Introduction: Foreign body ingestion usually occurs accidentally and is a common condition in childhood, but it is rarely seen in adults and is frequently encountered in people with mental retardation and psychiatric disease. The outcome is usually defecation of the ingested materials but rarely requires surgical intervention.Case Report: A 33-year-old male patient was admitted to the emergency department with the complaint of constipation as a result of swallowing about 1000 plastic buttons yesterday. His acute mechanical intestinal obstruction was alleviated with conservative treatment and the patient discharged with recommendations. Conclusion:The number, shape, size, and time of ingestion determine the mode of treatment. There are three main principles in treatment. Endoscopic retraction, conservative follow-up and surgical intervention. Also, tomography should be considered as an option for foreign bodies that can not be visualized with direct radiography.

Objective: This study aims to analyze the effects of the coronavirus disease-2019 (COVID-19) pandemic on the preparation process of the first responder teams in emergency medical services. Ambulance station response times, command and control centers' response times, and case response times are reported and compared with current literature. Research findings elaborate on how the procedures for corrective actions in the disinfection process affected these main parameters in a 24-hour period in prehospital care. Materials and Methods:The comparison was made for ambulance times, after the transportation of COVID-19 cases, between the March 2020 period when the ambulances were disinfected in five centers in the hospital yards and the April 2020 period when the disinfection devices were placed in all ambulances. Results:The total number of cases per ambulance per day was 10.1 (8.5-11.6) in the March group and 10.8 (8.8-13.2) in the April group (p<0.001). While the number of COVID-19 cases per ambulance per day was 1.7 (1.3-2.1) in the March group, it was 3.2 (2.4-4.1) in the April group. While the ambulance disinfection time per COVID-19 case was 51.9 (27.7-73.0) minutes in the March group, it was 11.0 (6.0-24.1) minutes in the April period (p<0.001). Conclusion:During the pandemic process, ambulance disinfection and wearing personal protective clothing-prolonged preparation times. In March 2020, ambulances had to travel to common sites for cleaning and disinfection. Changing this procedure to self-cleaning at the ambulances' own station locations in April 2020, decreased both the ambulance disinfection time and the ambulance response time, in spite of the increase in the number of COVID-19 cases.

Objective:The study aims to present calls received at the 112 Emergency Calls Centers in İstanbul. Algorithms were applied to analyze the demographic and clinical characteristics of coronavirus disease-2019 (COVID-19) cases. Materials and Methods:Incoming calls at the 112 Emergency Call Centers of the European and Anatolian regions of the metropolitan city of İstanbul were assessed. In the retrospective study, the period under investigation was from March 11 to May 1 of 2020.Results: Patients with suspected severe acute respiratory syndrome-coronavirus-2 pneumonia (n=35,443) were analyzed. The mean age of the patients was found to be 50.6±22.3. Of this total, 16,902 (47.7%) cases were female. Ambulance response times for these cases were reported as 10.2 (7.0-16.3) minutes. In terms of clinical symptoms, 18,958 (53.50%) of the cases had fever, 18,359 (51.86%) had a cough, and 21,121 (59.60%) had shortness of breath. The district with the highest number of cases was Gaziosmanpasa with 1,256 cases, 42.16 people per square meter. Conclusion:Prehospital health services are an important link in the chain of survival. Ambulance services act as a bridge between individuals in the community and hospital care services in cases of disasters such as earthquakes, floods, pandemics. The structural establishment of a robust system to meet the incoming demands, the construction of applicable algorithms, building the optimal infrastructure for ambulances in accordance with the population intensity, will both protect the system and help to improve the quality of health services delivery.

BACKGROUND Central venous catheterization is currently an important procedure in critical care. Central catheterization has important advantages in many clinical situations. It can also lead to different complications such as infection, hemorrhage, and thrombosis. It is important to investigate critically ill patients undergoing catheterization. AIM To evaluate the characteristics, such as hospitalization, demographic characteristics, post-catheterization complications, and mortality relationships, of patients in whom a central venous catheter was placed in the emergency room. METHODS A total of 1042 patients over the age of 18 who presented to the emergency department between January 2005 and December 2015 were analyzed retrospectively. The patients were divided into three groups, jugular, subclavian, and femoral, according to the area where the catheter was inserted. Complications related to catheterization were determined as pneumothorax, guidewire problems, bleeding, catheter site infection, arterial intervention, and sepsis. Considering the treatment follow-up of the patients, three groups were formed as outpatient treatment, hospitalization, and death. RESULTS The mean age of the patients was 60.99 ± 19.85 years; 423 (40.6%) of them were women. Hospitalization time was 11.89 ± 16.38 d. There was a significant correlation between the inserted catheters with gender ( P = 0.009) and hospitalization time ( P = 0.040). Also, blood glucose, blood urea nitrogen, creatinine, and serum potassium values among the biochemical values of the patients who were catheterized were significant. A significant association was observed in the analysis of patients with complications that develop according to the catheter region ( P = 0.001) and the outcome stage ( P = 0.001). In receiver operating characteristic curve analysis of hospitalization time and mortality area under curve was 0.575, the 95% confidence interval was 0.496-0.653, the sensitivity was 71%, and the specificity was 89% ( P = 0.040). CONCLUSION Catheter location and length of stay are important risk factors for catheter-borne infections. Because the risk of infection was lower than other catheters, jugular catheters should be preferred at entry points, and preventive measures should be taken by monitoring patients closely to reduce hospitalization infections.

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