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.

Extreme heat wave increases the number of emergency department (ED) admissions and mortality rates. The purpose of our study is to investigate the effects of the heat wave experienced in Izmir province of Turkey on mortality.During a 9-day period between 17th and 25th June 2016 (study period), air temperature values were higher than the seasonal norms in Izmir, Turkey. In this cross-sectional study, nontraumatic admissions and in-hospital mortality rates were compared this historical interval of the extreme heat wave with the same period of the previous year and the other 21 days of June 2016.The average air temperature between 17th and 25th June 2016, was higher than the average air temperature of the previous year's same period and the average air temperature from the other 21 days of June 2016 (27.8 ± 3.6 °C, (24.5 ± 1.9°C, 24.1 ± 2.1°C, respectively) (P <.01)During the study period, the mean number of ED visits and mortality rates were significantly higher than the previous year's same period (320 ± 30/day vs 269 ± 27/day, [P <.01], and 1.6% vs 0.7%, [P <.01]).Although the admission rate was similar between the study period and the other 21 days of June 2016 (320 ± 30/day vs 310 ± 32/ day, [P = .445]); in-hospital mortality rate was significantly higher during study period (1.6% vs 0.7%, [P <.01]).During the extreme heat waves, ED admissions and in-hospital mortality rates are increased. Precautions should be addressed for adaptation of people to extreme hot weather.

SUMMARYBladder rupture is a rare complication following bladder cancer, but has a high mortality rate. Since bladder rupture is an emergency, the diagnosis and treatment of the cancer is usually delayed. Here we report a 56-year-old male patient who presented to our emergency department with severe abdominal pain, abdominal distension, left leg pain and difficulty in walking without history of significant trauma and ended up with diagnoses of spontaneous bladder rupture and non-traumatic pelvic fracture caused by bladder carcinoma.

SUMMARYObjectivesThis study aims to evaluate the features of rabies suspected animal contact cases in the emergency department and the appropriateness of administering post-exposure prophylaxis procedures according to World Health Organization (WHO) instructions.MethodsRabies suspected animal contact cases that applied to the emergency department between August 2012 and December 2013 were included in the study. Patients’ data were obtained retrospectively from patient files, records of hospital automation system, and the “Rabies Suspected Animal Contact Cases Examination Form”. The post-exposure prophylaxis recommended by the WHO were compared to the prophylactic applications administered by the emergency department.ResultsA total of 515 cases were included in the study. According to WHO classification, cases involving category 3 injuries (n=378, 73.4%) were more common than the others (p>0.0001). Compared to post-exposure prophylaxis recommendations by the WHO, 44.7% of all cases (n=230) were administered inappropriate prophylaxis. Thirty-seven percent of cases received less rabies Ig than recommended, despite category 3 contact. Six percent of cases with category 2 contact were given unnecessary rabies Ig and all cases with category 1 contact (1.5% of all cases) were given unnecessary rabies vaccine.ConclusionsWe observed that in 44.7% of cases, post-exposure prophylaxis was applied inappropriately according to WHO instructions. Not only were there unnecessary vaccine and Ig applications, there were also missing prophylaxis procedures. Updating the current “Rabies Prevention and Control Directive” plus educating and controlling healthcare personnel on a regular schedule may help prevent inadequacies in prophylactic application.

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