Background:The readmission in the early period (RAEP) is defined as the admission of a patient to emergency department (ED) for the second time within 72 hours after discharge from the ED. Aims: The aim of this study was to determine the disease, patient, doctor, and system related causes of RAEP. Study Design: Descriptive study. Methods: This study is a two-stage study that was conducted at Department of Emergency, Gazi University Faculty of Medicine. The causes of RAEP were defined as disease, patient, doctor, and system related causes. Results: A total of 46,800 adult patients admitted to ED during the study period and 779 (1.66%) patients required RAEP. After the exclusion criteria, 429 of these patients were included the study. The most common reasons for RAEP were renal colic in 46 (10.7%) patients. It was detected that 60.4% of the causes of RAEP were related to disease, 20.0% were related to the doctor, 12.1% were related to the patient, and 7.5% were related to the hospital management system. Conclusion: This study revealed that there are patient-, doctor-, and system-related preventable reasons for RAEP and the patients requiring RAEP constitute the high risk group.

and Quality 1-Triage is the right decision for the right patient at the right time, that puts the patient in the right track for further management 2-Tirage is done every minute during the patient care process in the Emergency Department 3-In order to assess the Emergency Department Triage performance this procedure is proposed 4-Review periodically the patient's priority, times, distension and outcome 5-Using the above mentioned definition of Triage, the outcome of the patient care will be assessed 6-Continuous periodic evaluation will explore the areas that needs improvement. Background: Triage is an Emergency Tool, used to handle patient overcrowding in an emergency department. Case mix validity and reliability of different systems had been evaluated. The aim of this paper is to assess the performance of emergency department in using the applied triage system. Methods: A retrospective review of the patient outcome, according to their priority and the distension in relation to the time spent, will be reviewed monthly to identify delays and/or wrong triage methods, or outcomes and point out areas for improvement. Results: The outcome will be benchmarked to other institutions and hospitals. Continuous, periodic review will also be able to view the performance improvement after correction of deficiencies. Conclusion: Continuous triage performance and quality evaluation, is important for identification of deficiencies and of course for patient safety.

Carbon monoxide (CO) poisoning is an important cause of mortality and morbidity. Although measured in CO levels are not always correlated with clinical symptoms, neurological symptoms may present in lower CO levels, and cardiac signs and symptoms may occur in high CO levels. Low levels of CO exposure are very rare causes of myocardial injury. In this case presentation, we aimed to report on a patient who had a 20% level of CO and high troponin level without cardiac signs and symptoms. (JAEM 2015; 14: 91-3)

BackgroundHere we aimed to investigate sociodemographic characteristics, psychiatric history, and association between sociodemographic characteristics and anxiety levels of violence-exposed patients admitted to emergency clinic.MethodsThis study consists of 73 violence-exposed patients admitted to emergency clinic who were literate and agreed to participate in the study. A sociodemographic data form created by us to investigate alcohol-substance abuse, suicide attempt, previous history of trauma, self and family history of psychiatric disorders and Beck Anxiety Inventory was given to the patients.ResultsOf the patients exposed to violence 63% (n=46) were female and 27% (n=27) were male. Of these patients, 68.5% (n=50) were married, 43.8% (n=25) were workers, 34.2% were housewives, 11% were unemployed, and 11% were civil servants. Of the violence-exposed patients, 56.2% (n=41) were primary school, 21.9% (n=16) were high school, and 21.9% (n=16) were university graduates. Smoking and alcohol use rates were 54.8% (n=40) and 17.8% (n=13), respectively. The most common trauma type was assault using physical force with a ratio of 78.1% (n=57). In addition, anxiety scores were high in 42.5% (n=31) and moderate in 9.6% (n=7) of the patients. Mentioned psychiatric disorder was present in 17.8% (n=13) of the patients and 19.2% (n=14) of the patients’ relatives. The correlation between sociodemographic characteristics and anxiety scores revealed that married patients had higher anxiety scores (P<0.01) and patients assaulted by their parents had lower anxiety scores (P<0.00).ConclusionA total of 63% of the violence-exposed patients admitted to emergency room were females, 56.2% were primary school graduates, and 43.8% were factory workers; this result shows that low socioeconomical status and education level affect exposure to trauma especially in females. In addition, ~20% of the patients and patients’ relatives had a psychiatric disorder and 53.4% of perpetrators were parents, spouses, and children; this result shows that psychiatric history and family relations are one of the issues that should be taken into account and treated.

Stroke occurs due to the interruption of blood flow to the brain and it is divided into ischemic and hemorrhagic. In the ischemic strokes, while the most commonly affected vessel is median cerebral artery (MCA), it is particularly affected bilateral posterior cerebral artery (PCA) is very rare condition. In this study, a case of sudden loss of vision and bilateral occipital infarct associated with bilateral vertebral system pathology and methylene tetrahydrofolate reductase (MTHFR) gene mutation were reported. A 62-year-old man was admitted with sudden loss of vision complaint starting 10 h before applying to emergency department. The patient was oriented and cooperative. On neurological examination, there was complete loss of vision in the right eye and only a response to light in the left eye. On the brain computerized tomography (CT), ischemic lesions were observed in the bilateral occipital areas and on magnetic resonance imaging (MRI), there were foci showing diffusion limitation in cortico-subcortical areas of bilateral parieto-occipital region. On the detailed examination at the clinic, MTHFR (a1298c) gene mutation was detected. Bilateral occipital infarction is rare and its diagnosis can be difficult because of its atypical symptoms. Therefore, occipital infarction should be suspected when the only sign is isolated vision loss in patients with risk factor for thromboembolism in their history and detailed visual-neurological examination of these patients should be performed.