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A case report of ammonium sulfate inhalation
(Aves, 2011-12-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Almacıoğlu, Meral Leman; ÖZDEMİR, FATMA; Aydın, Şule Akköse; AYDIN, ŞULE; Bulut, Mehtap; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAK-8332-2020; AAX-5571-2021; HHN-5686-2022
Ammonium sulfate is widely used in agriculture and the leather trade in many countries. Although it is reported to have potential effects on respiratory, gastrointestinal systems and the skin, there are a few case reports and toxicological studies about ammonium sulfate intoxication after ingestion and there is no case about ammonium sulfate inhalation. Thus, we report the clinical and laboratory findings of a patient who inhaled ammonium sulfate gas due to a work accident and was brought to our emergency department directly from the factory. When he arrived, loss of consciousness, cyanosis, tachypnea and metabolic acidosis were observed and convulsions were reported before arrival at the emergency department. After intubation and mechanical ventilator support in the emergency department, he was admitted to the intensive care unit, was given a T tube - mechanic ventilator support and was discharged in a healthy condition on the 8th day of admission. Ammonium sulfate intoxication should be suspected for the patients which brought from the leather industry or an agricultural environment, who inhaled bad or dense odored material, and had loss of consciousness, convulsions, acidosis and respiratory failure.
A preventable public health challenge in Southeastern Turkey: Rabies risk-contact cases
(Aves, 2011-03-01) Sayhan, Mustafa Burak; Gökdemir, Mehmet Tahir; Kara, Hanife Pınar; Söğüt, Özgür; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı
Objective: It is projected that about 10 million persons are being treated worldwide every year due to contact with rabies-suspect animals. In this study, we aim to emphasize that rabies risk-contact cases are important public health problems for our region, and that the solution lies in an effective and accurate prophylaxis.Materials and Methods: Demographical data of 742 cases who presented to the emergency departments of three different hospitals in Sanliurfa between January 2007 and February 2009 due to animal bites and contacts were accessed from the "rabies risk- contact cases examination form" register, which were then entered into the previously prepared data forms.Results: A total of 501 (67%) cases were male, while 241 (33%) were female, with an average age of 22.78 +/- 0.63 years. The most commonly involved animals were dog (61.3%) and cat (33%) bites in our study. The majority (70%) of the cases entered into the prophylactic vaccination program were biting cases The remainder of the cases were included into the program due to scratching (28%) and suspicious indirect contact (2%). 3 doses of protectivevaccines were administered to 439 (59%) of the cases and 5 doses to 303 (41%) of the cases. Addtionally, 114 of the cases were treated with human rabies immune globulin. No rabies infections developed in the cases included into the vaccination program.Conclusion: It is indicated that there is an unsolved public health challenge in Sanliurfa and its vicinity due to the prevalence of cattle biting in addition to pet-related biting incidents.
Acute temporal lobe infarction in a young patient associated with marijuana abuse: An unusual cause of stroke
(Zhejiang Univ Sch Medicine, 2014-03-01) İnal, Taylan; Köse, Ataman; Özdemir, Fatma; KÖKSAL, ÖZLEM; Köksal, Özlem; Armağan, Erol; ARMAĞAN, EROL; Aydın, Şule A.; AYDIN, ŞULE; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAM-7896-2020; AAH-8846-2021; AAI-2164-2021; AAK-8332-2020; L-7334-2015
BACKGROUND: Cardiovascular or cerebrovascular events associated with drug abuse have been frequently reported, particularly in young patients. The drugs include generally cocaine, heroin, and amphetamines. Although marijuana is among the widely used narcotics in the world, stroke associated with the marijuana use is infrequently reported.METHODS: Stroke caused by the use of marijuana was investigated in a 23-year-old man and the importance of inquiry of drug abuse in case of stroke was emphasized.RESULTS: The patient was treated for 7 days in a follow-up, but he was not recovered. The patient was discharged in his existing condition and was directed for physiotherapy and rehabilitation.CONCLUSION: Ischemic stroke is associated with drug abuse and/or substance use, mainly cannabinoids and amphetamines, particularly in young patients.
Admission appropriateness and profile of the patients attended to a state hospital emergency department
(Aves Press Ltd, 2011-04-01) Köse, Beril; Öncü, M. Reşit; Tuğrul, Fuzuli; Köse, Ataman; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; L-7334-2015; AAM-7896-2020; GNH-4101-2022; A-1247-2018
The aim of this study was to determine the profile and appropriateness of the patients' indications admitted to the emergency department in a state hospital. Adult and pediatric trauma patients admitted to the emergency department of Van State Hospital between March 01 and March 31, 2010, in the course of one month period, were retrospectively analyzed. Data of the 32800 patients admitted to the emergency department during this period were evaluated. Male and female ratio of these patients was 54.8% and 45.2%, respectively, and the most intense group with 77% was the age group of 17-65. The majority of the applications with 60.5% occurred between 8 a.m. and 17 p.m. An examination was asked for 50% of the patients. It was determined that emergency examinations and therapies were applied to 9.9% of the patients, consultation rates were 4.5%, and the highest consultations were taken from orthopedic clinics (16.1%). It was established that 1.4% of the patients were hospitalized, with the highest admission to the general surgery clinic (13.8%). In hospitalized patients, the most common diagnoses were abdominal pain (9.6%), and 88.4% of the patients were discharged from the emergency department. It was observed that the majority of patients admitted to the emergency department need not have been in emergency, and should have applied to primary health care services and policlinics. The results of this study showed that non-emergency patients highly increase the workload of emergency departments, therefore, patients should be trained and awareness of patients should be increased; primary health care services should be made available; accurate, effective and enforceable policies for emergency medical services in the country must be established.
An investigation of the comt gene val158met polymorphism in patients admitted to the emergency department because of synthetic cannabinoid use
(Macedonian Acad Sciences Arts, 2020-06-01) Nennicioglu, Y.; Kaya, H.; Eraybar, S.; Atmaca, S.; Görükmez, O.; Armağan, Erol; ARMAĞAN, EROL; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAH-8846-2021
Catechol-O-methyl transferase (COMT) enzyme has a role in the inactivation of catecholamine neurotransmitters. Functional polymorphism in the COMT gene has been reported to play an important role in schizophrenia, bipolar affective disorder, aggressive and antisocial behavior, suicide attempts and the pathogenesis of Parkinson's disease. In this study, we aimed to investigate the effect of the Val158Met polymorphism of the COMT gene on substance use, and treatment history in patients with synthetic cannabinoid (SC) intoxication. The COMT enzyme Val158Met polymorphisms from DNA of 49 patients who were evaluated in the Emergency Department after SC use and 50 healthy control groups aged 18-45 years, were identified by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses as reported in the literature. Information regarding recurrent intake or hospitalization due to substance use was obtained from hospital records. Wild-type (WT) genotypes in 14 (28.6%) patients, heterozygous genotypes in 25 (51.0%) and homozygous genotypes in 10 (20.4%) patients were detected. Wild-type genotypes The homozygous genotype was found to be significantly higher in patients hospitalized due to drug addiction and substance use (p 0.008). The Val158 Met polymorphism of the COMT gene was not found to be significant in the first use after substance intake, while a significant relationship was found in terms of this polymorphism in patients with substance addiction diagnosis and treatment history.
Analysis of acute adult poisoning cases among patients admitted to the emergency department in Bursa, Turkey
(Galenos Yayınevi, 2009-01-01) Demircan, Celaleddin; Kahveci, Ferda; Engindeniz, Zülfi; Kıyıcı, Murat; Girgin, Nermin Kelebek; Ercan, İlker; Tekce, Hikmet; Özdemir, Fatma; Özyurt, Gurayten; DEMİRCAN, CELALEDDİN; KAHVECİ, FERDA ŞÖHRET; Engindeniz, Zülfi; KIYICI, MURAT; KELEBEK GİRGİN, NERMİN; ERCAN, İLKER; Tekce, Hikmet; ÖZDEMİR, FATMA; Özyurt, Gurayten; Tıp Fakültesi; Dahili Tıp Bilimleri Ana Bilim Dalı; 0000-0003-4820-2288; 0000-0003-1874-5097; 0000-0002-3208-6211; 0000-0002-2382-290X; HJZ-4470-2023; AAG-9356-2021; JBJ-5787-2023; AAI-4213-2021; AAH-7250-2019; ABF-2367-2020; JGP-4019-2023; JKS-7683-2023; JKO-9428-2023
Purpose: The aim of this study was to define the epidemiological features such as age, sex, toxic substance, suicide, and mortality rates of the adult poisoning cases among patients admitted to the Emergency Department (ED) of Uludag University Medical Faculty Hospital.Materials and Methods: Records of acute adult poisoning cases at the ED within a one-year period (June 1, 2002 - May 31, 2003) were evaluated retrospectively. Data were compared to those of similar studies from Turkey and around the world.Results: In total 430 (1.96%) of 21,934 patients admitted to the ED during the study period suffered acute poisoning. Of these patients 259 (60.2%) were women and 171 (39.8%) were men and the mean age of the patients was 29.9. Patients were exposed to different types of toxic substances: drugs (47.4%), pesticides (10.7%), toxic gases (10%), corrosives (6.5%), alcohol (3.5%), food (15.8%), toxic substances of animal origin (3.0%), and others (3.0%). In all, 29.8% of the patients were admitted to hospital, 22.3% were transferred to other hospitals, and 47.9% were discharged from the ED, and the overall mortality rate was 1.2%. In addition, 54.9% of the poisonings were suicide attempts and within this group the women to men ratio was 2.2 and the most common toxic substance was a drug (85.2%).Conclusion: Our results were similar to those of previous studies from this country as acute poisonings are more common in women and younger ages, most of them were suicide attempts, and the mortality rate was low. Our transfer rate was high and this may necessitate the organization of short-term observation of these patients.
Analysis of the degree of accuracy and reliability of emergency medicine residents in interpreting computed tomography of the abdomen
(Galenos Publ House, 2022-06-01) Çetin, Murat; SARKI CANDER, SÜMEYYE TUĞBA; DURAK, VAHİDE ASLIHAN; AYDIN, ŞULE; Aydın, Şule Akköse; Durak, Vahide Aslıhan; SIĞIRLI, DENİZ; Sığırlı, Deniz; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0002-4161-5381; AAI-2164-2021
Aim: In this study, we aimed to investigate the accuracy and reliability of emergency medicine residents in the interpretation of radiological investigation of patients with trauma, who received abdominal computed tomography in the emergency department.Materials and Methods: We prospectively evaluated the reports of 200 patients who presented to the emergency medicine department of a university hospital with trauma, and who received abdominal computed tomography (CT) due to suspected abdominal pathology.Results: In this study, 33% (66/200) of the patients were female and 67% (134/200) were male. CT scans of these 200 patients were examined by emergency medicine residents and radiology specialists. The results of the study showed that emergency medicine residents performed well in interpreting abdominal CT scans of patients with trauma with an agreement rate of 90.5%. Evaluation of the results obtained in our study suggested that emergency medicine residents generally performed well in interpreting abdominal CT scans of patients with trauma with suspected abdominal pathology in the emergency room.Conclusion: The high rate of agreement may be associated with the fact that emergency medicine residents are usually the first physicians who meet and treat patients with trauma and thus have gained sufficient experience in this field.
Clinical value of D-dimer and other coagulation markers in differantial diagnosis of hemorrhagic and ischemic stroke
(Galenos Yayıncılık, 2009-12-01) Aydın, Şule Akköse; Köksal, Özlem; Bulut, Mehtap; Özuçelik, Doğaç Niyazi; Özdemir, Fatma; AYDIN, ŞULE; KÖKSAL, ÖZLEM; Bulut, Mehtap; ÖZDEMİR, FATMA; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; HHN-5686-2022; AAX-5571-2021; AAK-8332-2020; JCE-0651-2023; ITH-9225-2023
PURPOSE: This study aims to determine the clinical value of some laboratory markers(D-dimer, Fibrinogen, etc levels) as alternatives to expensive and sometimes unavailable advanced radiographic techniques, in differentiation and early diagnosis of hemorrhagic and ischemic stroke which require distinct diagnosis, monitoring and treatment methods.MATERIALS AND METHODS: The study includes 100 adult patients who applied to Emergency Department of Uludag University with clinical symptoms of stroke. At presentation on all of the patients and D-dimer, fibrinogen and other laboratory tests were studied. For differentiation of hemorrhagic and ischemic stroke, computerized tomography(CT) and magnetic resonance imaging(MRI) were taken. CT and MRI detections were assessed by radiology specialists blindly.FINDINGS: Of 100 patients included in the study, 53% were women and 47% were men. In 28% of the patients, ischemic stroke, in 21%, hemorrhagic stroke and in 48%, transient ischemic attack (TIA) was detected, while remaining 3% were assessed as normal. Average age of patients with ischemic stroke was found higher than that of patients with hemorrhagic stroke. No significant difference was observed when patients were grouped by sexes. Coagulation markers, D-dimer and aPTT were significantly different between hemorrhagic stroke and TIA groups while no significant difference was observed between ischemic and hemorrhagic stroke groups.RESULTS: Ischemic and hemorrhagic strokes cause homeostatic anomalies besides the brain damage accompanying. In our study, a difference between hemorrhagic stroke and TIA groups was observed, while no difference was found between ischemic and hemorrhagic stroke groups regarding coagulation markers.
Comparison of ice and lidocaine-prilocaine cream mixture in the reduction of pain during peripheral intravenous cannulation in emergency department patients
(Galenos Yayıncılık, 2013-03-01) Aygün, Hüseyin; Armağan, Erol; Özdemir, Fatma; Köse, Ataman; Selimoğlu, Kerem; Köksal, Özlem; Aydın, Şule Akköse; Aygün, Hüseyin; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Köse, Ataman; Selimoğlu, Kerem; KÖKSAL, ÖZLEM; AYDIN, ŞULE; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-3635-7282; AAK-8332-2020; AAI-2164-2021; AAH-8846-2021; AAM-7896-2020; JKT-3402-2023; JPE-0854-2023; CDS-3299-2022
Objective: We aimed to compare the efficacies of ice, lidocaine-prilocaine mixture cream and the classical method in reduction of the pain observed during intravenous cannulation, which is the most frequently performed procedure in emergency departments and to define the most effective method.Material and Methods: One hundred-twenty patients who applied to the emergency department of Uludag University Faculty of Medicine were included in this presented study. Cannulations were performed after one minute application of ice package in the ice group. Patients who applied to emergency only for blood transfusion were chosen for the lidocaine-prilocaine group and their cannulations were performed at the 60th minute of cream mixture application. Finally, no applications before cannulation were used for the control group. All cannulations were performed from antecubital region and 18 G cannula were used. Visual analog scale ( VAS) and patient satisfaction were scored.Results: VAS scores for ice, lidocaine-prilocaine and control groups are 2.8 +/- 1.7, 4.1 +/- 1.8, 4.4 +/- 1.9, respectively. VAS score in the ice group was significantly lower than both lidocaine-prilocaine and control groups. In addition, there was no statistically significant difference between lidocaine-prilocaine and control groups.Conclusion: Ice application method before intravenous cannulation, in addition to its advantages such as being inexpensive, easy to obtain and apply, is more effective than lidocaine-prilocaine cream.
Covid-19 pandemic and anxiety related factors in patients treated in the emergency department
(Mre Press, 2020-10-01) Durak, Vahide Aslihan; DURAK, VAHİDE ASLIHAN; Günay, Seyda; GÜNAY POLATKAN, ŞEYDA; Sığırlı, Deniz; SIĞIRLI, DENİZ; Akova, Bedrettin; AKOVA, BEDRETTİN; Armağan, Erol; ARMAĞAN, EROL; Tıp Fakültesi; Spor Hekimliği Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0003-1044-8805; AAA-7472-2021; AAI-4550-2021; AAH-8846-2021; AAI-5350-2021
Aims: A novel coronavirus, now known as SARS-CoV-2019, suddenly emerged in Wuhan, China and within threemonths of the initial outbreak, the virus had spread rapidly to neighboring countries causing a pandemic. After the first case was announced, emergency departments were immediately reorganized as pandemic clinics. Special areas with maximum precautions were designed to evaluate patients. The majority of studies on this pandemic have focused on the treatment of respiratory symptoms and comorbidities in intensive care units. In this study, we sought to determine those factors that contributed to the anxiety level during the COVID-19 pandemic using the 'State' subscale of State-Trait Anxiety Inventory (STAI-S). Methods: A survey was performed in the emergency department by using an online questionnaire which consisted of demographic variables, questions about the opinions and behaviors of patients during the pandemic, diagnostic test results for COVID-19, and treatment methods. Results: There was a statistically significant difference between employment status (p < 0.001), monthly income (p < 0.001), the food consumption changes during the pandemic period (p = 0.001) and the estimated end-date for the COVID-19 pandemic (p < 0.001) and total STAI-S points. Conclusions: Our study has identified factors which significantly increase anxiety during the COVID-19 pandemic and identified those individuals who may benefit from psychiatric and social support.
Diagnostic accuracy of fresno-quebec rules and risk factors for an associated fracture in patients presenting to the emergency department with anterior shoulder dislocation: A retrospective study
(Turkish Assoc Trauma Emergency Surgery, 2021-01-01) Durak, Vahide Aslihan; DURAK, VAHİDE ASLIHAN; Atici, Teoman; ATICI, TEOMAN; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0002-3396-3407; AAE-9483-2021
BACKGROUND: Anterior shoulder dislocation is the most common shoulder injury in patients presenting to the emergency department (ED). Up to 25% of these injuries are fracture-dislocations. In general, the standard approach is to obtain plain radiographs before and after reduction. Fresno-Quebec Rules (FQR) are described to identify the patients who require an x-ray before reduction to reduce radiation exposure and delays in treatment. We aimed to evaluate the efficacy of clinical predictors used in the Fresno-Quebec algorithm for detecting a shoulder fracture-dislocation.METHODS: Records of patients who presented to the Emergency Department with presumed shoulder dislocation were retrieved and retrospectively analyzed according to 'Fresno-Quebec Rule (FQR)'. Sensitivity, specificity, and predictive values of FQR for detecting associated injuries were calculated.RESULTS: Eighty-nine (65.9%) men and 46 (34.1%) women were included. The mean age of patients was 46 years (16-89). Ninety-nine (73.3%) of the cases had their shoulder dislocated for the first time, whereas 36 (26.7%) patients had a recurrent dislocation. Fifty percent of the patients (18 cases) with recurrent dislocation presented with an atraumatic episode. The remaining 18 patients with a history of recurrent dislocations had their shoulder dislocated as a result of trauma, and four (22%) of them had fracture-dislocation. Using the Fresno-Quebec rules yielded 100% specificity for the diagnosis of fracture-dislocation. The severity of the injury mechanism was not predictive in traumatic but recurrent dislocations. Only one of four patients with a fracture-dislocation in the traumatic recurrent dislocation group had high energy trauma.CONCLUSION: FQR has 100% sensitivity in detecting fracture-dislocations in patients admitted to ED with anterior shoulder dislocation. It utilizes simple parameters that are easy to use and recall. Using these rules, 30% of unnecessary radiographs can be avoided, saving time and money and reducing radiation exposure in anterior dislocations.
Diagnostic accuracy of symptoms, signs and one-year prognosis of patients with acute non-specific abdominal pain: : Prospective survey
(Turkish Assoc Trauma Emergency Surgery, 2008-04-01) Özgüç, Halil; Çakın, Nurşen; Duman, Uğur; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0002-4946-555X; H-5770-2018
BACKGROUNDThe aims of this study were to determine the diagnostic value of elements of the disease history, the clinical findings and basic laboratory examinations in differential diagnosis of the patients with nonspecific abdominal pain and to analyze the long-term survey of these patients.METHODSA prospective observational study was performed at the Department of General Surgery Medicine Faculty of Uludag University between November 2001 to November 2002. Based on the diagnosis reasons for abdominal pain, 610 patients were classified as being of specific abdominal pain (n=501) versus nonspecific abdominal pain (n=109). Patients with nonspecific abdominal pain were invited to a follow-up examination 24 hours later and 4 follow-up interviews were conducted on days 8, 15, 30 and at the end of I year. Statistical analyses were performed between findings of two groups.RESULTSIn logistic regression analysis, presence of a history of similar pain (odds ratio 1.88; p=0.009), nausea (odds ratio 0.46; p=0.001), rigidity (odds ratio 0.24; p=0.024), fever <= 36.6 degrees C (odds ratio 1.66; p=0.037), leukocyte count <= 8700 (odds ratio 1.85; p=0.011), age <= 39 years (odds ratio 1.85; p=0.018), respiratory rate <= 15 (odds ratio 3.19; p=0.00..) were significantly independent diagnostic factors. There was no malignancy during one-year follow-up period.CONCLUSIONThe possibility of a specific cause is higher in patients with history of a similar pain, nausea, rigidity, fever >36.6 degrees C, leukocyte count >8700, age >39 years, respiratory rate >15 in admission and persistent pain 24 hours after discharge.
Discharge of emergency patients to the clinical wards or intensive care units: An assessment of complications and possible shortcomings
(Elsevier, 2015-07-01) Durak, Vahide Aslıhan; Armağan, Erol; Özdemir, Fatma; Kahriman, Nezahat; DURAK, VAHİDE ASLIHAN; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Kahriman, Nezahat; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; AAE-9483-2021; Y-3674-2018; AAH-8846-2021; IOY-2055-2023; CXL-2354-2022
Objective: We aimed to evaluate the most common complications and possible shortcomings in the emergency patients who were admitted to the clinical wards or intensive care units.Materials and methods: 1000 patients were included in this study. The patients's complication rates were compared with the clinical diagnosis, age groups, the section of the emergency department initially managed the patients, the time of the shift (daytime or night), the accompanying medical staff and specific type of patient populations. Also the interventions of the complications were recorded.Results: 37.5% of the patients who were included in the study were female and 62.5% were male. The median age of the patients was 54.2 year (min: 1 max:92). The vital signs that were recorded prior to transport of the patients did not interfere with the complication rates (p > 0.05). Complication rates in the night were found to be higher as more admissions took place during the night shift (p < 0.05). The complication rates were found higher in patients who were admitted to coronary care unit. The most frequent complication was the dislocation of the intravenous catheter. Replacing the dislocated intravenous catheter was the most frequently noted intervention. However, initiating inotropic agents to the hypotensive patients was done more frequently in the admitted clinical departments.Conclusion: The overall complication rate was low in this series of patients. The majority of them can be prevented by having in house guidelines. (C) 2015 Elsevier Ltd. All rights reserved.
Evaluation of features of patients attending the emergency department of Uludag University medicine faculty hospital and emergency department practices
(Aves, 2010-12-01) KÖKSAL, ÖZLEM; Aydın, Tayfun; AYDIN, ŞULE; Aydın, Şule Akköse; Kulaç, Semih; Bulut, Mehtap; Özdemir, Fatma; ÖZDEMİR, FATMA; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; HHN-5686-2022; AAK-8332-2020; AAX-5571-2021
Objective: We aimed to evaluate the demographic and clinical features of patients who attended the emergency department of Uludag University Hospital, our emergency practices and the defi ciencies.Materials and Methods: All adults and trauma patients under 18 years were included in this prospective study. The evaluations were done with the study forms including patient data recorded by the doctors and nurses.Results: The mean age was 42.00 +/- 20.8 years, most (37,5%) comprised young adults (20-39). Only 10.1% of patient transfer to hospital was by ambulance. Most attendences were between 12: 00-16: 00 hours. 19.6% of the patients were categorized as Triage 1, signifying the very urgent group. were Evaluation by the physician of 76.4% of the patients was made in the fi rst 5 minutes of attendance. Consultations were required in 39.1% of the patients,, mostly from internal medicine, cardiology and orthopedics. Of the patients, 12.2% were hospitalized and 4.5% were referred to another hospital. Patients were most frequently admitted to internal medicine, plastic surgery and cardiology clinics. Besides radiography, radiologic investigations were needed in 12.6% of patients and Cranial Computed Tomography was the most frequently required. The average length of stay was 143.1 minutes for all patients, but this was 585.1 minutes for patients needing hospitalization.Conclusion: It was determined that the lengih of stay of patients admitted to the hospital is longer than expected. Although there are defi ciencies which must be ameliorated, it was concluded that the emergency department of Uludag University Hospital is adequate for a 3rd step emergency.
Evaluation of trauma patients admitted to emergency department according to triage categories
(Galenos Yayıncılık, 2015-06-01) Pozam, Suna Eraybar; Özdemir, Fatma; Sert, Pınar Çınar; Mert, Dilek Kostak; Öner, Nuran; Beğenen, Magruf; Önen, Gizem; ÖZDEMİR, FATMA; Sert, Pınar Çınar; Mert, Dilek Kostak; Beğenen, Magruf; Önen, Gizem; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; JKS-7683-2023; FZV-9566-2022; DGZ-3639-2022; EMD-6092-2022; DJQ-1494-2022
Aim: In our study, we aimed to evaluate the trauma patients who were admitted to Department of Emergency Medicine, Uludag University Hospital for demographic characteristics, triage categories, and necessity of a third-level emergency service.Materials and Methods: Data of the trauma patients admitted between November 1, 2012 and November 1, 2013 were selected by a retrospective systematic sampling. The patient age, sex, admission date, trauma mechanism, body part affected by trauma, and triage categories have been recorded.Results: In all, 3251 patients were included. Most cases were men (66%); the age of trauma exposure was 18-64 years age. Most patients were admitted between April and June, and the most frequent mechanism of trauma was sprain and crush. The hospital admission rate is higher in triages 1 and 2, and discharge rates were higher in triages 4 and 5.Conclusion: To determine the severity of the trauma patients that comprised a special group in the emergency department, triage categories can be effectively used. Considering emergency admissions, 80.4% were not found to be emergent patients group, and these patients should be referred to outpatient clinics.
Experience of pandemic influenza A (H1N1) 2009
(Aves, 2012-12-01) Kebabçı, Nesrin; Akalın, Halis; Bölük, Gülçin; Oğuz-Ayarcı, Ayşe; Kazak, Esra; Topal, Uğur; Yorulmaz, Hakan; Akköse, Şule; Özvatan-Şener, Tülay; Aslan, Emel; Köprücüoğlu, Duygu; Heper, Yasemin; Yılmaz, Emel; Kahveci, Ferda; Mıstık, Reşit; Helvacı, Safiye; Kebabçı, Nesrin; AKALIN, EMİN HALİS; Bölük, Gülçin; Oğuz-Ayarcı, Ayşe; KAZAK, ESRA; Topal, Uğur; Yorulmaz, Hakan; Akköse, Şule; Özvatan-Şener, Tülay; Aslan, Emel; Köprücüoğlu, Duygu; HEPER, YASEMİN; YILMAZ, EMEL; KAHVECİ, FERDA ŞÖHRET; Mıstık, Reşit; Helvacı, Safiye; Tıp Fakültesi; Anesteziyoloji ve Reanimasyon Ana Bilim Dalı; 0000-0001-7530-1279; 0000-0002-3894-1231; 0000-0003-4820-2288; FCW-3335-2022; AAU-8952-2020; KFT-0453-2024; FOZ-1105-2022; AAG-8459-2021; JLP-0593-2023; EIO-1059-2022; EJV-1316-2022; FQE-4671-2022; EJJ-4181-2022; FGO-0266-2022; AAH-6506-2021; HJZ-6992-2023; AAG-9356-2021; DFY-3761-2022; EXQ-2687-2022
Objective: Pandemic influenza A (H1N1) 2009 first appeared in April, 2009 in Mexico and affected the entire world. The objective of this study is to analyze epidemiological, clinical and laboratory findings of probable or confirmed pandemic inluenza A (H1N1) 2009 adult cases who were admitted to our clinic.Methods: Eighty-five patients with pandemic influenza A (H1N1) 2009 admitted to Uludag University Hospital between November 3, 2009 and January 22, 2010 were retrospectively evaluated.Results: Of the 85 cases, 44 (51.8%) were females and 41 (48.2%) were males. The median age was 33 (17-82). 16 of cases (18.8%) were assessed as accurate, and 69 (81.2%) as probable cases of influenza. Pneumonia was diagnosed in 17 (20%) patients by evaluating clinical findings and chest X-ray. Eleven of the cases were treated in the Intensive Care Unit. Seventy-one (83.5%) of the cases were treated by oseltamivir. Mean duration of treatment was 10 days. The mortality rate of the cases was 4.7%.Conclusions: Pandemic influenza A (H1N1) 2009 perpetuates its epidemic potential as in the past years. The disease is frequently accompanied by pneumonia during its course.
Frequency of post-traumatic stress disorder among relief force workers after the tsunami in asia: Do rescuers become victims?
(Cambridge Univ Press, 2006-06-01) Devay, Ali Önder; Erdur, Bülent; Armagan, Erol; ARMAĞAN, EROL; Özçakır, Alis; ÖZÇAKIR, ALİS; Engindeniz, Zülfi; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-1874-5097; JBJ-5787-2023; AAG-8209-2021; AAH-8846-2021
Objective: The objective of this study was to evaluate the frequency of posttraumatic stress disorder (PTSD) among the participants of the Turkish Red Crescent Disaster Relief Team after the Tsunami in Asia.Methods: The Clinician Administered PTSD Scale-1 (CAPS-1) was administered to 33 of 36 team members one month after their Disaster Relief Team duty. Along with the CAPS-1 interview, demographic features, profession, previous professional experience, previous experience with traumatic events and disasters also were recorded. To be classified as present, a symptom must have a frequency score of "1" and an intensity score of "2" at the CAPS-1 interview. For a diagnosis of PTSD, at least one re-experiencing, three avoidance and numbing, and two increased arousal symptoms should be present.Results: The PTSD was diagnosed in eight of the 33 (24.2%) participants. No significant difference was detected in the distribution of PTSD diagnosis according to gender, age, profession, professional experience, previous disaster experience, and/or previous experience of traumatic events. However, the severity of PTSD symptoms as measured by the CAPS-1 score was significantly higher in women, nurses, and participants with <3 previous disaster duty experiences.Conclusion: Post-traumatic stress disorder is prevalent within disaster teams and healthcare workers, and measures should be taken to prevent PTSD within this group.
General characteristics of patients with electrolyte imbalance admitted to emergency department
(Zhejiang Univ Sch Medicine, 2013-06-01) Balcı, Arif Kadri; ARMAĞAN, EROL; Köksal, Özlem; KÖKSAL, ÖZLEM; Köse, Ataman; ÖZDEMİR, FATMA; Özdemir, Fatma; Öner, Nuran; İnal, Taylan; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAH-8846-2021; ABD-7228-2021; AAK-8332-2020; L-7334-2015; AAM-7896-2020
BACKGROUND: Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department.METHODS: This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study.RESULTS: The mean age of the patients was 59.28 16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rates (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%).CONCLUSIONS: Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics.
Investigation of early diagnostic value of glial fibrillary acidic protein and ubiquitin c-terminal hydrolase blood levels in minor head trauma in Turkey
(Clin Lab Publ, 2021-12-06) Polat, Zeynep M.; Yücel, Murat; Yürümez, Yusuf; Çıkrıklar, Halil I.; ÇIKRIKLAR, HALİL İBRAHİM; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAH-8714-2021
Background: The aim was to investigate the early diagnostic value of serum glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase (UCH-L1) levels in adults with minor head trauma (MHT) and whether it could be an alternative diagnostic method to computed tomography (CT). This is the first study with the combination of GFAP and UCH-L1 in the first 3 hours of MHT. Methods: The study comprised 88 patients, 60 patients and 28 controls, who were evaluated as having MHT, were admitted to the emergency department of our hospital within the first 3 hours of the trauma and met the inclusion criteria. CT was performed on all patients. Serum GFAP and UCH-L1 levels were measured within the first 3 hours of the trauma. Results: The median serum GFAP level was 1.07 ng/mL in the group with pathology on CT and 0.42 ng/mL in the group with no pathology on CT. The median serum UCH-L1 level was 0.40 ng/mL in the group with pathology on CT and 0.39 ng/mL in the group with no pathology on CT. A statistically significant difference was found between the serum GFAP levels of the CT (+) group and the CT (-) group (p = 0.021). GFAP levels were compared according to the CT (+) and CT (-) groups with a cutoff value of ??? 1.56 ng/mL for GFAP, which had 50% sensitivity and 97.5% specificity. This was statistically significant (p = 0.008). It was found that the UCH-L1 level of the control group was lower than the UCH-L1 levels of the CT (+) and CT (-) groups, and this difference was found to be statistically significant (p = 0.003 and p = 0.018, respectively). Conclusions: GFAP was found to be more specific than UCH-L1 in demonstrating the presence of intracranial pathology in patients with head trauma who were admitted to the emergency department in the first 3 hours after trauma.
Is cranial computerized tomography really necessary for infants with minor head trauma?
(Aves, 2011-06-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Özeren, Gülden; Yenice, Hüseyin; Cıldır, Ergün; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAK-8332-2020
Objective: It is quite difficult to evaluate the necessity of cranial computerized tomography (CT) in children with minor head trauma (MHT) under two years old. We aimed to draw attention to the unnecessary cranial CT performance and the cost caused by these unnecessary CT's.Materials and Methods: The medical registry of 100 patients who applied to our emergency department (ED) between December 2008 and October 2009 were investigated retrospectively. The inclusion criteria were patients <= 2 years old, with GKS= 15, who had fallen from a height of <= 1m and having normal neurological examination.Results: 51% were girls and 49% were boys, total of 100 cases, with a mean age of 13.66 months. Crying/uneasiness was the most frequent symptom at admission (67%), vomiting was the second symptom with frequency of 19%. Abrasion was the most frequent finding (39%). Cranial CT was performed on 70% of patients. There were no pathological findings in 25 (83.3%) patients who were evaluated with CT, there were pathological findings in only 5 (16.7%) patients. Linear fractures were found in 4 (80%) and linear fracture and subarachnoid hemorrhage was found in 1 (20%). There was no necessity for operation in any of these patients evaluated with cranial CT. Finally, these patients were called by telephone in 48 hours after they had applied to the ED, of whom only 47% could be reached. None of these patients had complaints and did not apply to the ED with recurrent symptoms.Conclusion: Cranial CT is unnecessary in most infants with MHT.

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