Search

Objective: The increasing number of geriatric admissions to emergency departments (EDs) necessitates a separate study of geriatric admissions for forensic reasons. This study investigated the reasons for geriatric forensic cases presented to the ED, the one-month mortality rates of these cases, and the factors affecting mortality. Methods: This was a retrospective cohort study. All patients 65 years old and older who were reported as forensic cases and presented to the ED of a tertiary care hospital between June 2018 and April 2021 were included. Forensic diagnoses, type of injury, age, gender, Glasgow Coma Scale score, consultation details, outcomes, and 1-month mortality status were recorded. Results: Among the 10.128 adult forensic presentations, 396 (3.9%) geriatric patient presentations were included in the study. The most common forensic diagnoses were motor vehicle accidents (24.2%) and pedestrian accidents (24.2%). Soft tissue injuries were the most common type of injury, followed by extremity fractures. Logistic regression analysis showed that age [odds ratio (OR): 1.095; 95% confidence interval (CI): 1.027-1.169], GCS (OR: 0.655; 95% CI: 0.560-0.765), number of consultations (OR: 1.840; 95% CI: 1.312-2.581), and pedestrian accidents (OR: 0.052; 95% CI: 0.006-0.460) were significantly associated with 1-month mortality. Conclusion: Traffic accidents, including motor vehicle and pedestrian accidents, were the most common type of forensic cases in this group of patients. One-month mortality increased with age, number of consultations, low GCS, and absence of pedestrian accident. [ABSTRACT FROM AUTHOR]

Background/Objective: The knowledge, attitudes, and behaviors of healthcare professionals are directly related to mortality and morbidity due to road traffic crashes. It has become important to investigate the causes of various injuries in electric vehicle accidents. These issues are indirectly the responsibility of forensic medicine. This study aimed to develop an Electric Vehicle Accidents Attitude Scale (EVAAS) regarding cognitive, affective, and behavioral dimensions to determine the attitudes of healthcare professionals toward electric vehicle accidents. Materials and Methods: The sample group of the study consisted of 386 physicians and other health professionals, working in the emergency services and 112 units (emergency health services in Türkiye) of hospitals in Türkiye. The Delphi technique was performed in the development of EVAAS, and validity/reliability analyses were conducted after a focus group study and a pilot application. Results: The 26-item EVAAS scale was grouped into three-dimensional factors (cognitive, affective, and behavioral), which explained 65.257% of the total variance. Cronbach's alpha coefficient for EVAAS was 0.859, retest reliability was 0.781, and the test-retest reliability was calculated as 0.766. Conclusion: A valid and reliable EVAAS scale consisting of 26 items in three dimensions (cognitive, affective, and behavioral) was developed in the study. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Journal of General Medical Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bulletin of Legal Medicine / Adli Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pneumomediastinum and massive subcutaneous emphysema are clinical conditions that can occur during head and neck surgeries, bronchoscopy and tracheostomy, after thoracic trauma, rarely during dental procedures and sometimes spontaneously. Patients often present with symptoms such as swelling of the face, neck and sometimes the whole body, difficulty swallowing, shortness of breath, chest pain and skin crepitus. These findings usually develop suddenly and sometimes may occur within hours or days. A 48-year-old man is applies to the hospital with complaint chest pain due to a fall in the garden. If no pathology is thought to be present as a result of the X-ray, the patient is prescribed ibuprofen for pain relief and discharged. Patient who presents with what appears to be angioedema after taking ibuprofen is found to have pneumomediastinum. In the cases mentioned in the report and initially thought to be angioedema, seeing that the lips are not swollen and feeling subcutaneous crepitation, i.e. even just inspecting and palpating the patient, will distract the clinician from angioedema in a few seconds and direct him/her to the correct diagnosis and perform examinations in the direction of pneumomediastinum. [ABSTRACT FROM AUTHOR]

Objective: The elderly population is increasing worldwide and in Turkish society due to increased life expectancy, decreased mortality rate, and developments in medicine. This situation, together with the aging society, brings with it the need for quality long-term care of geriatric patients and the effective use of ethical principles such as autonomy, justice, and non-maleficence by considering a holistic ethical approach in elderly care. In this study, we aimed to determine the demographic and general characteristics of geriatric patients admitted to the emergency department (ED) and to compare the ED admissions of those who benefit from Home Health Services (HHS) with those who do not use this service. Materials and Methods: The study was conducted as a retrospective file review in the ED of a district state hospital, taking into account that there is only one ED in the district, and HHS patients cannot apply to another emergency department. It was aimed to access the data of all patients aged 65 years and over who applied to the ED within 1 year. Results: It was found that 11.4% (n=13,261) of 116,263 examinations performed in the ED within one year belonged to individuals in the geriatric age group. The median age of the patients admitted to the ED who were registered to HHS was 77 (65-101), while the median age of those who were not registered was 72 (65-107). Conclusion: Many results obtained in this study, especially the fact that the rate of repeated admissions, which is an important indicator for the health system and the ED, is higher in geriatric patients enrolled in HHS, indicate that there is a relationship between HHS and ED admissions. This suggests that making HHS and home care practices more efficient may reduce geriatric patients' ED visits. [ABSTRACT FROM AUTHOR]

Background: Trauma is a critical public health issue, particularly impacting the young and causing significant financial and moral losses. Approximately one-third of trauma-related hospitalizations and 20-25% of trauma-related deaths are caused by serious chest injuries. We aimed to determine the prognostic value of changing pediatric global troponin levels in the emergency department after trauma. Materials and Methods: Patients who applied to the emergency department with complaints of trauma between January 1, 2015 and January 31, 2022 were evaluated. Records of pediatric patients between the ages of 0 and 18 were reviewed. The cause and severity of the trauma, electrocardiography and echocardiography results, and laboratory data (biochemical, hemogram, C-reactive protein, pro-BNP, CK-MB, troponin, etc.) of the patients were evaluated. This study is an observational and retrospective. Results: Falling from height was the most prevalent cause of injury, accounting for 43% of cases. Chest trauma was observed in 55 patients (56%). All patients with chest trauma exhibited elevated troponin levels. Troponin levels were found to be significantly higher in patients with chest trauma (p=0.011). Conclusions: Our findings highlighted the prognostic importance of cardiac troponins, especially in pediatric patients presenting with trauma. [ABSTRACT FROM AUTHOR]

Backround: The aim of this study is to evaluate how competent family medicine residents see themselves in the interventional competency goals targeted in emergency medicine rotation and the factors associated with their competency levels. Methods: The study is a methodological and cross-sectional study carried out between 01 May-31 October 2022. 138 family medicine residents who completed their emergency medicine rotation and agreed to participate in the study were included in the study. In the questionnaire used to collect data in the study, there were the Emergency Medicine Rotation Interventional Competence Scale (EMRICS) developed by the researchers based on the family medicine specialty training curriculum and sociodemographic characteristics. Results: The mean ages of the study group 29.71±4.27 (Mean±SD) years, and 60.10% (n:83) were women. The mean scores obtained from the scale in the study group were 59.86±11.72 (Mean±SD). While the interventional competence in which family physician residents had the highest proficiency was arterial blood gas with 97.80% (n:135), the lowest was tracheostomy with 15.20% (n:21). Evaluation of BLS (p:0.037), intubation (p:0.028), tracheostomy (p:0.034), trauma patient assessment (p:0.004) in the study group who applied five or more applications received higher EMRICS than those who did not apply at all. Conclusion: In order to achieve the desired competence in interventional competency goals, it is recommended to be repeated at least 5 times.

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Trauma-related injuries constitute an important part of emergency department admissions. In order to provide appropriate health services to these patients, the readiness of physicians, especially those with limited clinical experience, should be increased in terms of knowledge and skills. In this study, it was aimed to evaluate an asynchronous e-learning module, which was prepared in order to increase the knowledge and skill levels of physicians who do not have sufficient experience in the evaluation of trauma patients, before starting to serve patients in a supervised manner, with student feedback. Methods: This research is a retrospective study in which the course feedback data of 28 students out of 39 students studying in the Emergency Medicine Specialization Training program, to whom the e-learning module on trauma was applied, were analyzed descriptively. The students' opinions were collected through an electronic questionnaire consisting of 18 likert-type and 2 open-ended questions. Results: The findings of the study showed that the asynchronous e-learning module on trauma was found to be effective in providing a flexible and accessible learning environment for students. The students found the content of the module easy to understand and evaluated it as a positive feature that they could access the content repeatedly. Conclusion: Asynchronous e-learning is a flexible, learner-centered and effective method adopted by learners for teaching theoretical content in emergency medicine residency education, while also providing more time for practical training in clinical settings for trainers and learners. [ABSTRACT FROM AUTHOR]

Objective: Pain is the most common reason for the emergency department (ED) visits of geriatric patients. Pain management might be challenging in this age group of patients which may spur delays in pain treatment and oligoanalgesia. In addition, failure to provide effective pain control in geriatric patients can lead to delirium, depression, and prolonged hospital stay. The aim of the study was to compare the changes in pain scores of geriatric and non-geriatric patients in the first 60 min who applied to the ED with acute pain. Methods: This prospective study was conducted between January 2022 and March 2022 in an academic ED. All patients older than 18 years old who presented with acute pain were enrolled in the study. The primary outcome measure of the study was determined as the alteration in pain levels between geriatric and non-geriatric groups at the visual analog scale (VAS) at 0-60th min. The secondary outcome measures of the study were to determine the opioid doses between the two groups and the alteration in pain levels between the two groups at the VAS at 0-20th min and 0-40th min. Results: The change in pain levels did not differ significantly between the groups at 0-60th, 0-20th, and 0-40th min. Opioid doses were also not significantly different among the two groups. Conclusion: The findings of this study indicate that oligoanagesia is not a significant risk neither for geriatric nor for non-geriatric patients in the ED population. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Taktik Muharebe Yaralı Bakımı, 1996 yılında ilk ele alınan ve sivil tıbbi müdahale algoritmalarından oldukça önemli farklılıklar gösteren bir tıbbi müdahale şeklidir. Silahlı çatışma alanlarında yapılıyor olması, bu algoritma değişikliklerini hem özel hem de gerekli kılar. Harp şartları ve yerel imkânlardaki sınırlılıklar ile tahliyede yaşanabilecek aksaklıklar, yapılabilecek tedavi seçeneklerini sivil yaralanma algoritmalarının dışına çıkarmıştır. Taktik Muharebe Yaralı Bakımı Algoritmaları 1996 yılı sonrası 2003, 2015 ve 2021 yılları arasında her yıl güncellenmiştir. Vietnam, Irak ve Afganistan savaşlarında elde edilen veriler ışığında düzenlenen bu güncellemeler sahadaki personelin eğitilmesi suretiyle hayata geçmektedir. Çatışma altında ölümlerin önemli bir kısmının bu algoritmaların uygulanması ile önlenebileceği gösterilmiştir. Askeri hastanelerin artık faal olmadığı ülkemizde Askeri Hekim sayısı da son yıllarda artış göstermesine rağmen, istenilen sayıda değildir. Yurdumuzda karşılaşılan sağlık hadiselerinde sivil sağlık personeli ile desteklenmekte ise de harp alanlarında bu hekimlerden faydalanma oranları kısıtlıdır. Sağlık personeli olmayan silahlı personelin tıbbi müdahaleleri uygulamaları ile ilgili olan hukuki ve idari boşluk 22.03.2016 tarih ve 29661 sayılı Resmi Gazetede yayınlanan “Sağlık Meslek Mensubu Olmayan Personelin Sağlık Personeli Yokluğunda Yapmaya Yetkili Oldukları Acil Tıbbi Müdahaleler Hakkında Yönetmelik” ile giderilmiştir. Bu personelin “Taktik Muharebe Yaralı Bakımı” eğitimi, çatışma alanındaki ölüm riskini azaltmada en önemli etken olacaktır. Ayrıca Askeri Hasar Kontrol Resüsitasyonunu da içeren tıbbi ilaç ve malzemelerdeki gelişim ve ilerlemeler, yaralanma sonrası ölüm insidansını azaltmada daha da etkin rol oynayacaktır.

Objective: Besides the known co-morbidities, emergency department (ED) applications reveal an increasing trend due to the complications originating from the increase in the elderly population in the society. In addition, ED applications with psychiatric symptoms also continuously rise in numbers. Along these lines, in the current study, we focus on the fundamental causes associated with the ED applications of geriatric patients (> 64 years old) with psychiatric symptoms. Materials and Methods: The patients who applied to our ED with psychiatric symptoms between February 2019 and August 2019 and who had a psychiatry consultation were evaluated retrospectively. The demographic data, co-morbidities, known psychiatric diseases, admission symptoms, and outcome diagnoses of the patients were recorded. The results were evaluated statistically. Results: A total of 43.2 % of male patients who were over the age of 65, and 43.3 % of female patients were admitted to our ED with the most common complaint of anxiety. No significant relations were detected between suicide attempts and the presence of psychiatric disease in elderly patients (p = 0.93). Delirium was the most common diagnosis in the geriatric population without any known psychiatric disease (n = 10). All patients were diagnosed with depression, delirium, and dementia, respectively, after the emergency psychiatric evaluation. Conclusion: Healthcare costs and morbidity-mortality rates of the senior patients with psychiatric symptoms can be significantly diminished upon the diagnosis of depression, delirium, and dementia via psychiatric examinations. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to make a bibliometric analysis of the publications made about the increasing triage in recent years. Materials and methods: The review of the articles to be included in this study was conducted on June 8, 2021 using the database of Web of Science Core Collection. Triage was written in the subject section and a search was made in the form. “Web of Science Categories: (All); Document Types: (All); Languages: (English); Timespan: (All); Indexes: (All)”. During the search, no restrictions were entered regarding the dates of the publications. The data were transferred to VOS viewer software and analyzed systematically. Results: A total of 22653 publications were descripted between 1980 and 2021. It was found that the most publications were made in the field of emergency medicine (EM) (n=3798; 16,76%). It has been observed that the most publications have been made from the United States. (n=10049; 44,36%). When Turkey's place in all fields and EM is examined; it was seen that it was in the 26th rank (n=225; 0,99%) in the all fields, and 18th in the EM field (n=50; 1,32%). Conclusion: Studies and publications on triage have been conducted most often in the field of emergency medicine. However, Turkey's place in the current literature is far behind compared to the risks it poses. It is recommended to increase the work on this area in our country.

Copyright of Community & Physician / Toplum ve Hekim is the property of Turk Tabipleri Birligi / Turkish Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Aim: Whole body of computed tomography (WBCT) approach is increasingly being preferred by the clinicians over the traditional selected CT approach worldwide, not only for major trauma patients but even for minor trauma patients. Our aim was to determine the ratio of polytrauma patients in minor trauma patients imaged with WBCT and to determine demographical and clinical predictors of polytrauma. Methods: This retrospective-descriptive-study was conducted at the emergency department with patients older than 16 but had an injury severity scores of less than 16 and those who underwent WBCT trauma patients between January 2015 and December 2018. The presence of polytrauma, which defined presence of injury with an abbreviated injury scale score ≥2 according to tomography results in at least two body regions, was considered as the primary outcome of the study. Results: Total 3924 (ISS lt;16) patients’ data were enrolled in the study. Only in 278 of all patients (7.1%) polytrauma was detected. After the multi-logistic regression analysis, fall from height ( gt;3 meters), pedestrian struck, altered mental status (GCS lt;14), and male sex were found as significant predictor factors for presence of polytrauma. When created a model with these parameters, it was found that it had low diagnostic accuracy value as 0.6 (95%CI: 0.59 to 0.72). Conclusion: When considered only minor trauma patients with small polytrauma and mortality ratio, routine using of WBCT approach is not rational. The predictors found in our study can be used to develop a clinical decision rule in the future for minor trauma patients. ÖZET Amaç: Tüm vücut bilgisayarlı tomografi (TVBT) yaklaşımı, klinisyenler tarafından sadece majör travma hastaları için değil, hatta minör travma hastaları için de dünya çapında geleneksel seçilmiş BT yaklaşımına göre giderek daha fazla tercih edilmektedir. Amacımız, TVBT ile görüntülenen minör travma hastalarında çoklu travma hastalarının oranını belirlemek ve çoklu travmanın demografik ve klinik belirleyicilerini belirlemekti. Yöntemler: Bu retrospektif-tanımlayıcı-çalışma, acil serviste 16 yaşından büyük ancak injury severty skoru lt;16 olan ve Ocak 2015 ile Aralık 2018 tarihleri arasında, WBCT çekilmiş olan travma hastalarının verileri incelenerek yapıldı. En az iki vücut bölgesinde tomografi sonuçlarına göre abbreviated injury scale skoru ≥2 olan yaralanma varlığı çalışmanın birincil sonlanımı olarak belirlendi. Bulgular: Çalışmaya toplam 3924 hastanın verileri dahil edildi. Tüm hastaların sadece 278'inde (%7.1) çoklu travma tespit edildi. Çoklu lojistik regresyon analiz sonuçlarına göre, yüksekten düşme ( gt;3 metre), yayaya araç çarpması, değişen mental durum (GCS lt;14) ve erkek cinsiyet, çoklu travma varlığı için anlamlı değişkenler olarak bulundu. Bu değişkenlerle bir model oluşturulduğunda, bu modelin 0,6 (%95 CI: 0,59 ila 0,72) gibi düşük tanısal doğruluk değerine sahip olduğu bulunmuştur. Sonuç: Çoklu travma ve mortalite oranı küçük olan sadece minör travma hastaları düşünüldüğünde, TVBT yaklaşımının rutin kullanımı akılcı değildir. Çalışmamızda bulunan prediktörler, minör travma hastaları için gelecekte klinik bir karar kuralı geliştirmek için kullanılabilir.

Purpose: The primary aim of this study was to determine the role of the optic nerve sheath diameter (ONSD) measured using ultrasonography in the differentiation of hypoxemic respiratory failure and hypercarbic respiratory failure. The secondary aim was to determine the value of ONSD in predicting the clinical outcome in hypercarbic patients. Materials and Methods: Non-traumatic adult patients presenting with dyspnea were included in this study. Arterial blood gas and concurrent ONSD measurements were obtained from all patients included in the study during presentation and at the second hour of treatment. The patients were divided into two groups - hypoxic and hypercarbic respiratory failure. An equivalent number of healthy volunteers were enrolled as the control group. Result: Mean ONSD values were 3.8±0.2 mm in the 24 patients with type 1 respiratory failure, 5.2 ± 0.5 mm in the 25 patients with type 2 respiratory failure, and 3.9±0.3 mm in the healthy controls. The ONSD of the hypercarbic patients was statistically significantly greater than that of the hypoxic patients and healthy volunteers. The ONSD of the hypercarbic patients was 5.2±0.5mm at baseline and 4.4±0.6 mm after treatment, the difference being statistically significant. However, the difference in ONSD was not statistically significant in predicting hospitalization and mortality. Conclusion: Sonographically measured ONSD may be an effective parameter in the differential diagnosis of type 1 and 2 respiratory failure. ONSD values changed significantly with treatment in patients with type 2 respiratory failure. [ABSTRACT FROM AUTHOR]

Glasgow coma scale (GCS) is one of the most important parameters in deciding rapid sequential intubation (RSI) in emergency department (ED). The aim of this study is to determine the effectiveness of the GCS and each of its parameters in making RSI decisions in non-traumatic patients brought to the ED. Methods: This prospective observational study was conducted in an ED of a tertiary training and research hospital, which accepts approximately 250.000 patients annually. The value of GCS and GCS parameters in deciding to intubation in patients with an RSI indication was compared with the Pearson χ2 test. Multivariate logistic regression analysis was used for assessment of combinations of GCS parameters. Results: A total of 276 patients were included in the study. It was found that the mortality rates was statistically significantly higher in the cases with GCS 4-10 (including) in the combinations with the low motor response. Motor scoring was more statistically significant for mortality in the evaluation made by creating 120 combinations between the remaining 4-14 GCS scores after the 3 and 15 GCS scores of the cases were removed from the GCS scores. Conclusion: It was found that the motor response showed more linear progress compared to the verbal response and eye response evaluation, and the other parameters were not linear in the evaluation between the GCS total score and GCS combinations of the cases. Motor response was determinant in the total GCS score. [ABSTRACT FROM AUTHOR]

Amaç Radyoloji kılavuzlarında medikal monitör kullanımı önerilmesine rağmen medikal monitörlerin radyoloji dışı bölümlerde kullanımı nadirdir. Bu çalışmada acil serviste tecrübesiz hekimlerin radyografi yorumlanmasına; led, tablet ve medikal monitör kullanımının etkisini araştırdık. Gereç ve Yöntem Çalışmaya tıp fakültesinden 50 intörn doktor dahil edildi. Katılımcılardan önceden hazırlanmış radyografi setlerine led, tablet ve medikal monitörlerde tanı koymaları, karar veremedikleri radyografiler için radyoloji konsültasyonu istemeleri istendi. Katılımcıların tanıları ve radyoloji konsültasyonu isteme durumları kaydedildi. Bulgular Katılımcıların monitörlere göre doğru tanılarının median değerleri; led monitörde 13.5, tablet monitörde 13 ve medical monitörde 16 olarak bulundu. İstenilen radyoloji konsültasyonu sayılarının medyan değeri; led monitörde 6, tablet monitörde 7 ve medikal monitörde 4 olarak bulundu. Medikal monitör, doğru tanı ve istenilen konsültasyon sayısında diğer iki monitöre göre istatistiksel olarak üstün bulundu. Sonuç Tecrübesiz hekimlerin, acil servis gibi iş yükünün fazla ve zamanın değerli olduğu yerlerde medikal monitör kullanmaları tanı doğruluğunu artıracak ve konsültasyon isteme oranını azaltacaktır.

Aim Although it is recommended to use a medical monitor in radiology guides, it is rare to use a medical monitor in non-radiology departments. In this study, the effect of using LED, tablet and medical monitor in the radiography evaluation of inexperienced physicians in the emergency room was investigated. Materials and Methods Fifty medical intern from the medical school were included in the study. Participants were asked to diagnose pre-prepared radiography sets on LEDs, tablets and medical monitors and to request a radiology consultation for radiographs they could not decide. The diagnoses of medical interns and cases of requesting radiology consultation were recorded. Results The median values of the correct diagnosis of the participants according to the monitors; 13.5 on led monitor, 13 on tablet monitor and 16 on medical monitor. The median value of the desired radiology consultation numbers; 6 on led monitor, 7 on tablet monitor and 4 on medical monitor. The medical monitor has statistically signficant difference to the other two monitors, in the correct diagnosis and number of consultations desired. Conclusion The use of medical monitors by inexperienced physicians in the emergency room where workload is extreme and time is valuable, will increase the diagnosis accuracy and decrease the rate of request for consultation.

Amaç: İş kazaları önemli bir mortalite ve morbidite nedenidir. Ayrıca meydana getirdiği tedavi giderleri ve iş gücü kayıpları nedeni ile ekonomik açıdan ciddi yüklere sebep olmaktadır. Bu çalışmanın amacı, hastanemize başvuran iş kazalı hastaların demografik bilgileri, yaralanmaların özellikleri, acil servis maliyetleri ve bunlar arasındaki ilişkiyi incelemektir.Gereç ve Yöntem: 01.01.2017–31.12.2017 tarihleri arasında hastanemiz acil servisine başvuran 18 yaş ve üzeri iş kazalı 323 hasta çalışma kapsamına alındı. Veriler hastane bilgi sistemi ve hasta dosyalarının geriye dönük olarak incelenmesiyle elde edildi.Bulgular: Çalışma grubunun yaş ortalaması 34,03±9,8 idi. Olguların %89,8’i erkekti. Yaralanmalar en sık 28-47 yaş grubunda %62,9 görüldü. Acil Servis başvurularında yıl içinde en çok Aralık ayında görüldü. Günlere göre dağılımda en sık Salı günü, gün içinde ise en sık 08.00-16.00 saatleri arasında artış göstermekteydi. Olguların %24,1’i inşaat alanında çalışmaktaydı. Yaralanmaların %66,6’sının işe başladıktan sonraki ilk dört saat içerisinde olduğu belirlendi. Çalışma grubunda taburculuk oranı %69 idi. En fazla konsültasyon işlemi plastik ve rekonstrüktif cerrahi ile yapıldı. Ortalama acil servis maliyeti 119,40±115,38 TL idi. Eğitim durumu azaldıkça kazanın maliyetinin anlamlı olarak arttığı saptandı. Sonuç: İş kazalarının ve kaza neticesinde oluşacak kayıpların azaltılabilmesi için koruyucu faktörlerin yanı sıra, yaralanmaya yatkınlık oluşturacak etmenlerin de sorgulanması ve kaydedilmesi gereklidir

Objective: To reveal how the coronavirus disease-2019 pandemic has affected the characteristics of patient visits by comparing profiles in a pediatric emergency department (ED). Material and Methods: The period between March 11, 2020, and June 1, 2020, and the same timeframe in 2019 were retrospectively evaluated. For each day, the total number of ED visits was calculated. Patient gender, age, time of ED visit, triage priority, arrival characteristics, diagnostic codes, and hospital admissions for each day’s visits were recorded and the proportion was calculated for each parameter. Results: During the study period, ED visits declined by 80.8% in comparison to the previous year. In terms of diagnoses, in 2020, there was a decrease in the mean daily number and proportion of patients diagnosed with infectious diseases (p<0.05). In terms of traumatic injuries, there was a decrease in the number of visits in 2020, but the overall rate had increased, being 14.7% in 2019 and 18.4% in 2020. There was a decrease in the rate of visitors with green codes (p<0.001), but there was an increase in yellow codes (p<0.001) and no difference in red codes (p= 0.980). The proportion of hospitalizations also increased while the total number declined (p<0.05). Conclusion: During the pandemic period, our pediatric ED experienced a significantly decreased volume of visitors presenting with low-acuity conditions. Understanding the frequency and distribution of ED visits can help shape public health preparedness policies such as healthcare planning to ensure the availability of resources. [ABSTRACT FROM AUTHOR]

Copyright of Eurasian Journal of Toxicology is the property of Eurasian Journal of Toxicology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Meandros Medical & Dental Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Systemic juvenile idiopathic arthritis is deemed as a subtype of the disease complex known as juvenile idiopathic arthritis but differs in the point of its clinical manifestations and pathophysiological features. Besides, macrophage activation syndrome is a potentially fatal complication of systemic juvenile idiopathic arthritis requiring timely management. The study aims to evaluate the presence and recurrence of macrophage activation syndrome according to the initial symptoms and pattern of different phenotypes in systemic juvenile idiopathic arthritis to reveal the comprehensive association of these interrelated disorders. Methods: The study was conducted at the Department of Pediatric Rheumatology in Istanbul University, Istanbul Faculty of Medicine with a retrospective design, covering the date range 2015 to 2021. Patients, aged 0-18 years, being followed up with a diagnosis of systemic juvenile idiopathic arthritis with or without macrophage activation syndrome were enrolled in the study. The details of demographic data and disease-related clinical and laboratory information were investigated both from their records and the hospital database. The patients with missing or insufficient data and without regular follow-up were excluded from the study. Results: Seventy-eight patients followed up with the diagnosis of systemic juvenile idiopathic arthritis were included in the study. The gender distribution in the study was equivalent randomly (F/M: 39/39). The median age at the study was 174 (29-229) months. The development and recurrence of macrophage activation syndrome revealed statistical significance between the genders; p=0.01 and p=0.02 respectively. Macrophage activation syndrome was more common in patients with evanescent rash (p=0.00) and those without arthritis (p=0.01). The development of macrophage activation syndrome was statistically higher in patients with predominant systemic symptoms (p=0.02) and polyphasic course (p=0.01). The presence of serositis (p=0.01) correlated with the recurrent macrophage activation syndrome. Conclusion: The results from our study were consistent in revealing the association between macrophage activation syndrome and the systemic features in systemic juvenile idiopathic arthritis, despite a lack of correlation with arthritis in the initial presentation of the disease. Early clinical indicators and comprehensive studies are required to predict the development of macrophage activation syndrome. [ABSTRACT FROM AUTHOR]

Foreign body aspiration is one of the leading causes of preventable mortality and morbidity in children. Foreign body aspiration cases are most common in the first 3 years of life. Not leaving children out of adult supervision is the most important precaution for foreign body aspiration. Educating parents about first aid and the heimlich maneuver will prevent potential negative consequences. In this article, it is aimed to present a case who was brought to the emergency department in cardiac arrest after foreign body aspiration and to examine the subject of foreign body aspiration in the light of current literature. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmanın amacı, elektif ürolojik cerrahi uygulamalar ve acil tıp kliniklerinde uygulanan prosedürlere ait aydınlatılmış hasta onam formlarının okunabilirliklerinin, okunabilirlik formülleri aracılığı ile karşılaştırılarak değerlendirilmesidir.Gereç ve Yöntem: Acil tıbbı prosedürler için toplam 32 adet, ürolojik cerrahi uygulamalar için toplam 61 adet onam formu değerlendirmeye alındı. Ortalama kelime sayısı, hece sayısı ve hece sayısı 4 ve üzeri olan kelimeler hesaplandı. Onam formlarının okunabilirlik düzeyinin hesaplanmasında, Türkçe metinlerin okunabilirlik düzeyinin belirlenmesi için tanımlanmış olan Ateşman ve Bezirci-Yılmaz formülleri ve genel okunabilirlik düzeyini ölçen Gunning fog, Flesch kincaid formülleri kullanıldı. Bulgular: Elektif ürolojik onam formlarının okunabilirliği Ateşman, Gunning fog, Flesch kincaid formüllerine göre anlamlı düzeyde daha zor okunabilir olarak bulundu p=0.001, p

Copyright of Yeni Üroloji Dergisi is the property of Ali Ihsan Tasci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: E-learning gained popularity since the sudden pandemic entry, which revealed the need to adapt to our practice after becoming mandatory. Thus, this study aimed to investigate the perceptions toward e-learning among emergency medicine physicians. Methods: In this questionnaire-based cross-sectional study, an online questionnaire was given about demographics, self-efficacy, satisfaction, self-control, anxiety, perceived usefulness, and attitudes toward e-learning was conducted on emergency medicine residents and specialists who are remotely involved in emergency medicine training in their departments due to the pandemic. The self-efficacy, satisfaction, interactivity, perceived ease of use, perceived benefit, self-control, and attitude scores were calculated based on the total Likert points of statements, and correlations were analyzed. Results: This study included 74 participants who remotely performed emergency medicine training during the study. Experience in years showed statistically higher satisfaction (p=0.018), self-control (p=0.003), ease of use (p=0.042), perception of benefit (p=0.022), and attitude (p=0.030) rates in residents. Experienced participants has a statistically lower self-efficacy (p=0.044) and higher perception of ease of use (p=0.034). Perception of benefit (p=0.009), self-control (p=0.006), perception of ease of use (p=0.01), and attitude (p=0.018) was statistically higher in high computer skill levels. Perception of benefit (r=0.543) is associated with higher computer skill levels, satisfaction (r=0.407), and perception of interactivity (r=0.498). Satisfaction had a positive correlation with self-control (r=0.543, p=0.000) and benefit perception (r=0.543, p=0.000). Conclusion: Increased interaction, improved users' computer skills and maintained higher self-efficacy and benefit perception are important to increase the satisfaction and adoption with e-learning. [ABSTRACT FROM AUTHOR]

Copyright of Eurasian Journal of Family Medicine (EJFM) is the property of Eurasian Society of Family Medicine / Avrasya Aile Hekimligi Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Çalışmamızda acil servise başvuran hastalarda ne sıklıkla amilaz testi istendiğini ve bu testin etkinliğini göstermeyi amaçladık.Gereç ve Yöntem: Amilaz tetkiki istenilen 32.922 hastadan amilaz yüksekliği (>100 IU/L) saptanan 4318’nin dosya bilgileri incelendi. Geriye kalan 1543 hasta çalışmaya dahil edildi. Hastaların demografik verileri ile laboratuvar değerleri, hastaların nihai tanıları ve ilaç bilgileri değerlendirildi.Bulgular: Acil servise başvuran hastaların %15,1’inden amilaz tetkiki istenilmiş olup, %1,98’inde amilaz yüksekliği saptandı. Acil servisteki tanı alan akut pankreatit insidansı 100.000’de 60 olarak saptandı. Serum amilaz kestirim değeri normalin üst limitinin 3 kat ve üzeri esas alındığında amilazın akut pankreatit tanısı koymadaki sensitivitesi ve spesifitesi amilaz düzeyini yükselttiği bilinen hastalıklarla ayırımda %85,4 ve %98,0 idi. Amilazın akut pankreatit tanısı koymadaki sensitivitesi ve spesifitesi amilazı yükselttiği bilinen bir hastalık veya ilaç kullanımı olmayan hastalarla ayırımında %85,4 ve %95,3 olarak saptandı. Sonuç: Amilaz yüksekliği akut pankreatit ile beraber diğer gastrointestinal, jinekolojik, kardiyovasküler, nörolojik hastalıklar ve renal fonksiyon bozukluklarında da görülmektedir. Acil servislerde hastalardan kliniğine göre amilaz tetkiki istenilmesi gereksiz tetkik istenilmesini önleyecektir.

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The many authors claim that poor communication may lead to bad consultations and patient results, but there is not enough evidence to support this argument. In this study, the aim was to determine whether consultation training makes a difference in the consultation process and patient outcomes. Method: This prospective, pre-/post-training study was conducted from June 1, 2019 to August 12, 2019 in an adult emergency department (ED). A feedback form with 9 questions related to the communication styles of emergency physicians (EPs) and their consultation processes was filled out by consultants. ED and hospital length of stay, in-hospital mortality, and additional requests were also noted. The validated 5Cs consultation model was used for training. Results: In the study, 724 of 1,295 eligible consultations (55.9%) were evaluated by consultants. The median scores of 7 questions related to the consultation processes and communication styles of the EPs increased after training, while there was no difference in patient outcomes or additional requests. In subgroup analyses, the median score of only 1 question increased in the internal consultations after training, while increases were noted for scores on 6 questions relating to surgical consultations. Similarly, there was no significant difference related to patients' outcomes and additional requests in these subgroup analyses. Conclusion: Consultation training had positive effects on the consultation processes and communication styles of the EPs. However, there was no difference in patient outcomes. Nevertheless, we believe that there should be communication skills training in countries that don't already have this in place. [ABSTRACT FROM AUTHOR]

Objective: Occupational accidents are an important cause of mortality and morbidity. In addition, due to the treatment costs and labor losses, it causes serious economic burdens. The aim of this study is to investigate demographic information, characteristics of injuries, emergency department costs and the relationship between them. Material and Methods: In the study, 323 patients who were 18 or older and who were admitted to the emergency department of our hospital between 01.01.2017--31.12.2017 because of occupational accidents were included. The data was obtained from the hospital management information system and through a retrospective investigation of the patient folders. Results: Mean age of the study group was 34.03±9.8 (18-63). 89.8% of the cases were male. Most of the injuries were in the 28-47 age-group (62.9%). An increase in the number of Emergency Department applications was observed in December. Tuesday and between 08.00-16.00 hours. 24.1% of the cases were working in the construction work. It was determined that 66.6% of the injuries occurred within the first four hours after starting work. Discharge rate in the study group was 69%. Consultation were highest in plastic and reconstructive surgery. Average Emergency Service cost was 119.40±115.38 TL. The cost of the accident increased significantly as the education level decreased. Conclusion: In order to reduce occupational accidents and losses resulting from the accident, it is necessary to question and record the factors that may predispose to injury as well as protective factors. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the readabilities of informed consent forms (ICFs) used for elective urological surgical applications and those used for procedures in emergency medicine by comparing through readability formulas. Material and Methods: A total of 32 consent forms were evaluated for emergency medicine procedures while a total of 61 consent forms were evaluated for urological surgical applications. Word number, syllable number and words with syllable number of four and above were calculated. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog, Flesch kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms. Results: Readability of elective urological consent forms was found to be at a significantly more difficult level to read compared to Ateşman, Gunning fog and Flesch kincaid formulas(p=0.001,p<0.001,p=0.006,respectively). It was measured that the sentence, word, syllable, letter and multi syllable numbers were significantly high in elective urological consent forms(p<0.001). Even though there is a difference among them, the readability levels of the consent forms of both groups were detected at average difficulty level according to Ateşman formula, very difficult according to Flesch kincaid formula, difficult according to Gunning fog formula and at high school level according to Bezirci-Yılmaz. Conclusion: Even though Medical Intervention is urgent or elective, difficulty of readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Emergency medical conditions involve rapid decision making and applying these decisions to prevent mortality and morbidity. Dermatologic emergencies may primarily occur in association with skin-involved diseases, and underlying systemic diseases or infections, as well. Dermatologic emergencies are uncommon than other branches of medicine; however, it involves the cases of potentially life-threatening, having high mortality rate, negatively effecting the quality of life on highest degrees, and requiring hospitalization or intensive care units, if possible, to give a convenient medical treatment immediately. The diseases causing mortality and morbidity, such as Urticaria-angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis, toxic shock syndrome, erythroderma, pruritic urticarial papules and plaques of pregnancy (PUPPP), autoimmune bullous diseases, acute graft versus host disease, scalded skin syndrome and necrotizing cellulitis, are known as dermatologic emergencies. Determining the dermatologic emergencies and providing an immediate medical response decreases the incidence of mortality and morbidity, and they are important to prevent unnecessary examinations, treatment, money and time loss for the consultation of conditions even they are not real dermatologic emergencies. We examined the dermatologic emergencies under the titles of etiopathogenesis, clinics, differential diagnosis and treatment, and we edited practical approaches for dermatology and non-dermatology physicians. [ABSTRACT FROM AUTHOR]

Aim: Aimed to evaluate the relationship of serum biochemical and blood parameters with aortic rupture and dissection types according to the DeBakey classification. Methods: Forty-three patients, who were admitted to the emergency department between 01.01.2011 and 01.01.2019 with the diagnosis of aortic dissection, were retrospectively evaluated. Gender, age, symptoms at presentation, vital parameters, creatinine and, troponin levels, and hemogram parameters were recorded after blood tests. Neutrophil-tolymphocyte ratio and monocyte-to-platelet ratio were obtained from these values. These results were compared with the presence of aortic rupture and the DeBakey classification. Results: Of the 43 patients included in the study, 30 were male (69.8%), and 13 were female (30.2%). Aortic rupture was seen in two of the 30 male patients (6.7%) and none of the females (p=1.000). There was a significant difference only in blood urine nitrogen and monocyte-to-platelet ratio between patients with and without aortic rupture (p=0.035 and p=0.015, respectively). Conclusion: Most of the routinely evaluated blood and biochemical parameters in aortic dissection cases did not yield significant results in comparison to the DeBakey classification and the presence of rupture. Only blood urea nitrogen and monocyte-to-platelet ratio values were lower in patients with aortic rupture. [ABSTRACT FROM AUTHOR]