Aluminum phosphide (AP) is a condition that results in death in case of use for suicide purpose. The phosphine gas, which is released as a result of aluminum phosphide intake, has high level of toxicity. It leads to cellular level hypoxia and inhibition of oxidative phosphorylation. Aluminum phosphide intoxication may cause metabolic acidosis, arrhythmia, acute respiratory distress syndrome, and shock. High-dose intakes may lead to death within hours. 22 year-old female patient was taken to our emergency service because of the suicide attempt with 6000mg aluminum phosphide tablet. We aimed to share our experience with our aluminum phosphide intoxication, which has no known antidote and leads to rapid death in follow-up. We aim to present our experiences with our case of intoxication from aluminum phosphide, which causes high mortality after the intake. 22 year-old female patient was transferred to our hospital due to suicide attempt with 6000mg aluminum phosphide tablet. The patients have no known comorbidities, medicine use or allergic history. We believe that, in preventing the high mortality rate in aluminum phosphide intoxication, metabolic acidosis, arrhythmia, ARDS and measures against the shock and the hemodialysis in early period should be performed. Although its efficiency has not been clearly proved and its use has not entered into algorithms, the use of MgSO4 and N-Acetyl-Cysteine in supportive care is an option for such cases. Further studies and proven treatment methods are needed in AP toxicity.
Objectives. The personnel of Emergency Service (ES) is under stress due to the intensity of the resulting from the very nature of the work to be performed in this department, which is characterized by the need of providing rapidly medical care to patients with often severe or even life-treating health problem and by though working conditions. In our study, we aimed to determine the satisfaction of resident physicians about choosing the emergency medicine, the factors affecting this satisfaction, and the plans of these resident doctors. Methods. In our study, we surveyed 66 resident physicians working in 4 emergency centres. The resident physicians completed the survey form given to them. Results. Regarding the occupational satisfaction of 66 resident physicians participating working in emergency medicine department, we obtained the following results: 54.5% (n=36) satisfied, 22.7% (n=15) not satisfied, 9.1% (n=6) more satisfied than expected, and 9.1% (n=6) neither satisfied nor not satisfied. When the opinions of residents were asked about how likely it was that they would be working in emergency medicine in 10 years hence, 40.9% (n=27) of the participants stated that they wanted to work there, 36.4% (n=24) stated that they were not sure, and 22.7% (n=15) stated that they didn't want to work. Conclusions. The encouraging legal regulations in regard to physicians' rights about working in emergency medicine branch should be revised, working conditions should be improved, and it is important to provide young doctors with carrier and educational opportunities. Otherwise, it is likely that we might lose our national and international achievements in emergency medicine branch.
Fahr's disease is a rare degenerative neurological disorder characterized by the presence of abnormal calcium deposition and associated cell loss in the areas of the brain that control movement, including the basal ganglia and cerebral cortex. Clinical findings associated with Fahr's disease include parkinsonism, dystonia, chorea, ataxia and psychiatric symptoms. Fahr's disease may result from metabolic disorders, especially parathyroid disorders. We report our experience with 4 patients admitted to our emergency department with complaints such as convulsions, hand spasms, loss of consciousness, and weakness. Computed tomography of all patients showed calcification in the bilateral basal ganglia. The purpose of this paper is to draw attention to a rare disorder involved in the etiology of elderly patients admitted to the emergency department for seizure and/or unconsciousness..Eur Res J 2016;2(2):157-161
Introduction: Illicit drug addiction and comorbid psychiatric disorders are among the most complex patient groups in the emergency department. In this study, to share the results of patients who admitted to our emergency department after illicit drug abuse and accepted hospitalization and treatment in the rehabilitation clinic. Methods: The study was planned retrospectively and in two centers. The medical records of patients who were admitted to the emergency department between 1th of January 2015 and 31th of December 2019 and subsequently received addiction treatment in our rehabilitation clinic were examined. Among the patients included in the study, the data of the patients with positive results in the urine drug and alcohol screening were analyzed and the study was completed. Results: In our study, the mean age was 32.09 y. It was observed that 12.5% of the cases had a psychiatric disorder. The most frequently detected illicit drugs are amphetamine and cannabis. The average length of stay was 11.57 days. The average number of admissions to the emergency department was 5.81 ± 3.03. The most common symptoms at admission were injury 114 and muscle pain 94. Conclusion: Especially low socioeconomic level increases susceptibility to illicit drug abuse. In addition, individuals with psychiatric problems also tend to use illicit drugs. With illicit drug abuse, the possibility of being involved in judicial cases also increases. It is appropriate to follow up patients who apply to the emergency department by rehabilitation units for their long-term treatment.
Objectives. The aim of this study was to analyze the cases transferred by 112 emergency healthcare services (EHS) according to the triage criteria of Turkish Ministry of Health. Methods. All of the patients brought to adult emergency service unit of our hospital between April 01, 2015 and May 01, 2015 by 112 EHS have been involved in this study. The triage tags of the patients have been determined according to the criteria specified in T.R. Ministry of Health's "Procedures and principles of emergency health services in inpatient healthcare facilities" dated October 16, 2009. The end of emergency service process has been classified as discharge, hospitalization in service, transfer to another healthcare center, and excitus. Results. A total of 1,101 patients have been involved in this study. The mean age was 45.6 years. The age range was 1-94 years. While 545 (49.50%) patients were female, 556 (50.49%) were male. The portion of Red area was 15.16% (n=167), that of Yellow 1 area 34.60% (n=381), that of Yellow 2 area 23.34% (n=279), and that of Green area 24.80% (n=274). The distribution of the patients by treatment results was as follows; discharge 86.46% (n=952), hospitalization in service 10.08% (n=111), hospitalization in intensive care 2.27% (n=25), transfer to another healthcare center 0.63% (n=7), excitus 0.5% (n=6). The total share of the 65 year-old or older cases was 23.88% (n=263). The distribution of the red area patients by triage was as the following; 47.30% (n=79) hospitalization in service, 10.7% (n=18) hospitalization in intensive care unit, 33.53% (n=56) discharge, 3.59% (n=6) exitus and 4.19% (n=7) transfer to another healthcare service. Conclusions. The inappropriate use of 112 EHS is very common. Majority of the patients taken into emergency service by 112 EHS does not require urgency. After the triage in the ambulance, the patients can be directly transferred to an appropriate field without creating a time and work load on emergency service. Moreover, after the triage in ambulance, the patients requiring the hospitalization may be transferred to the appropriate facility according to the available bed capacity.
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