In this study, we aimed to evaluate the mean platelet voulme (MPV) levels of trauma patients who were admitted to our emergency department. Of the total 232 trauma patients, 40 females and 192 males over the age of 18 years were included in this study. Of them, 102 patients were mild trauma [Glasgow Coma Scale (GCS) 15–13)], 40 patients were moderate (GCS 12–9) and 90 patients were severe trauma (GCS 8–3) patients. We also calculated the Revised Trauma Score (RTS) of the patients. MPV levels were evaluated with GCS and RTS values. The control group was constituted of 100 healthy adults. Mean initial MPV value of GCS 15–13 patients was 8.25 fL, 8.25 fL in GCS 12–9 patients and 8.47 fL, in GCS 8–3 patients. Trauma severity was significantly related with initial MPV (iMPV) levels (p < 0.05), initial Hb (iHb) levels (p < 0.05), initial white blood count (iWBC) (p < 0.05) and initial platelet (iPlt) levels (p < 0.05). Severity of trauma was related with control MPV (kMPV) levels (p < 0.05), control Hb (kHb) (p < 0.05), control WBC (kWBC) (p < 0.05), control Plt (kPlt) levels (p < 0.05). MPV levels (p < 0.05), Hb levels (p < 0.05), WBC levels (p < 0.05), Plt levels (p < 0.05) were significantly different between trauma group and healthy group. IMPV and control kMPV levels were not related (p = 0.149). But kHb – iHb levels (p < 0.05), kWBC – iWBC levels (p < 0.05), kPlt – iPlt levels (p < 0.05), kGCS – iiGCS (p < 0.05) were related to each other. We found a correlation between iMPV and iWBC levels (p < 0.05, r = −0.342). Similarly, there was a correlation between severity of trauma and iMPV level (p < 0.05, r = −0.224). We determined a significant correlation between iMPV and iPlt levels (p < 0.05, r = −0.246). There was not a correlation between kMPV and kWBC (p > 0.05, r = 0.124). kMPV and kPlt levels (p < 0.05, r = −0.174) were correlated. RTS was statistically related with GCS (p < 0.05). Similarly, RTS was related with iMPV (p < 0.05), iWBC(p < 0.05) and iPlt (p < 0.05) values, but there was not a relation with iHb (p > 0.05). We found correlations between iMPV– trauma severity (p < 0.05, r = −0.224), iMPV – RTS (p < 0.05, r = 0.134), iMPV – iWBC (p < 0.05 r = −0.342), iMPV – iPlt (p < 0.05, r = −0.246). Control RTS (seventh day of hospitalization) values were not related to kMPV (p > 0.05), kHB (p > 0.05), kWBC (p > 0.05) and kPlt(p > 0.05). There was a correlation between kRTS and kMPV (p < 0.05, r = −0.169). Similarly, kMPV – kHb (p < 0.05, r = −0.141), kMPV – kPlt (p < 0.05, r = −0.174) were correlated. KMPV and kPlt were not correlated (p < 0.05, r = 0.124). Initial RTS and seventh day RTS values were significantly different (p < 0.05). MPV may be helpful for emergency physicians for predicting the severity of trauma.

There is no specific laboratory method for the diagnosis of acute mesenteric ischemia (AMI). In this study, we aimed to determine the efficacy of the D-dimer test in selected cases prior to multi-detector angio-CT, which is expensive and has side effects. Patients, over 65, with abdominal pain were included in this study. The D-dimer test was applied to 230 (34%) of 676 abdominal pain patients admitted to our emergency service. The D-dimer levels of the patients diagnosed with AMI by angio-CT were compared. In AMI patients sensitivity of the D-dimer test was 84.6% and the specificity was 47.9%. Elevated D-dimer levels and AF were observed in 90.9% of the patients diagnosed with AMI by CT. D-dimer levels were elevated in the AMI patients. Patients suspected of having AMI with unclear clinical results and patients with D-dimer levels above 1000 ng/ml and AF should undergo further evaluation.

Background: In this study, we aimed to determine knowledge levels regarding Crimean-Congo hemorrhagic fever (CCHF) among emergency healthcare workers (HCWs) in an endemic region. Methods: A questionnaire form consisting of questions about CCHF was applied to the participants. Results: The mean age was 29.6 ± 6.5 years (range 19 - 45). Fifty-four (49.5%) participants were physicians, 39 (35.8%) were nurses and 16 (14.7%) were paramedics. All of the participants were aware of CCHF, and 48 (44%) of them had previously followed CCHF patients. Rates of the use of protective equipment (masks and gloves) during interventions for patients who were admitted to the emergency service with active hemorrhage were 100% among paramedics, 76.9% among nurses and 61.1% among physicians (P = 0.003). Among 86 (78.9%) HCWs who believed that their knowledge regarding CCHF was adequate, 62 (56.9%) declared that they would prefer not to care for patients with CCHF (P = 0.608). Conclusions: The use of techniques to prevent transmission of this disease, including gloves, face masks, face visors and box coats, should be explained to emergency room HCWs, and encouragement should be provided for using these techniques. J Clin Med Res. 2014;6(3):197-204 doi: http://dx.doi.org/10.14740/jocmr1801w

This study aimed to determine the reasons for long stays in monitoring units and to propose a solution. The patients who were followed in monitoring units of emergency service and the factors affecting the length of their hospital stay were analyzed retrospectively. Demographic features, their initial complaint that lead to monitoring, diagnosis, their means of arrival to emergency service, their admittance date and hour, medical history, basic vital signs, length of stay in emergency service, invasive interventions, intubation, mortality rates, consultations, and clinical results were evaluated. The study included 603 patients. Average emergency service stay in monitoring unit was found to be 6.5 hours. In addition, 15 patients (2.5%) stayed 24 hours or longer, and 78 patients (12.9%) stayed 12 to 24 hours. Of the 15 patients who stayed in emergency service for 24 hours or more, 8 (53.3%) stayed because there wasn't enough space in intensive care units. The most prevalent complaint for admission to the emergency service was chest pain (25.5%), followed by dyspnea (21.9%) and tachycardia (11.6%). For real emergency conditions, monitoring units are necessary to follow patients closely and to perform immediate interventions. The fullness of the intensive care units primarily affects the emergency service and leads to long stays in emergency service as patients are waiting to be admitted to the intensive care unit. As the number of consultations increases, the monitoring period is prolonged.

Objective: To determine the prediction ability of the National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2), and quick Sequential Organ Failure Assessment (qSOFA) score for the prognosis of pulmonary embolism (PE) in the emergency department. Methods: This retrospective study involved 245 patients with PE. The NEWS, NEWS2, and qSOFA scores were compared according to the hospitalization clinic (ward vs. intensive care unit), hospitalization length (10 days), severity of embolism (massive vs. submassive), and outcome (discharged vs. died). Results: The areas under the curve of the NEWS, NEWS2, and qSOFA score for 1-week mortality were 0.854 (sensitivity, 78%; specificity, 73%; cutoff, 7.5; confidence interval, 0.807–0.902), 0.870 (sensitivity, 83%; specificity, 73%; cutoff, 5.5; confidence interval, 0.825–0.915), and 0.789 (sensitivity, 83%; specificity, 51%; cutoff, 0.5; confidence interval, 0.720–0.858), respectively. Conclusion: The NEWS2 more accurately predicts 1-week mortality than do the NEWS and qSOFA score in patients with PE.