BackgroundMedicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians’ legal-administrative problems and reveal their level of understanding on forensic cases.MethodsAn electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.Results294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.ConclusionWe found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians’ level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might be beneficial.
ABSTRACT Hoverboards were designed for making our Daily life easier. However, lots of patients admitted to emergency services due to. These devices require a high level of balance, coordination and strength. Traumatic injuries are more common especially in children and young adults. Forearm fractures are one of the important trauma outcomes in the pediatric age group. Although supracondylar or forearm fractures are common, we rarely encounter a combination of both, defined as floating arm fractures. A 9-year-old boy falling from a hoverboard had supracondylar humerus fractures accompanied by olecranon and distal Radius fractures in the same arm. A temporary long arm splint was applied to the patient who was transferred to the orthopedic clinic and surgical operation was planned for stabilization. In our case, we aimed to discuss the coexistence of olecranon and distal radius fracture accompanying ipsilateral supracondylar humerus fracture in a child hoverboard user.
Acute non-traumatic spinal subdural hematoma (SSDH) is a rare clinical condition in the emergency medicine practice and difficult to diagnose during the primary physical examination. It mostly occurs at thoracal vertebra levels due to trauma, use of anticoagulants, medical procedures such as acupuncture, arteriovenous malformations, hematological disorders or space-occupying lesions. Here, we discussed an elderly female patient who was not on anticoagulant and described sudden loss of muscle strength and sensation in both lower extremities. Initial laboratory and imaging including brain computerized tomography (CT) and magnetic resonance imaging (MRI) were in normal range. Her secondary examination revealed anesthesia under the T4 dermatome level. Cervical spine-MRI imaging revealed a subdural hematoma significantly compressing the spinal cord on the C7-T1 dermatome segments. Any emergency neurosurgical intervention was not considered and the patient was interned in the neurosurgical clinic for conservative treatment and further examination. Patient , with no progress seen in consecutive MRI scans, was discharged after offering an outpatient check-up. We recommend secondary physical examination in emergency department (ED). In the case of appearance of sensory deficits of certain dermatomes, spine-MR imaging may lead to put the diagnose early in ED.
Introduction: Pleuritic pain can be misconstrued as renal colic. Case: 32 years old female complained about her flank pain with changeable character for last three days. She had started to get oral treatment as renal colic in another hospital. The vitals were; temperature 36.8°C, pulse 92/min, respiration rate 22/min, blood pressure 130/80 mm/Hg. Physical examination and bedside ultrasonography were unremarkable. The sinuses were not identified on chest x-ray. WBC was 13.40 K/mm3. The biochemistry tests were normal. D-dimer was 98 ug/L (50-228 ug/L). There were bilateral multiple periferic tromboembolus on computerised tomography pulmonary angiography. Bilateral distal extremity venose system colorful Doppler were normal. Right heart cavities and all cardiac functions were normal. There was not an indication of trombolitic administration and the patient was admitted to intensive care with anticoagulation treatment. Conclusion: If there were thrombosis risc factors, they should be evaluated in differential diagnose of pulmonary embolus. Evaluation of history about dyspnea could be the clue. Inexplicable dyspnea was the indication for advanced investigation methods. As symptoms were nonspesific, appropriate management can identify pulmonary embolus without any consultation in a short time, merely.
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