Rib fractures account for a significant number of emergency department visits each year. A patient’s disposition often depends on the severity of rib fractures, comorbidities, and ability to achieve adequate analgesia. We present a 44-year-old male patient with severe pain secondary to rib fractures. The initial disposition was to admit for pain control. However, upon performing a serratus anterior plane block, patient was functionally appropriate for discharge with proper return precautions. Serratus anterior plane block is within the skillset of the emergency physician and can be used to achieve analgesia for rib fractures without the sedative and respiratory depressive effects associated with opioids.
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Use of fascial plane blocks for traumatic rib fractures: a scoping review Ahtsham U Niazi, Max Solish, Aneurin Moorthy, Faizan Niazi, Antonio Hermes Abate, Catherine Devion, Stephen Choi Regional Anesthesia & Pain Medicine.2026; 51(4): 414. CrossRef
Ultrasound-Guided Serratus Anterior Plane Block for Acute Pain Management in Emergency Medicine: A Systematic Review Richard J. Gawel, Jennifer X. Hong, Erin E. Hassel, Jeffrey A. Kramer The Journal of Emergency Medicine.2025; 74: 13. CrossRef
Validation of the 35-mm rule in traumatic pneumothorax in an Asian population Woo Young Nho Postgraduate Medicine.2024; 136(1): 60. CrossRef
Efficacy and safety of the serratus anterior plane block (SAP block) for pain management in patients with multiple rib fractures in the emergency department: a retrospective study Sossio Serra, Domenico Pietro Santonastaso, Giuseppe Romano, Alessandro Riccardi, Stefano Geniere Nigra, Emanuele Russo, Mario Angelini, Vanni Agnoletti, Mario Guarino, Claudia Sara Cimmino, Michele Domenico Spampinato, Raffella Francesconi, Fabio De Iaco European Journal of Trauma and Emergency Surgery.2024; 50(6): 3177. CrossRef
Objective Remote cardiac implantable electronic device (CIED) interrogators, originally developed for home use, have been proven to be efficacious in clinical settings, especially emergency departments. Concern exists that attempting to interrogate a CIED with the remote interrogator of a different brand, i.e., a brand-mismatched interrogator, may cause device malfunction. The aim of this study was to determine if intentionally attempting to interrogate a CIED with a brand-mismatched remote interrogator resulted in device malfunction.
Methods A total of 75 ex vivo CIEDs manufactured by various companies underwent attempted interrogation by a brand-mismatched remote interrogator. CIED settings were compared before and after attempted mismatch interrogation. A total of 30 in vivo CIEDs were then randomized for an attempted 2-minute mismatched remote interrogation by one of the two possible mismatched remote interrogators. CIED settings were compared before and after attempted mismatch interrogation.
Results Of 150 ex vivo brand-mismatched interrogations, no device setting changes or malfunctions occurred; no remote interrogators connected to a mismatched CIED, and no devices were turned off. In the 30 patients undergoing brand-mismatched interrogations, the mean (standard deviation) age was 71.6 ( ± 14.7) years, 16 (53%) were male, with 24 pacemakers (80%), four pacemaker/implantable cardioverter defibrillators (13%), and two implantable cardioverter defibrillators (7%). Of the 30 mismatched interrogations performed, no device setting changes or malfunctions occurred; no remote interrogators connected to a mismatched CIED, and no devices turned off.
Conclusion In a total 180 attempted brand-mismatched CIED interrogations, no CIED malfunctions occurred. This suggests that the use of remote CIED interrogators when device manufacturer is unknown is unlikely to result in adverse CIED-related events.
Objective The primary aim of this study was to prospectively compare the performance of the Broselow tape, Mercy method, pediatric advanced weight prediction in the emergency room extra-long (PAWPER XL) tape, and PAWPER XL mid-arm circumference (MAC) method in estimating the weight of children from a low-income setting. The secondary aim was to analyze the time taken to perform each method.
Methods This analyzed a convenience study sample of 300 children aged 0 to 18 years at the Baragwanath Hospital in South Africa. Weight estimations were obtained using each of the weight estimation systems on each child. These weight estimations were then compared against the actual weight to determine bias, precision, and accuracy of the estimation methods.
Results The PAWPER XL tape and PAWPER XL-MAC methods performed the best and provided estimated weights within 10% of the actual weight in 62.7% and 67.3% of cases, respectively, followed by the Mercy method (56.5%) and Broselow tape (43.9%). The use of MAC improved the accuracy of estimation, especially in heavier and taller children. The median times taken to perform measurements using the Broselow tape, Mercy method, PAWPER XL tape, and PAWPER XL-MAC method were 11.3 seconds, 34.7 seconds, 9.3 seconds, and 33.9 seconds respectively.
Conclusion The PAWPER XL tape and PAWPER XL-MAC methods were the most accurate methods of estimating weight in this group of children. These methods may be considered in preference to the Broselow tape or the Mercy method for emergency weight estimation in low socioeconomic status populations.
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A global perspective on the accuracy of pediatric weight estimation methods in emergency care: A systematic review Irrintzi Fernández-Aedo, Sendoa Ballesteros-Peña, Sandra Tobar-Cabrera, Gorka Vallejo-De la Hoz, Julia Fernandez-Alonso The American Journal of Emergency Medicine.2026; 102: 81. CrossRef
Artificial intelligence for weight estimation in paediatric emergency care Iraia Isasi, Elisabete Aramendi, Erik Alonso, Sendoa Ballesteros-Peña BMJ Paediatrics Open.2025; 9(1): e002891. CrossRef
Accuracy of Paediatric Advanced Weight Prediction in the Emergency Room-eXtra Length (PAWPER XL) Tape in Estimation of Body Weight in Pediatric Emergencies Tejavath K Singh, Kafeel Khan, Suresh R J Thomas Cureus.2025;[Epub] CrossRef
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A validation of newly developed weight estimating tape for Korean pediatric patients Sungwoo Choi, Sangun Nah, Sumin Kim, Eun O. Seong, So Hyun Kim, Sangsoo Han, Tariq Jamal Siddiqi PLOS ONE.2022; 17(7): e0271109. CrossRef
Accuracy of Weight Estimation in Children Using the Broselow, PAWPER XL, PAWPER XL-MAC, and Mercy Tapes Rafiuk Cosmos Yakubu, Nedda Ayi-bisah, Samuel Blay Nguah Pediatric Emergency Care.2022; 38(9): e1517. CrossRef
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