{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:39:14Z","timestamp":1760369954421,"version":"3.38.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p> Plant exposures leading to systemic or topical toxicity are common presentations seen in the emergency department. While often nonfatal, certain highly toxic plants result in cardiovascular or respiratory failure requiring invasive management. We describe a 65-y-old patient who presented with a refractory ventricular dysrhythmia secondary to an unintentional ingestion of an aconitine-containing plant after incorrect identification. Despite aggressive treatment with vasopressors, intravenous fluids, antiarrhythmics, as well as electrolyte correction and multiple attempted synchronized cardioversions, the patient remained in a refractory dysrhythmia with cardiogenic shock. Venoarterial extracorporeal membrane oxygen (ECMO) therapy was initiated successfully and resulted in rapid resolution of the unstable dysrhythmia. The patient was weaned from ECMO in under 48 h and was discharged without neurological or cardiovascular sequelae. This case highlights management options available to clinicians who encounter toxicity associated with aconitine ingestion. Fatal consequences were averted, and caution is required with the use of plant-identifying applications and resources. <\/jats:p>","DOI":"10.1016\/j.wem.2023.09.006","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T13:33:12Z","timestamp":1699018392000},"page":"567-570","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Stir Fry with a Side of Extracorporeal Membrane Oxygen: Management of Cardiogenic Shock Secondary to Unintentional Aconitine Ingestion"],"prefix":"10.1177","volume":"34","author":[{"given":"Natasha L.","family":"Goumeniouk","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Calgary, Calgary, Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davis N.","family":"Maclean","sequence":"additional","affiliation":[{"name":"University of Calgary, Cumming School of Medicine, Calgary, Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua S.","family":"Howie","sequence":"additional","affiliation":[{"name":"University of Saskatchewan, Department of Psychiatry, Regina, Saskatchewan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason E.","family":"Waechter","sequence":"additional","affiliation":[{"name":"University of Calgary, Department of Critical Care Medicine, Calgary, Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Couillard","sequence":"additional","affiliation":[{"name":"University of Calgary, Department of Critical Care Medicine, Calgary, Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Shaw","sequence":"additional","affiliation":[{"name":"University of Calgary, Department of Cardiology, Calgary, Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott N.","family":"Lucyk","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Calgary, Calgary, Alberta"},{"name":"Poison and Drug Information Service (PADIS), Alberta Health Services, Calgary, Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"key":"bibr1-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2018.05.001"},{"key":"bibr2-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1080\/15563650902904407"},{"key":"bibr3-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92951-B"},{"key":"bibr4-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1016\/0378-8741(81)90001-5"},{"key":"bibr5-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1016\/j.jep.2009.07.031"},{"key":"bibr6-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1993.tb01730.x"},{"key":"bibr7-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1111\/j.1556-4029.2007.00647.x"},{"key":"bibr8-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1007\/BF03086125"},{"key":"bibr9-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2021.03.005"},{"key":"bibr10-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-022-00877-4"},{"key":"bibr11-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1017\/cem.2020.30"},{"key":"bibr12-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.3390\/molecules26134103"},{"key":"bibr13-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2017.1291944"},{"key":"bibr14-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1254\/jjp.48.290"},{"key":"bibr15-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2021.1945082"},{"key":"bibr16-j.wem.2023.09.006","volume":"8","author":"Ren B.","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"bibr17-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.1839"},{"key":"bibr18-j.wem.2023.09.006","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2021.1989785"}],"container-title":["Wilderness &amp; 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