Objectives: Ultrasonography (US) has been shown to be helpful in diagnosing fractures in the emergency department (ED) setting. The aim of this study was to determine the diagnostic accuracy of US for fractures in patients presenting to the ED with foot and/or ankle sprain and positive Ottawa foot and ankle rules.Methods: This was a prospective study of consecutive patients aged 18 years and over were admitted to the ED with acute foot and/or ankle sprain and positive Ottawa foot and ankle rules. After the patients by were examined by bedside US, anteroposterior and lateral ankle radiographs were obtained, as well as anteroposterior and oblique foot radiographs. The films were evaluated by an orthopedic surgeon who was blinded to the US examination results. The orthopedic surgeon's evaluation was considered the criterion standard for diagnosing a fracture.Results: A total of 246 patients were included in the study. In 76 (30.9%) of the patients, a total of 79 fractures were detected by radiography. Ten false-negative and nine false-positive results were obtained by US examination. Only one patient, whose US showed a fracture but whose radiographs were normal, had a fracture detected by computed tomography (CT). The sensitivity and specificity of US scanning in detecting fractures were 87.3% (95% confidence interval [CI] = 77.5% to 93.4%) and 96.4% (95% CI = 93.1% to 98.2%), respectively.Conclusions: Ultrasound had good sensitivity and specificity for diagnosing fifth metatarsal, lateral, and medial malleolus fractures in the patients with foot and/or ankle sprain. However, sensitivity and specificity of US for navicular fractures were low.

We investigated Turkish emergency physicians' views regarding family witnessed resuscitation (FWR) and to determine the current practice in Turkish academic emergency departments with regard to family members during resuscitation. A national cross-sectional, anonymous survey of emergency physicians working in academic emergency departments was conducted. Nineteen of the 23 university-based emergency medicine programs participated in the study. Two hundred and thirty-nine physicians completed the survey. Of the respondents, 83% did not endorse FWR. The most common reasons for not endorsing FWR was reported as higher stress levels of the resuscitation team and fear of causing physiological trauma to family members. Previous experience, previous knowledge in FWR, higher level of training and the acceptance of FWR in the institution where the participant works were associated with higher rates of FWR endorsement for this practice among emergency physicians.

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We report a case presenting with massive overdose of hydroxychloroquine who survived without any sequelae. A 17-year-old girl presented to the Emergency Department 45 min after the ingestion of 22 g of hydroxychloroquine in a suicide attempt. We believe this is highest dose yet reported in the medical literature. The patient developed hypotension, life-threatening ventricular arrhythmias and mild hypokalemia. She was managed with saline infusion and dopamine for hypotension, gastric lavage and activated charcoal for decontamination, lidocain, magnesium sulfate and defibrillation for pulseless ventricular tachycardia. Potassium replacement and bicarbonate administration were performed. Quick treatment of hypotension, gastric decontamination, continuous long-term cardiac monitoring, and treatment of arrhythmias are the cornerstones of hydroxychloroquine overdose management.

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AIM:We aimed to intend to contribute to our countries database for acute stroke patients with identifying etiological, epidemiological, demographic and clinical features of those patients. METHODS:This is a retrospective descriptive study. Patients' charts are identified with help of ICD-10 coding system. 124 patients were enrolled to the study. RESULTS:Patients in male gender were 56.5 % (n: 70) and mean age of the study group was 67.5 ± 11.8. Average time of the onset of the symptoms was found to be 13.0 ± 18.5 hours. Only twenty five patients (20.5 %) were attended to the emergency department (ED) with in the there hours of symptoms onset.In patients past medical history, 58.8 % (n: 73) patients are hypertensive, 35.0 % (n: 43) are diabetic, 25.0 % (n: 31) of them have coronary artery disease, 20.1 % (n: 25) have a previously known stroke attack.Hundred patients (80.6 %) have a normal head CT. Mortality and morbidity rate was found to be 0.8 % and 6.5 % respectively in patients who were observed in the ED. Average observation time in the ED was 21.5 ± 30.5 hours (1-168). Fifty one patients (41.1 %) were admitted to intensive care unit and six patients were admitted to the neurology ward. CONCLUSION:Acute ischemic stroke is common in old male patients. Most important risk factors are hypertension and diabetes. Patients mostly attend to the hospitals lately. Observation periods of those patients are very long in the ED.

Sonographic examination can be used as an effective diagnostic tool in patients with fifth metacarpal trauma.