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.
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.
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