SUMMARY Objectives This study aimed to determine the clinical factors that contribute to the admission, management, and outcome of blunt trauma to geriatric patients. Methods This prospective, cross sectional study was conducted at a tertiary Emergency Department (ED) Results The study included 406 geriatric patients (268 (66%) female) with a mean age of all patients being 75.6±7 years (65-102 years). Extremities and head injury were the most common injury sites. The femoral neck was the most common fracture site (24%). Low velocity fall (LVF) was the most common mechanism of blunt trauma (79%). Advancing age was also significantly related with LVF incidence, fracture incidence and ISS ≥9. Five patients died in the hospital (1.2%). Conclusions ÖZET AmaçÇalışmamızın amacı acil servisimize künt travma nedeni ile başvu-ran 65 yaş ve üstü hastaların başvuru, müdahale ve sonlanmasında-ki klinik faktörlerin incelenmesidir. Gereç ve YöntemÇalışmamız Ocak-Nisan 2012 tarihleri arasında, 3. basamak acil servisinde yapılan ileriye yönelik, kesitsel bir çalışmadır. Çalışmaya 65 yaş ve üstü, künt travma nedeni ile başvuran hastalar kabul edildi. Hastaların demografik verileri, yandaş hastalıkları, kullandığı ilaç sayıları, yaralanma mekanizması, son 6 ay içinde travma öyküsü, yaralanma bölgesi, yaralanma ağırlık skoru (ISS), hastane kalım süreleri, hastane sonlanımları veri toplama formuna kaydedildi. BulgularÇalışmaya 406 hasta kabul edildi (n=268, %66 kadın). Yaş ortalaması 75.6±7 (dağılım 65-102 yaş) idi. En sık yaralanma bölgesi ekstremiteler ve baş idi. Femur kırıkları en sık saptanan kırıklardı (%24). Düşük enerjili düşmeler (DED) en sık (%79) travma mekanizması idi. Yaş artışı ile DED, kırık oluşumu ve ISS≥9 olma insidansının arttığı belirlendi. Tüm hastaların 5'i hayatını kaybetti (%1.2). Sonuç DED, geriatrik künt travmada birincil etyolojiyi oluşturdu. En sık yaralanma bölgesi baş ve ekstremitelerdi ve ekstremitelerde en sık femur kırıkları saptandı. İleri yaş ve 5 ve üstü ilaç kullanımı kırık oluşumu için, kadın cinsiyet DED için bağımsız risk faktörleri olarak saptandı. İleri yaş ve inme öyküsü travma ağırlığı ile ilişkili bulundu.Anahtar sözcükler: Acil servis; geriatrik hasta; klinik özellikler; künt travma.

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Objectives: Dizziness is a common symptom among emergency department (ED) patients and is often associated with benign processes. The aim of this study was to investigate the incidence of severe central neurological pathologies in isolated dizziness cases and the diagnostic efficiency of neuroimaging studies. Methods: All applications for isolated dizziness to an academic ED between January 1, 2011, and December 31, 2017 were retrospectively reviewed. The frequency of these admissions, the demographic data of the patients, the results of cranial computed tomography (CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) studies, and the central neurological causes of isolated dizziness were recorded. Results: The percentage of patients with isolated dizziness among all ED admissions was 2.5% (29,510/1,190,857). The median age of these patients was 52 years (interquartile range: 38 to 66) and 58% were female. During the study period, the rate of neuroimaging studies for isolated dizziness increased year by year, and a total of 6406 (21.7%) cranial CTs and 2896 (9.8%) DW-MRIs were performed. The diagnostic yield of neuroimaging studies was 0.6% for cranial CT and 3.9% for DW-MRI. Central neurological disorders were detected in 143 (0.48%) patients with isolated dizziness. The most common causes were posterior circulation ischemic strokes (47.5%), other ischemic strokes (18.9%), vertebrobasilar insufficiency (10.5%), and transient ischemic attack (8.4%). Conclusions: Isolated dizziness is rarely associated with central neurological pathologies. Neuroimaging studies, especially cranial CT, have low diagnostic yield in isolated dizziness and should therefore not be routine in the evaluation process.

Introduction Glenohumeral dislocation is the most commonly encountered dislocation in the emergency department. The most frequent complications of glenohumeral dislocation are rotator cuff tears and an increase in the risk of recurrent dislocation. Less common acute complications include fractures, neurological complications and vascular injuries. The incidence of axillary artery injury associated with shoulder dislocation is reported to be about 1–2%. Case An 81-year-old male presented to the emergency department with pain in the right shoulder after a fall. On physical examination, the shoulder was in slight abduction and external rotation. Shoulder movements were painful and there was a swelling in the axillary region which was tender to palpation. There was no sensory or motor deficit and the peripheral pulses were equal and palpable. Following the administration of analgesics, shoulder reduction was performed using the flexion-adduction-external rotation method. After reduction, the patient started complaining of axillary pain. On control examination, the patient did not have any motor or sensory deficits, but peripheral pulses were not palpable on the right arm. The right upper extremity computed tomography angiography, which was performed with the suspicion of vascular injury, revealed a right axillary artery rupture. Conclusion Axillary artery injury accompanying anterior shoulder dislocation is a rare but serious condition which may result in limb loss and death.