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This compilation covers emergency medical management lessons from the February 6th Kahramanmaraş earthquakes. The objective is to review relevant literature on emergency services patient management, focusing on Koenig’s 1996 Simple Triage and Rapid Treatment (START) and Secondary Assessment of Victim Endpoint (SAVE) frameworks. Establishing a comprehensive seismic and mass casualty incident (MCI) protocol chain is the goal. The prehospital phase of seismic MCIs treats hypovolemia and gets patients to the nearest hospital. START-A plans to expedite emergency patient triage and pain management. The SAVE algorithm is crucial for the emergency patient secondary assessment. It advises using Glasgow Coma Scale, Mangled Extremity Severity Score, Burn Triage Score, and Safe Quake Score for admission, surgery, transfer, discharge, and outcomes. This compilation emphasizes the importance of using diagnostic tools like bedside blood gas analyzers and ultrasound devices during the assessment process, drawing from 6 February earthquake research. The findings create a solid framework for improving emergency medical response strategies, making them applicable in similar situations.

BACKGROUND: Selective lung intubation is a life-saving procedure in emergency departments. While various equipment can be used in selective lung intubation, most of this equipment is not readily available; therefore, single-lumen endotracheal intubations are performed for rapid interventions.MATERIALS AND METHODS: This study was designed as a randomized, prospective, cross-over study using the 90° rotation technique for selective intubation on a manikin model with and without endotracheal tube introducer (ETI) in difficult airway settings. Forty-six emergency physicians were included in the study. The primary outcome was evaluating time to selective intubations, and secondary outcomes were first and second attempt success rates and the self-perceived difficulty level of each method according to the participants.RESULTS: The mean time to the first successful endotracheal intubation was significantly longer for both right selective and left selective intubations with ETI utilization than without ([39.71 ± 9.83 vs. 21.86 ± 5.94 s], [P < 0.001]), ([42.2 ± 10.81 vs. 26.23 ± 7.97 s], [P < 0.001], respectively). The first-pass success rate did not differ for right selective intubation with or without an ETI (45/46 [97.8%] and 45/46 [97.8%], respectively). However, the first-pass success rate for left selective intubation was significantly higher with ETI as compared to without an ETI (30/46 [65.2%] and 13/46 [28.3%], respectively) (P < 0.001).CONCLUSIONS: While the success rates of right selective intubation were the same, the left selective intubation success rates with ETI are higher than the styletted endotracheal tube, which can be strong evidence for this method's applicability in practice. Expanding the use of ETI and increasing the experience of the practitioners can contribute to further success.

A 27-year-old female patient, G2P1, presented to the emergency department (ED) with acute onset nausea, vomiting, and mild chronic abdominopelvic pain. Physical examination revealed bilateral lower quadrant tenderness without rebound, guarding, or rigidity, and vital signs were within normal limits. Electrolytes, complete blood count, and liver and kidney function tests were normal. A pregnancy test was negative, and urinalysis did not reveal any abnormalities. No free fluid was observed in the abdominal ultrasound, and the ovaries and other intra-abdominal structures were found to be normal. The patient underwent intravenous contrast-enhanced abdomiopelvic computed tomography (CT) scan.

SUMMARY: Objectives: The aim of this study was to determine the antibiotic resistance of infectious and non-infectious E. coli species in order to increase the success of empirical antibiotic treatment in urinary system infections. Methods: The antibiotic susceptibility of 464 E. coli strains that were isolated from urine samples of patients who visited Derince Training and Research Hospital Emergency Department between January 1 and December 31, 2012 were retrospectively evaluated from records. The antibiogram results were classified as susceptible, moderately susceptible or resistant. Moderately susceptible strains were assumed to be resistant. Results: Bacterial proliferation was seen in 563 (28.1%) of the 1998 urine cultures tested. One hundred and twelve cultures could not be evaluated due to contamination, and there was no proliferation in 1323 cultures. E. coli strains were isolated in 464 (82.4%) of the cultures in which proliferation was seen. Three hundred and sixty seven (79%) of the patients were female, 97 (21%) were male, and the mean age of all of the patients was 41.1±24.1 years (min: 1, max: 90). The antibiograms of the E. coli strains revealed that meropenem had the lowest resistance (0%), while ampicillin-sulbactam had the highest resistance (36.8%). Conclusions: In this study, we investigated the antibiotic resistance of E. coli strains isolated from urine cultures in our region. Future studies, perhaps similar to this one, can be performed in the future to increase the success of treatments. ÖZET: Amaç: Bu çalışmada üriner sistem enfeksiyonlarında ampirik antibiyotik tedavi başarısını artırmak için enfeksiyon etkeni olan veya olmayan E.coli suşlarının çeşitli antibiyotik türlerine direnci araştırıldı. Gereç ve Yöntem: 1 Ocak-31 Aralık 2012 tarihleri arasında Derince Eğitim ve Araştırma Hastanesi acil servisine başvuran hastaların mikrobiyoloji laboratuvarına gönderilmiş idrar örneklerinden izole edilen 464 E.coli suşunun antibiyotik duyarlılıkları bilgisayar kayıtları üzerinden retrospektif olarak değerlendirildi. Antibiyogram sonuçları duyarlı, orta duyarlı ve dirençli olarak sınıflandırıldı. Orta duyarlı suşlar dirençli kabul edildi. Bulgular: 1998 idrar kültüründen 563'ünde (%28.1) üreme oldu. Kültürlerin 112'si kontaminasyon nedeniyle değerlendirilemedi, 1323 kültürde ise üreme olmadı. Üreme olan kültürlerden 464'ünde (%82.4) E.coli suşları izole edildi. Hastaların 367'si (%79) kadın 97'si (%21) erkek, tüm hastaların yaş ortalaması 41.1±24.1 (min: 1, maks: 90) idi. E.coli suşlarına karşı antibiyogramlar incelendiğinde, direncin en düşük görüldüğü antibiyotik meropenem (%0), en yüksek görüldüğü antibiyotik ise ampisilinsulbaktam olarak saptandı (%36.8). Sonuç: Bölgemizde idrar kültürlerinden izole edilen E.coli suşlarına karşı antibiyotik dirençlerini incelediğimiz çalışmamızın benzerlerinin ilerleyen dönemde yapılmasının tedavi başarısına yardımcı olacağını düşünmekteyiz. Key words: Culture, E. coli, emergency, urine, Anahtar sözcükler: Kültür, E.coli, acil, idrar