Acil Servise Başvuran Hastaların Akılcı İlaç Kullanımı Konusundaki Tutum Ve Davranışları

Amaç: Bu araştırma; acil servise başvuran hastaların akılcı ilaç kullanımı konusundaki tutum ve davranışlarının incelenmesi amacıyla yapılmıştır. Yöntem: Kesitsel, tanımlayıcı tipte yapılan bu çalışmaya, Haziran-Eylül 2018 ayları arasında bir Üniversite hastanesi acil servisi’ne başvuran 388 birey katılmıştır. Araştırmanın verilerinin toplanmasında araştırmacılar tarafından literatür doğrultusunda hazırlanan anket formu kullanılmıştır. Çalışmanın verileri Üniversite Klinik Araştırmalar Etik Kurulundan ve kurumdan yazılı izin; örnekleme seçilen hastalardan ise yazılı ve sözlü bilgilendirilmiş gönüllü olurları alınarak toplanmıştır. Bulgular: Bireylerin %35.5’inin hekimin vermiş olduğu ilaçları hekim veya eczacının önerdiği süre, %32.1’inin ilaç bitene kadar, %31.6’sının şikayeti geçene kadar kullandığı; %80.5’inin yanlış ilaç kullanım durumlarında, %78.3’ünün ise ilaca bağlı yan etki yaşadığı durumda hekime başvurduğu, %71.1’inin kendi hastalığına iyi gelen kullandığı bir ilacı başkasına önermediği, %62.3’ünün ise basında reklamı yapılan ürünleri kullanmadığı saptanmıştır. Sonuç: Araştırmaya katılan bireylerin akılcı ilaç kullanımı ile ilgili uygunsuz davranış ve alışkanlıkları vardı. Akılcı ilaç kullanımı konusunda farkındalığı artırmak için, sürekli ve yaygın eğitim fırsatları geliştirilmeli ve kullanılmalıdır

Prevalence and risk factors for methicillin resistant Staphylococcus aureus carriage among emergency department workers and bacterial contamination on touch surfaces in Erciyes University Hospital, Kayseri, Turkey

Objective: The aim of this study was to determine Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) nasal carriage among emergency department (ED) workers, and bacterial contamination on hand-touch surfaces at ED. Methods: This single-centered study enrolled 105 ED workers and 190 hand-touch surfaces at ED in June 2014. Nasal and environmental samples for S. aureus carriage and for bacterial contamination were obtained. For isolation swabs were cultured on ChromAgar S. aureus and environmental samples first cultured in broth and antibiogram obtained by clinical and Laboratory Standards Institute guidelines. A questionnaire was completed for each subject. Results: The S. aureus carriage rate was 18.1% (n=19), with 2.9% (n=3) MRSA positivity. There were two (1.9%) mobile phone positivities for S. aureus, one of them was MRSA, and a computer keyboard contamination for MRSA was also detected. All MRSA isolates were susceptible for the tested antibiotics. There was significant difference between gender (p=0.044) in terms of nasal carriage of S. aureus and MRSA, all three MRSA isolates were from females. Conclusion: Our study showed that the carriage of MRSA was not affected by clinical exposure in the hospital because of the existing infection control policy in our hospital

BNP shows myocardial injury earlier than Troponin-I in experimental carbon monoxide poisoning

OBJECTIVE: In this study, our purpose was to determine whether plasma BNP level can be useful or not in determining the severity of myocardial injury formed by CO poisoning and to compare plasma BNP level with serum cTnI level. MATERIALS AND METHODS: In the study, 46 female Wistar Albino rats were used. Rats were divided into four groups, one control group and three poisoning groups. The mixture of pure CO and air was injected for 60 minutes to provide 3000 ppm CO concentration. Blood samples of groups were collected to measure COHb, BNP and cTnI levels. Blood samples of poisoning groups were collected at the 1st, 6th and 12th hours after poisoning. After biochemical procedures, findings were analysed statistically and compared with each other. RESULTS: Eight rats which died in poisoning groups were excluded and 38 rats were evaluated. BNP levels were high in all poisoning groups compared to control group and the difference between them was statistically significant (p < 0.05). cTnI levels were high in 6th and 12th hours poisoning groups compared to control and 1st hour group but only 12th hour group had statistically significant difference (p < 0.05). A statistically positive relation was established between BNP and cTnI levels in 6th and 12th hour groups (R: 0.76 - p < 0.05 - n:38). CONCLUSIONS: It was found that BNP levels increased earlier than cTnI levels in acute severe CO poisoning. BNP levels of the cases which were determined to have increased cTnI levels showing myocardial injury increased as well. BNP can show myocardial injury and its severity in acute CO poisoning

Does usage of peritonism tests in an emergency department have any benefit?

Aim To evaluate the usage of inspiration, expiration, cough, and heel drop jarring tests that are applied for determination of peritonism in cases with acute abdominal pain. Methods A prospective study based on observation of patients between 16-65 years of age and presented to the Emergency Department within a 3-month period starting from June 2007, was conducted. The patients were asked to rate their pain level between "0" and "10". Following the measurement of the vital signs, 4 tests were conducted by an emergency medicine resident. The medical records of all the patients were reviewed after 3 months. Data concerning clinical diagnosis, hospital admission and discharge processes, and surgical results, were all recorded. Results Seventy-seven patients had peritonism tests performed. Inspiration test was positive in 29 (of 51, 56.9%) patients admitted to the hospital. However, there was no correlation between the cases admitted to the hospital and the other 3 tests (p>0.05). Twenty-one (of 34, 61.8%) patients which have been subjected to surgical treatment, showed positive inspiration test results. Surgical treatment was performed on nine (of 11, 81.8%) patients who showed positive results for all 4 tests. Conclusion The applied tests are helpful in determining a serious abdominal disease, particularly alongside findings of rebound, tenderness, and laboratory results

Characteristics of acute adult poisonings in a university hospital emergency department in central Turkey: a three-year analysis

Objective: To evaluate the etiologic and demographic characteristics of acute adult poisoning cases and to obtain up-to-date information on acute poisonings. Methods: A retrospective study was conducted to evaluate 1254 adults who presented with acute poisoning to the Emergency Department of our tertiary care university hospital in central Turkey from January 2007 to December 2009. The data extracted from each chart related to age, gender, marital status, agent involved in the poisoning, season of event, route of poisoning, time between ingestion or exposure and arrival at the casualty ward, mechanism of toxic exposure (unintentional or intentional), level of consciousness, length of stay in the ward, and outcome. Results: Acute poisonings comprised 1.40% of Emergency Department patients; 65% were female, while 47% were between the ages of 16 and 25 years. Medicinal drugs were the most common cause of poisonings (68%), followed by gases (9.5%). Antidepressants were the most frequent drug ingested (18%), followed by analgesics (16%). Intentional poisonings constituted the majority of cases (78%). Most suicide attempts were made by women (68%) and majority of the patients were married (57%). Twenty patients (1.6%) died during their hospital stay, with organophosphate pesticides being the most common agent (n=8) involved in fatal poisonings. Conclusion: Pharmaceutical agents, carbon monoxide and pesticides are the three most common poisoning agents. Deliberate self-poisoning is common in adults in the area of the study; the risk being highest in females and younger adults. These up-to-date data provide important information on the characteristics of acute poisonings and can guide activities such as professional training, preventive measures, community education and new research

Expectations and needs of relatives of critically ill patients in the emergency department

© The Author(s) 2018.Background: The care of critically ill patients is a strong indicator of service quality provided in the emergency department. Since families are the major social support sources, assessing the family members’ needs may reduce their anxiety and depression owing to the acute situation of their loved ones while improving the patients’ recovery. Objective: We aimed to evaluate the expectations and needs of relatives of critically ill patients to formulate solutions to improve the quality of emergency department service. Methods: We conducted a prospective, cross-sectional survey of 873 relatives of nontraumatic, critically ill patients who completed the Turkish version of the Critical Care Family Needs Inventory in the emergency department of a university hospital in Turkey. The needs statements were evaluated under five subheadings: meaning, proximity, communication, comfort, and support. Results: In total, 249 (28.5%) participants were females and 624 (71.5%) were males (mean age, 41.79 years). The “meaning” category was given the highest priority, followed by “communication,” with average points of 3.75 and 3.57, respectively. The most important needs were being informed regularly about the patient’s condition and being assured that the patient is under the best possible care, whereas personal, physical, and emotional needs were the least important. Conclusion: Relatives of critically ill patients primarily focus on the quality of patients’ care. Creating a positive rapport based on trust and providing a healthcare environment where the expectations and needs of relatives are met should be prioritized by emergency department physicians, nurses, and other staff while caring for critically ill patients