Objective: In this study, we compared the coronavirus disease-2019 (COVID-19)+/suspected patients who presented to the pandemia area (outpatient enterance/ambulance enterance) of our emergency department (ED) and to determine whether the ambulance system is used appropriately or not during this pandemia process. Materials and Methods:Patients were divided into two groups as outpatients and ambulance patients. Demographic data, sampling ratio of polymerase chain reaction (PCR) swab, PCR positivity, thorax computed tomography (CT), CT positivity, hospitalization ratio and hospitalization day, length of stay in the ED, and the outcome of the groups were compared. Results:The mean age of ambulance patients was 53.8±20.2 (min: 18, max: 93), and the ambulance patients were 41.4±16.04 (min: 18, max: 96) and this value was significantly higher in ambulance patients. Length of stay in the ED of the ambulance patients was 6.1 h and this value was 2.9 h for the other group. Hospitalization length of discharged patients from the intensive care unit (ICU) was 20.6 days for ambulance patients and 16.9 days for outpatients. Three of the outpatients and 22 of the ambulance patients died during hospitalization and 18 of these were males. Conclusion:The mean age, CT positivity, and PCR test positivity were significantly higher in ambulance patients. Similarly, ambulance patients' length of stay in the ED was higher who were discharged from the ED. ICU hospitalization, hospitalization length, and mortality ratio were higher in ambulance patients. Considering these results, it is important to develop appropriate strategies for ambulance and outpatients, to prevent already crowded EDs squeezing under the COVID-19 burden.

Objective: In this study, it was aimed to show the prognostic value of Ranson score + lactate level created by adding lactate to Ranson score in patients diagnosed with acute pancreatitis in the emergency department. Material and Methods:One hundred and sixty-three patients with acute pancreatitis were enrolled in this retrospective study. Demographic data, presentation time vital signs, biliary/non-biliary ethiology, Ranson score, hospitalisation clinic, length of hospitalisation, and 30-day mortlity rate data were noted. Ranson score and Ranson score + serum lactate levels were compared according to severity, prognosis and outcome.Results: Complication occurrence ratio was 8.6%. Totally, 160 (98.2%) patients were discharged and 3 (1.8%) patients died. Serum lactate level was significantly related with hospitalization of more than 10 days (p< 0.05). Correct prediction ratio of serum lactate level for complication occurrence during hospitalization was insufficient (p> 0.05). Ranson score and serum lactate levels were significantly correlated (p< 0.05). When we added lactate to Ranson score, correct outcome prediction ratio was significantly higher (p< 0.05). Serum lactate level and length of hospitalization and mortality were positively correlated (p< 0.05). According to ROC analyses, the cut-off level of serum lactate was 17.5 mg/dL for mortality prediction with 100% sensitivity and 75% specificity. Conclusion:Serum lactate level is an important parameter in predicting severity, prognosis and outcome of patients with acute pancreatitis. When serum lactate level is added to RS, better prediction ratios for prognosis and outcome are determined. Serum lactate level can be a useful parameter for emergency clinicians to plan the treatment strategy of acute pancreatitis patients in emergency medicine.

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