudden hemodynamic collapse.</div></div><div><h3>Case report</h3><div>An 83-year-old male presented with acute altered mentation and hypotension. He received 2 L of intravenous fluids with a transient improvement in symptoms. Broad-spectrum antibiotics were initiated for possible sepsis, and admission was planned. Hours later, while awaiting transfer, he developed worsening hypotension and new onset abdominal distension. Laboratory testing revealed a hemoglobin decline from 11.5 g/dL to 5.0 g/dL. Emergent imaging demonstrated free intraperitoneal air and hemoperitoneum. A massive transfusion protocol was activated, and the patient required intubation and vasopressor support. Emergency laparotomy identified a bleeding epiploic appendage with significant hemoperitoneum, which was surgically managed.</div><div>Why Should an Emergency Physician Be Aware of This?: This case highlights how a transient improvement in shock can mask intra-abdominal hemorrhage. Emergency physicians should maintain a broad differential in elderly patients with undifferentiated hypotension, reassess frequently after initial stabilization, and consider uncommon but life-threatening etiologies when abrupt decompensation occurs.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stewart-Treves syndrome post radical mastectomy: A case report 乳房根治术后Stewart-Treves综合征1例

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-10-11 DOI: 10.1016/j.jemrpt.2025.100197

Jack Golder , Luminita Rezeanu , Lindsay Tjiattas-Saleski

{"title":"Stewart-Treves syndrome post radical mastectomy: A case report","authors":"Jack Golder , Luminita Rezeanu , Lindsay Tjiattas-Saleski","doi":"10.1016/j.jemrpt.2025.100197","DOIUrl":"10.1016/j.jemrpt.2025.100197","url":null,"abstract":"<div><h3>Background</h3><div>Stewart-Treves Syndrome (STS) is a rare but serious complication observed in breast cancer patients who have undergone axillary lymph node radiation and developed postmastectomy lymphedema. STS typically presents as a purple-red cutaneous lesion, advancing over time to ulceration, edema, and hemorrhage. Its asymptomatic onset and inconspicuous presentation often delay diagnosis, complicating treatment and worsening prognosis.</div></div><div><h3>Case description</h3><div>This case report describes a 58-year-old female with a history of unilateral mastectomy and chronic lymphedema, who presented with a hemorrhagic wound on her upper extremity. Following multidisciplinary referrals, she was diagnosed with STS through biopsy and MRI, revealing angiosarcoma of the arm, forearm, and chest wall. The patient's treatment plan included forequarter amputation and chemotherapy.</div><div><strong>Why should an emergency physician be aware of this?</strong>: Despite advancements in treatment modalities, the prognosis for STS remains poor, emphasizing the importance of early diagnosis. Clinicians must maintain vigilance when encountering unusual skin lesions in breast cancer survivors, especially those with a history of radiation and lymphedema, to prevent delayed diagnosis and metastasis.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sodium of 106 in a 2-week-Old: An electrolyte crisis without a diagnosis 两周大的婴儿钠含量为106：没有诊断的电解质危机

JEM reports Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.jemrpt.2025.100199

Aleezay A. Khan , Alyssa M. Gill , Todd P. Chassee

{"title":"Sodium of 106 in a 2-week-Old: An electrolyte crisis without a diagnosis","authors":"Aleezay A. Khan , Alyssa M. Gill , Todd P. Chassee","doi":"10.1016/j.jemrpt.2025.100199","DOIUrl":"10.1016/j.jemrpt.2025.100199","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal electrolyte crises are rare yet potentially fatal. Hyponatremia in the neonatal population is associated with significant morbidity and mortality, with symptoms including vomiting, lethargy, seizures, and coma. Hyponatremia can co-occur with other electrolyte abnormalities such as hyperkalemia, which can induce life-threatening cardiac arrhythmias. We present the case of a neonate who appeared clinically stable but was discovered to have profound electrolyte disturbances requiring urgent intervention and extensive diagnostic evaluation.</div></div><div><h3>Case report</h3><div>A 15-day-old full-term male presented to the pediatric emergency department (ED) with persistent emesis and poor weight gain, weighing 0.78 kg below birthweight. Birth history, newborn screening, and physical exam were unremarkable, though family history included Russell-Silver Syndrome (RSS). Laboratory testing revealed hyponatremia (106 mmol/L), hyperkalemia (6.8 mmol/L), and hypochloremia (75 mmol/L). He was managed with isotonic saline, furosemide, calcium gluconate, albuterol, and magnesium sulfate. The patient was admitted to the intensive care unit, where electrolytes stabilized over an 11-day hospitalization. A comprehensive workup initiated in the ED investigated congenital adrenal hyperplasia (CAH), pseudohypoaldosteronism (PHA), Addison's disease, aldosterone synthase deficiency (ASD), and RSS, though no definitive diagnosis was established.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Neonates with severe electrolyte abnormalities may appear deceptively well on exam. Subtle signs such as persistent emesis and inadequate weight gain are critical clues. Early recognition and empiric management are imperative, especially as newborn screening may not detect rarer adrenal disorders. Multidisciplinary collaboration between the ED and pediatric subspecialists is essential for timely evaluation and effective treatment.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 4","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0