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 rales (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.
Objective: Acid-base disorders (ABDs) are usually correlated with high rates of morbidity and mortality. The objective of this study was to analyze the causes, outcomes, types and incidences of ABDs in patients presenting at the emergency department (ED). Material and Methods:We prospectively analyzed data from patients who presented between January 2011 and May 2011. Data on age, gender, chief complaint, and diagnosis in the ED were collected for ABD cases.Results: Of the 736 cases with an ABD, 173 patients (23.5%) had simple ABD and 563 patients (76.5%) had mixed ABD. The most common ABD was a mixed metabolic acidosis and respiratory alkalosis (MACRAL) (n=408, 55.4%). All ABD types were most commonly observed in patients over 65 years of age. Dyspnea was the most common complaint among ABD patients who presented at the ED (44.4%). In cases of ABD, pneumonia was the most common diagnosis (16.3%). Of the ABD cases, 379 patients (51.6%) were discharged, while 318 patients (43.2%) were hospitalized. Death was more commonly observed in cases with mixed metabolic and respiratory acidosis (MRAC) (n=6) and MACRAL (n=11). Conclusion:ABDs are quite common in patients presenting at the ED, especially among patients in a critical condition (71%). Mixed MACRAL was the most commonly noted ABD. Dyspnea and pneumonia were the most common diagnoses in ABD patients. Mortality was more common in cases with a mixed MRAC and MACRAL. This knowledge may provide important information concerning the diagnosis, treatment and early prognosis of patients. (JAEM 2014; 13: 4-9)
BACKGROUND:This study aimed to determine the necessity of pregnancy test in women of reproductive age admitted to emergency department (ED) in routine practice.METHODS:We retrospectively reviewed the records of patients who presented to the ED between January 1, 2006 and December 31, 2010 and received a pregnancy test.RESULTS:The median age of 1 586 patients enrolled into the study was 27 years. Of these patients, 19.55% had a positive result of pregnancy test. The most common complaint at admission was abdominal pain in 60.15% of the patients, and pregnancy test was prescribed. 15.83% of the patients with abdominal pain had a positive result of pregnancy test. Of the patients, 30.64% had nausea-vomiting at admission, and 11.52% had a positive result of pregnancy test. When other complaints were considered, the most commonly observed complaints were non-specific symptoms such as dizziness, malaise and respiratory problems. Of the patients, 70.93% were not remembering the date of last menstruation, and 9.51% showed a positive result of pregnancy test. Urinary tract infection (UTI) was commonly diagnosed with an incidence of 17.65%, which was followed by non-specific abdominal pain (NSAP) (16.77%) and gastrointestinal disorders such as gastritis and peptic ulcer (6.87%). Of the patients, 88.40% were discharged from ED, and 11.60% were hospitalized.CONCLUSION:Pregnancy test should be given to women of reproductive age as a routine practice in ED in developing countries like Turkey.
Objective This study presented the demographic, clinical and laboratory data for the patients who presented to our emergency department (ED) with mushroom poisoning. Methods We retrospectively examined the data for adult patients with mushroom poisoning that presented to the ED of Uludag University, Faculty of Medicine between 1 January 2007 and 31 December 2010. Results A total of 53 patients were enrolled in the study. The mean age was 46.58±15.47. 52.8% of the patients were female, while 47.2% were male. These patients were typically admitted in the autumn. The most commonly seen symptoms were gastrointestinal such as nausea and vomiting. The time to symptom onset was <6 hours for 30.2% of the patients and >6 hours in 69.8% of the patients. While 73.5% of the patients received gastric lavage, activated charcoal and intravenous fluid therapy, 15.1% received penicillin, N-acetylcysteine and intravenous fluid therapy. For the remaining patients (11.4%) silibinin, dialysis and plasmapheresis were administered. While 35.8% of the patients were hospitalised, 64.2% were discharged from the ED. The median duration of stay in the ED was 6 hours (range: 1-27 hours); the median duration of stay among inpatients was 6 days (range: 1-36 days). Three of the hospitalised patients died, and two underwent hepatic transplantation. Conclusions Mushroom poisoning remains an important issue that is encountered in rural areas during the rainy autumn season in our region. The condition may be fatal, but can be prevented by early and appropriate treatment.
ÖzetBu çalışmanın amacı acil serviste kan gazı elektrolit ve glukoz değerlerinin biyokimyasal elektrolit ve glukoz değerleri yerine kullanılabilirliğini araştırmaktır. Uludağ Üniversitesi Acil servisine Temmuz 2011 ile Ekim 2011 tarihleri arasında başvuran ve acil serviste kan gazı bakılan 18 yaş ve üzeri 1007 hastadan; kan gazı elektrolit ve glukoz ile biyokimyasal elektrolit ve glukoz değerlerinin bakıldığı grup çalışmaya alınmıştır. AbstractIt is aimed to investigate the utility of blood gas electrolyte and glucose values in place of biochemical electrolyte and glucose values in Emergency Department (ED). The group of patients, whose blood gas electrolyte , glucose and also biochemical electrolyte and glucose values were examined, These data were derived from 1007 patients at the age of 18 and older, who were admitted to Uludag University ED and whose blood gas values were examined between July 2011 and October 2011. While biochemistry K+ median was 4,2 mmol/L, blood gas K+ median was 3,86 mmol/L. When blood gas and biochemical K+ values were compared, average difference was -0,4 mmol/L (95% confidence limits: -1,5-0,7 mmol/L) and correlation coefficient was r=0.794 (p<0.001). Biochemistry Na+ median was 136 mmol/L whereas blood gas Na+ median was 138,6 mmol/L. When blood gas and biochemical Na+ values compared, average difference was 2,7 mmol/L (95% confidence limits: -3,8-9,2 mmol/L) and correlation coefficient was (r=0.836 p<0,001). Biochemistry glucose median was found out as 125,5 mg/dl whereas blood gas median was 147 mg/dl. When blood gas and biochemical glucose values were compared, average difference was 17,3 mg/dl, (95% confidence limits: -72,3-106,9 mg/dl), correlation coefficient was (r=0,904 p<0,001). Significantly positive correlation was determined between results. When blood gas electrolyte and glucose values compared with biochemical values, it was seen that they were consistent with each other. Blood gas values, which are rapid tests, might be used -especially in case of emergency, in treatment of critical patients -until biochemical values are obtained.
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