INTRODUCTION: The long-term trends of medical students' choice for emergency medicine (EM) in Turkey are unclear. With this background, we aimed to determine the change in the rate of EM preferences of students over the years. METHODS: This was a cross-sectional study originated from 6^th-year medical students' feedback forms, to examine trends of EM carrier preferences between 2005 and 2018 in a tertiary care academic emergency department. There are two main questions containing “would you choose EM as a specialty?” and “why?” as open-ended questions in the form. The answers to the open-ended question were classified as six main factors, which were perception of work, lifestyle, nature of work, personal job preference, mentorship/department experiences, and income. RESULTS: During the study, 2957 forms (80.6% of 3668) were completed by 6^th-year medical students. Of the students, 26.5% (n = 784) responded “yes” to the question, which was “would you choose EM as a specialty?,” 6.1% (n = 181) responded “do not know,” and 67.4% (n = 1992) responded “no.” In 2005, 15% of students stated that they would choose EM, while this rate increased to 29% in 2018 (χ²: 9.67; P trend = 0.003). Perception of work was the most common reason for “yes” (46.3%), “no” (46%), and “do not know” answers. CONCLUSION: The rate of EM choice of medical students doubled during the study, and approximately one in three students stated that they could choose EM as their future career in the past year. Perception of work was the main factor for choosing or rejecting to EM.

Aim: The assessment of gastric content using bedside ultrasound is a critical skill for emergency physicians, particularly in determining aspiration risk during procedural sedation or emergency intubation. This pilot study aimed to evaluate the effectiveness of a structured ultrasound training program for emergency medicine residents in assessing gastric content and volume. Material and Methods: A six-hour structured theoretical and practical training session was conducted for emergency medicine residents. Following the training, participants performed gastric antrum ultrasound measurements on eight healthy volunteers in both fasting and postprandial states. Measurements included anteroposterior (AP) and craniocaudal (CC) diameters in both the supine and right lateral decubitus (RLD) positions. Intraclass correlation coefficients (ICC) were calculated to assess interobserver reliability. Results: Emergency medicine residents demonstrated high interobserver reliability in gastric antrum ultrasound measurements following a structured training program. In the supine position, the ICC was 98% for AP diameter and 91% for CC diameter, while in the RLD position, ICC values were 95% for AP diameter and 96% for CC diameter. Postprandial measurements exhibited comparable reliability, with ICC values of 98% for supine AP, 97% for supine CC, 95% for RLD AP, and 98% for RLD CC, all of which were statistically significant (p < 0.001). Conclusion: In this study indicate that a short, focused ultrasound training session can effectively equip emergency medicine residents with the necessary skills to perform reliable gastric ultrasound assessments in clinical settings, facilitating improved aspiration risk evaluation and airway management decision-making. Keywords: Ultrasonography, Gastric Antrum, Emergency Medicine

Background: Emergency departments are increasingly managing older patients who frequently present with multimorbidity and functional decline, placing them at increased risk for short and long-term adverse outcomes. Early identification of patients at increased risk is essential for appropriate risk stratification and care planning. The Identification of Seniors at Risk (ISAR) is a brief screening tool developed to identify older emergency department patients at risk of adverse outcomes; however, its predictive performance has not been formally evaluated in the Turkish emergency department setting. This study aimed to evaluate the predictive validity and reliability of the Turkish version of ISAR among older ED patients. Methods: This prospective cohort study included patients aged ≥ 65 years presenting to a tertiary level emergency department in Türkiye. The ISAR tool was translated using a forward-backward translation process and administered at index ED presentation. Adverse outcomes were assessed at 30 and 180 days and included death, unplanned hospitalization, functional decline, or transfer to a nursing home. Predictive performance was evaluated using receiver operating characteristic (ROC) analysis, and the optimal ISAR cut-off was determined based on ROC analyses. Results: Among 356 included patients (median age:73 years), 54.5% were classified as high-risk (ISAR ≥ 2). High-risk status was significantly associated with advancing age, higher comorbidity burden, greater triage severity, longer ED stays and higher rates of hospital admission. At 30 days, ISAR demonstrated good predictive performance for the composite adverse outcome, with an area under the curve (AUC) of 0.790 (95% CI 0.741–0.838). Using a cut-off of ISAR ≥ 2, sensitivity was 89.3% and specificity was 61.7%. At 180 days, predictive performance remained robust, with an AUC of 0.818 (95% CI 0.772–0.864), sensitivity of 80.6%, and specificity of 71.1%. Inclusion of emergency department readmissions in the composite outcome resulted in lower sensitivity and higher specificity at both time points. Conclusions: The Turkish version of the ISAR screening tool demonstrated acceptable predictive validity for identifying older emergency department patients at risk of adverse outcomes, with consistently high sensitivity and moderate specificity. ISAR may be useful as a rapid risk stratification tool in the emergency department but should not be used as a standalone instrument for clinical decision-making.

Older adults account for an increasing proportion of emergency department (ED) visits and experience disproportionately high rates of short-term adverse ou