Although intrahospital transportation of critical patients from the emergency department (ED) is inevitable, it could also result in life-threatening situations. These situations, referred to as unwanted or unexpected events, mainly happen during the transportation of patients for diagnostic imaging or invasive procedures and result in a wide spectrum from vital condition changes, mental condition changes to cardiopulmonary arrest and death. Emergency departments have a high risk of facing such situations because these units are the first admission door of critical patients. This cross-sectional study was conducted prospectively, after interviewing the doctors who work in the ED actively, and by filling out the forms which were already prepared by the participants. Statistical analysis was performed according to the data received, and results were compared to the literature. Three hundred and forty-seven doctors from 52 hospitals were included in the study. 59.4% (n = 206) of them were working at EDs which had more than 500 patients admitted. 51.9% (n = 180) of doctors stated that they performed 10 or more critical patients' transport every day from their ED. 86.7% (n = 301) of the participants stated that usage of control checklists would decrease the rate of unwanted situations and stated that they wanted to use them. Intrahospital transportation of critical patients from the emergency room is a subject that should require attention by emergency room doctors, and using educated personnel, proper equipment, standardized protocols and control checklists will decrease the frequency of unwanted situations effectively.

OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

The lack of a specific biomarker that can be used in the diagnosis of acute cholecystitis, a common cause of admission to the emergency department, delays physician efforts to diagnose and treat these patients. Therefore, the aim of this study was to measure plasma YKL-40 levels and investigate their diagnostic value in patients with acute cholecystitis (AC). This study was carried out between February 2020 and September 2020 in the adult emergency department of a tertiary university hospital. Permission was obtained from the Ethics Committee of Scientific Research on 03/02/2020 with Decision No. 03/16. The study included 80 patients who were diagnosed with acute cholecystitis and 80 healthy volunteers without known chronic diseases. The median YKL-40 protein level was 798.66 pq/mL in the patient group and 392.45 pq/mL in the control group. A statistically significant difference in YKL-40 protein levels was found between the two groups. YKL-40 protein levels were significantly higher in patients diagnosed with acute cholecystitis than in healthy individuals (p < 0.001). A positive correlation was found between YKL-40 protein levels and ALT, AST, LDH, and GGT levels (r = 0.272, p = 0.015; r = 0.397, p < 0.001; r = 0.386, p < 0.001; and r = 0.264, p = 0.018; respectively). When evaluated together with physical examination, radiological imaging and other laboratory parameters, we think that plasma YKL-40 levels can be used effectively in the diagnosis of acute cholecystitis.

Amaç: Geriatrik travma hastalarındaki demografik özellikleri, travma şiddet skorları, travmanın oluş mekanlarını, hastalara istenen konsültasyonları ve sonlanış şekillerini tespit etmeyi hedefledik. Aynı zamanda olayın oluşu ile acil servise başvuru arasında geçen sürenin ve travma skorlarının mortalite ile ilişkisini ortaya çıkarmayı amaçladık. Gereç ve Yöntem: Bu çalışma retrospektif olarak 01.01.2011-31.12.2011 tarihleri arasında Erciyes Üniversitesi Tıp Fakültesi Acil servisine 65 yaş ve üzeri başvuran 250 hasta ile yapılmıştır. Cinsiyet, yaş, travmadan sonra geçen süre, travma mekanizması, tanılar, istenilen konsültasyonlar, yaralanma bölgesi, GKS, ISS ve sonlanış şekilleri araştırılmıştır. Bulgular: Bu hastaların %51,6’sı kadın, %48,4’ü erkektir. Hastaların yaş ortalaması 73,3’tür. Hastaların %32,4’ü ilk 1 saatlik zaman diliminde iken %11,2’si ilk 24 saatlik zaman dilimi sonrası acil servise müracaat etmiştir. Hastalarda sırasıyla en çok yumuşak doku travması (%36,4) saptanmışken travma bölgelerine de bakıldığında en sık %51,6 oranla ekstremite olduğu da tespit edilmiştir. Hastaların 86’sına herhangi bir branştan konsultasyon istenmezken; 79 hastaya ortopedi, 44 hastaya beyin cerrahi konsültasyonu istenmiştir. Çalışmadaki hastaların %54,8’i acil servisten tedavi sonrası taburcu olmuş, %28,4’ü servise yatmış, %12’si yoğun bakım şartlarında takibe alınmış ve %4,8’i yani 12 hasta exitus olmuştur. Hastaların acil servise başvuru süreleri, GKS ve ISS puanları ile acil serviste sonlanışları kıyaslanmış ve istatistiksel olarak anlamlı ilişki tespit edilmiştir. Sonuç: Geriatrik travma hastaları genç hastalara göre daha mortal ve morbid seyretmektedir. Yaşlılığa bağlı olarak genellikle medikal ek problemleri de mevcuttur. Tedavi süreçleri daha zahmetli ve emek istemektedir. Bu nedenle hastalar daha dikkatli ve multisistemik olarak değerlendirilmelidir.