Personal protective equipment (PPE) are equipment that protect healthcare workers from harmful agents and organisms. The importance of these equipment was noticed again with the Covid-19 pandemic. In this study, we investigated the effect of different masks used as PPE on resuscitation quality and rescuer fatigue. Participants applied chest compression without a mask, with a surgical mask, a filtering face-piece respirator (FFR) mask, and a half-face mask with active P3 filter. A smart watch was worn on the left wrists of the participants during chest compression in each condition. They were requested to rate their fatigue on the Visual Analogue Scale (VAS). Statistically higher average pulse rates were found in the FFR mask and half-face mask conditions. FFR mask and half-face mask resulted in statistically worse results than surgical mask and no-mask conditions in the number of compression per minute, compression depth, and compression effectiveness. Further, half-face mask and FFR mask caused more fatigue in participants. Protective masks used as PPE other than surgical masks increase rescuer fatigue in CPR and negatively affect the quality of chest compressions.

Objective: This study aimed to evaluate the relationship between the Prognostic Nutritional Index (PNI) and demographic characteristics, presenting complaints, clinical diagnoses, and patient outcomes in patients admitted to the emergency department for gastrointestinal (GI) emergencies. The predictive value of PNI for the clinical course of patients with GI emergencies was investigated. Method: This retrospective cross-sectional study included 583 patients with a diagnosis of GI emergencies in the emergency department of a tertiary university hospital between January 2021 and December 2024. Data such as age, sex, presenting complaints, final diagnosis, and emergency department outcomes (discharge, ward admission, and transfer to intensive care unit) were collected. The PNI value was calculated using serum albumin (g/dL) and total lymphocyte count (/mm³) with the formula PNI = 10 × albumin + 0.005 × lymphocyte. The PNI was calculated based on serum albumin levels and peripheral lymphocyte counts. Results: The mean age of the study group was 63.4 ± 17.4 years, and 52.1% of the patients were female. The number of patients with a PNI value < 38 was significantly higher in the intensive care unit (p < 0.001). PNI values were considerably lower, especially in patients diagnosed with malignancy, cirrhosis, and GI hemorrhage (X² = 71.387; p < 0.001). The PNI was an independent predictor of outcomes in patients with GI emergencies. The mean PNI was significantly higher in discharged patients but significantly lower in patients admitted to the intensive care unit (p < 0.002). The cut-off score for PNI was calculated using the median value, and the cut-off score for PNI was <38. Conclusion: PNI is a powerful biomarker for predicting the clinical severity and prognosis of patients with GI emergencies. Since it can be easily calculated from routine biochemical tests, it can be used as a practical and effective risk stratification tool. The evaluation of PNI, especially for the early detection of critically ill patients at high risk of malnutrition, may contribute to the reduction of morbidity and mortality through the timely initiation of appropriate supportive therapies.

Introduction: Approximately 50,000 patients per year present at emergency departments (EDs) because of carbon monoxide (CO) intoxication. The hypothesis of this study was that the half-life of CO and the regression period of complaints could be reduced more rapidly by applying oxygen with the Continuous Positive Airway Pressure (CPAP) modality using a non-invasive mechanical ventilator.Methods: The patients were divided into Group 1 and Group 2 in terms of the treatment method applied. Patients in Group 1 received FiO2 1.0 15 l/minute oxygen at room temperature for at least 30 minutes with a non-rebreather mask. Patients in Group 2 received FiO2 1.0 oxygen at 12 cmH2O pressure with non-invasive mechanical ventilation for at least 30 minutes with an oronasal mask in the CPAP modality.Results: The median values (interquartile range) of carboxyhemoglobin (COHb) levels at zero and 30 minutes of patients were 19% (8) and 14% (6) in Group 1 and 22% (8) and nine percent (3) in Group 2; a median difference of six percent (2) was detected in Group 1 and of 13% (4) in Group 2 in the first 30 minutes (P <.001). When the symptoms of the patients were examined, the median values of Group 1 and Group 2 at zero minutes were both eight units and at 30 minutes were five and three units, respectively. A decrease of five units was determined in the median of Group 2 in the first 30 minutes, and a decrease of two units in the median of Group 1 (P <.001).Conclusion: The use of CPAP was determined to more rapidly reduce COHb level as opposed to high-flow oxygen therapy. It is also thought that it may enable earlier discharge by reducing the duration of the emergency follow-up since it provides a faster improvement in the symptoms of the patients.

Objective: Non-contrast computed tomography (CT) remains the gold standard for diagnosing ureteral stones, with excellent sensitivity and specificity. However, reliance on CT alone raises concerns regarding cumulative radiation exposure, particularly in recurrent stone formers. Clinical scoring systems such as CHOKAI, STONE, and modified STONE have been developed to provide practical bedside tools for diagnostic decision-making. This study prospectively compared these three clinical scores for their ability to predict urinary-stone disease in the emergency department. Study Design: Prospective study. Methods and Duration of the Study: Between 6 August 2024 and 15 February 2025, 130 consecutively enrolled adults with flank pain underwent bedside scoring and reference-standard non-contrast CT. Associations were analysed with Chi-Square Tests and multivariable logistic regression. Model calibration was assessed with the Hosmer–Lemeshow test; overall accuracy was calculated. Results: When the variables used in different stone scoring formulas were compared according to the computer tomography results, there was a statistically significant difference (p < 0.01) between patients with and without a history of stone and hydronephrosis. Patients with nausea, history of stone, and hydronephrosis were 11, 4.2, and 5 times more highly to have a stone on computer tomography than those without, respectively. Conclusions: In this Turkish cohort, CHOKAI and modified STONE demonstrated superior predictive performance compared to the original STONE score. These findings suggest that clinical scoring systems, when incorporating predictors such as nausea, prior stone history, and hydronephrosis, may serve as practical alternatives to CT-first diagnostic approaches. Multicenter validation studies are required before routine clinical adoption.

Background/Objectives: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with significant morbidity, including stroke, heart failure, and increased mortality, necessitating oral anticoagulant (OAC) therapy to reduce thromboembolic risk. However, OACs, including warfarin and non-vitamin K antagonist oral anticoagulants (NOACs), increase the risk of gastrointestinal (GI) bleeding, a serious complication requiring precise risk stratification in the emergency department (ED). Methods: This retrospective cohort study was conducted in the Emergency Department of Balikesir University Hospital in Turkey between 2019 and 2023 and evaluates systemic inflammatory markers as predictors of GI bleeding in AF patients receiving OACs. A total of 155 patients were divided into case (GI bleeding) and control (no GI bleeding) groups, comparing demographics, comorbidities, CHA₂DS₂-VASc and HAS-BLED scores, and inflammatory indices (uric acid/albumin ratio, neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune inflammation index [SII]). Results: For patients receiving NOACs, the case group exhibited significantly higher uric acid/albumin ratio, NLR, PLR, and SII (p < 0.05). For patients receiving warfarin, only the uric acid/albumin ratio was significantly elevated (p < 0.001). Hypolipidemia and elevated uric acid were associated with bleeding risk in patients receiving NOACs, while hypoalbuminemia and elevated urea predicted bleeding in patients receiving warfarin. HAS-BLED scores were significantly higher in bleeding groups, unlike CHA₂DS₂-VASc scores. Conclusions: These findings suggest that inflammatory indices, particularly in patients taking NOACs, are associated with GI bleeding risk stratification. Integrating these biomarkers into clinical practice could optimize personalized anticoagulation strategies, reducing morbidity and mortality in AF patients.

Aims: Chemical, biological, radiological, and nuclear (CBRN) threats and natural or man-made disasters are among the serious risks faced by contemporary societies. The aim of this study was to evaluate the level of knowledge and awareness of health personnel working in a university hospital on CBRN and disasters and to examine the effectiveness of existing training programs. Methods: This cross-sectional study included doctors, nurses, and other health personnel working in a university hospital. We used a questionnaire as a data collection tool to measure the level of knowledge about CBRN and disasters. Results: The total number of participants was 295. The majority were aged between 26 and 35 years (n=118, 40.0%), and more than half were male (n=163, 55.3%). Most participants were university graduates (n=171, 58.0%), intern doctors (n=91, 30.8%) and nurses (n=70, 23.7%). A significant proportion worked in the emergency department (n=132, 44.7%) and had less than one year of professional experience (n=106, 35.9%). Only 43.7% (n=129) reported being informed about the hospital disaster plan, and just 30.8% (n=91) had received training on CBRN. Awareness and preparedness levels were notably higher among nurses and emergency department personnel. Conclusion: The majority of healthcare personnel lacked adequate knowledge and training regarding CBRN threats and disaster preparedness. Targeted and routine educational interventions are necessary to enhance hospital-based disaster response.