Objective:Our study was carried out to investigate the effects of focused ultrasound imaging which is performed by emergency physicians in diagnosis and duration of treatment of abdominal aortic aneurysm. Methods: The patients over 50 years; who applied to Uludağ University Emergency Department with the complaints of abdominal pain, side pain, chest pain, syncope, unexplained hypotension and under suspicion of the abdominal aortic aneurysm, were included in the study. Bedside ultrasound for abdominal aorta was done and diameter measurements of aorta recorded in order to determine the presence of an abdominal aortic aneurysm or to exclude the diagnosis. Results: A total of 133 patients were included in the study. Eight patients were excluded from the study because of inadequate bedside US imaging. The aortic diameter was measured as ≥ 3 cm in the 54 (43.2%) patients. The aortic diameter was found more than 5 cm in 8 (6.4%) patients. After ultrasonographic investigations, aneurysm rupture (n = 5; 4%), aortic dissction (n = 13; 10.4%) and aortic aneurysm (n =36; 28.8%) were detected. The diagnosis was confirmed with computed tomography in all patients who had aortic pathology. Because of the continuance of clinic suspects in the patients whose aortic diameters were less than 3 cm, their computed tomography images were obtained and their aortic diameters were found within normal limits. Further imaging studies weren't performed at the remaining 48 (38.4%) patients because different prediagnosis was considered. Emergency ultrasound had a sensitivity of 100% (95% CI: 87-100), a specificity of 91% (95% CI: 90.8-99.8). Conclusions:The diagnosis of abdominal aortic aneurysms is omitted 30% in emergency departments. It has a high morbidity and mortality if the diagnosis is skipped. In the presence of aortic aneurysm suspicion, evaluation of aortic diameter by bedside ultrasound is diagnostic. Bedside ultrasound evaluation by emergency physicians should become routine for using time and investigation numbers properly.The European Research Journal 2019;5(4):599-606 cute abdominal pain is a symptom which is presently less than a week, caused by non-traumatic reasons, developed in the progress of patholo-gies of abdominal or non-abdominal organs. Acute abdominal pain is the most important symptom of surgical or medical emergencies [1]. Abdominal pain
Aim. Injuries are among the main causes of mortality and morbidity all over the world, and effective initial triage of these patients can determine the thin line between death and life. Tractor accidents and related injuries are significant problems particularly in rural areas. However, major trauma classification systems do not include tractor accidents as a criterion for trauma team activation or transportation of the patients to a trauma center. This study evaluated the general characteristics and outcomes of tractor accidents in comparison to motorcycle accidents, which are considered as a comparison criterion for major trauma. Materials and Methods. This is a multicenter study conducted in 6 emergency departments in 4 cities over a six month period. All cases over 18 years of age who were admitted to emergency service due to tractor or motorcycle accidents and meet the criteria were included in the study. The general characteristics and outcomes of both trauma types were compared to determine whether tractor accident should be considered as major traumas. Results. Eighty-eight patients had a tractor accident, and 339 patients had a motorcycle accident. The tractor accident victims were significantly younger (p<0.001), and the proportion of females was higher in this group (p=0.001). Glasgow coma score (p=0.062), revised trauma score (p=0.201), duration from incident to admission (p=0.481), and route of admission (p=0.810) were similar between both accident types. The rates of thoracic traumas (42% versus 23%, p<0.001) and spinal injuries (17% versus 5.9%, p=0.002) were significantly higher in tractor accidents. The hospitalization rates of the patients were significantly higher in tractor accidents (p=0.008). Conclusion. The findings of this study support the hypothesis that tractor accidents should be included in the criteria of ATLS major trauma classification system and trauma team activation procedures.
Aim:The aim of this study is to investigate the relationship between high carboxyhemoglobin (CoHb) levels and hyperbaricoxygen (HBO) treatment in acute carbonmonoxide (CO) poisoning.Material and Methods: Patients examined due to CO poisoning with a COHb level> 20 were evaluated retrospectively. In accordance to the CoHb levels after the treatment of patients with normobaric oxygen or HBO; duration of emergency stay, indications for HBO treatment, current clinical findings were evaluated.Results: While the CO source was coal stove in 66 cases (60%), 99.1% of the exposures occurred in the home environment. HBO therapy was applied in 20.9% (n: 23) patients. Indications for HBO treatment were syncope in 10 (9.1%) patients, blurred consciousness in 7 (6.4%), and cardiac toxicity in 2 (1.8%). A positive correlation was found between the arrival COHb values of the patients and their length of stay in the emergency room (p = 0,000).Conclusion: CO poisoning is a common emergency. Oxygen therapy with a reservoir mask is the main treatment in the emergency room and provides adequate treatment for the majority of patients. HBO treatment is not available in every center and emergency departments experience difficulties in terms of establishing correct indications. Regardless of COHb level, the patient should be evaluated clinically for HBO indication.
Background This study aimed to analyze patients who apply to emergency services and need palliative care regarding appropriate patient care and effective use of health institutions. Materials and Methods The study was conducted prospectively on patients who applied to the emergency services of Bursa Uludag University Health Application and Research Center, Health Sciences University Bursa Yüksek Ihtisas Training and Research Hospital and Bursa City Hospital between 15.08.2021 and 15.02.2022 and needed palliative care. Results A total of 261 patients, 143 male (54.8%) and 118 female (45.2%), were included in the study. It was determined that 50 (19.1%) of these patients had previously received palliative care services. It was determined that the patients included in the study applied to the emergency services 7.52±6.77 times in the last year. The three most common diseases diagnosed in patients admitted to the emergency department were pneumonia (24.5%), urinary system infection (7.7%), and cerebrovascular disease (5.4%). Of the patients, 39.84% were referred/hospitalized, 25.28% were referred/hospitalized to intensive care units, 2.68% refused treatment, 2.68% died, and 29.5% have been discharged. Conclusion As a result, it is understood that most of the patients in need of palliative care do not receive this service, and patients who can be treated in palliative care units are treated in clinics and intensive care units.
Background: The aim of this study is to analyze the reasons for admission of Alzheimer's patients who applied to the emergency services. Methods: The study was conducted prospectively on patients with Alzheimer's disease who applied to the emergency departments of Bursa Uludag University Health Application and Research Center, Health Sciences University Bursa Yüksek İhtisas Training and Research Hospital and Bursa City Hospital between 01.07.2021 and 01.07.2022. Results: A total of 248 patients, 103 male (41.5%) and 145 female (58.5%), were included in the study. It was determined that the three most common diagnoses received by the patients in the emergency department were pneumonia (17.7%), ischemic cerebrovascular disease (10.3%), and urinary system infection (9.3%). It was determined that 42.7% of the patients were hospitalized in clinical and 18.1% in intensive care units. Conclusion: As a result, it was determined that the most common diagnoses of Alzheimer's patients admitted to the emergency department were pneumonia, ischemic cerebrovascular disease and urinary tract infection, respectively and more than half of all admitted patients had indications for hospitalization.
Head trauma usually causes hemorrhage, but in children ischemia of basal ganglia may develop. Traumatic stroke occasionally develops after dissection of brain vessels, leading to disseminated cerebral embolism. Stretching forces in cerebral intraparenchymal arteries can cause vascular damage followed by an occluding thrombus. An 18-month-old girl presented to our emergency department with the complaint of head trauma after falling down while playing. Her parents recognized the weakness of her left site extremity after 6 hours after the event. After initial physical examination and further imaging studies brain magnetic resonance imaging (MRI) showed an infarct affecting the caudate nucleus in the right cerebral hemisphere. In childhood, ischemic stroke due to mild head trauma is an exceedingly rare event and may be overlooked in emergency medicine practice. We aimed to emphasize that mild head trauma may cause critical situations such as acute infarct in children.
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