Pub Date : 2014-09-29DOI: 10.5152/jaemcr.2014.70238
B. Gullupinar
Introduction: Low-molecular-weight heparin is one of the most preferred agents used in the prevention and treatment of thromboembolic disorders. Case Report: An 85-year-old female patient was admitted for 3 days wıth ongoing and growing vaginal bleeding. Bladder hematoma and postrenal acute renal failure, rare complications of low-molecular-weight heparins, are presented in this case. Conclusion: Patients who have complaints about vaginal bleeding or hematuria should be questioned about a detailed history and the use of low-molecular-weight heparin. Lowmolecular-weight heparin in rare cases may lead to bleeding, and postrenal acute renal failure should be kept in mind.
{"title":"A Rare Complication of Low-Molecular-Weight Heparin Therapy: Bladder Hematoma","authors":"B. Gullupinar","doi":"10.5152/jaemcr.2014.70238","DOIUrl":"https://doi.org/10.5152/jaemcr.2014.70238","url":null,"abstract":"Introduction: Low-molecular-weight heparin is one of the most preferred agents used in the prevention and treatment of thromboembolic disorders. Case Report: An 85-year-old female patient was admitted for 3 days wıth ongoing and growing vaginal bleeding. Bladder hematoma and postrenal acute renal failure, rare complications of low-molecular-weight heparins, are presented in this case. Conclusion: Patients who have complaints about vaginal bleeding or hematuria should be questioned about a detailed history and the use of low-molecular-weight heparin. Lowmolecular-weight heparin in rare cases may lead to bleeding, and postrenal acute renal failure should be kept in mind.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"13 1","pages":"232-234"},"PeriodicalIF":0.0,"publicationDate":"2014-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76223532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Decontamination: Decontamination of the body by washing with soap and water is to be thorough and complete. A repeat stomach wash in every case is recommended to remove residual OP. Remove all clothing, hair accessories and place them in appropriate waste bags. Gastric lavages is indicated once patient is stabilized, calm enough to give consent and in unconscious intubated patient, which is recommended to be repeated after 2-3 hrs. Though it has been recommended only to be carried out within 1-2 hours of ingestion of OP elsewhere it has been started even after 12 hrs of ingestion and repeated thrice at an interval of 4 hrs.
{"title":"Management Guidelines of Organophosphorus Poisoning in Emergency Department","authors":"B. Al","doi":"10.5152/jaem.2014.1909","DOIUrl":"https://doi.org/10.5152/jaem.2014.1909","url":null,"abstract":"Decontamination: Decontamination of the body by washing with soap and water is to be thorough and complete. A repeat stomach wash in every case is recommended to remove residual OP. Remove all clothing, hair accessories and place them in appropriate waste bags. Gastric lavages is indicated once patient is stabilized, calm enough to give consent and in unconscious intubated patient, which is recommended to be repeated after 2-3 hrs. Though it has been recommended only to be carried out within 1-2 hours of ingestion of OP elsewhere it has been started even after 12 hrs of ingestion and repeated thrice at an interval of 4 hrs.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86811667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case 1 An 81-year-old male presented to the emergency department (ED) with falling at floor level. He complained of pain of the left parietal area and left wrist. At the time of admission, his vital signs and neurological examination were normal and Glascow coma scale score (GCS) was 15. Physical examination revealed 1x2-cm tender swelling in his left parietal area and a tenderness on his left wrist. X-ray of the wrist and non-enhanced computed tomography (CT) of the head were performed, and he was diagnosed with a distal radius fracture. The patient’s head CT is shown in Figure 1. Case 2 A 69-year-old male presented to the ED with a motorcycle accident. He had head trauma and did not remember what happened. When he arrived to the ED, the patient’s vital signs were normal. Neurological examination revealed only amnesia, and other system examination findings were normal. Non-enhanced CT of head was performed, and it is shown in Figure 2.
{"title":"White Spots on CT Scan of Brain","authors":"G. Aksel, Ş. K. Çorbacıoğlu","doi":"10.5152/JAEM.2014.369","DOIUrl":"https://doi.org/10.5152/JAEM.2014.369","url":null,"abstract":"Case 1 An 81-year-old male presented to the emergency department (ED) with falling at floor level. He complained of pain of the left parietal area and left wrist. At the time of admission, his vital signs and neurological examination were normal and Glascow coma scale score (GCS) was 15. Physical examination revealed 1x2-cm tender swelling in his left parietal area and a tenderness on his left wrist. X-ray of the wrist and non-enhanced computed tomography (CT) of the head were performed, and he was diagnosed with a distal radius fracture. The patient’s head CT is shown in Figure 1. Case 2 A 69-year-old male presented to the ED with a motorcycle accident. He had head trauma and did not remember what happened. When he arrived to the ED, the patient’s vital signs were normal. Neurological examination revealed only amnesia, and other system examination findings were normal. Non-enhanced CT of head was performed, and it is shown in Figure 2.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"13 1","pages":"99-99"},"PeriodicalIF":0.0,"publicationDate":"2014-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85211268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can an Article Be Worth $25 000?","authors":"H. Cebicci, Sukru Gurbuz","doi":"10.5152/JAEM.2014.358","DOIUrl":"https://doi.org/10.5152/JAEM.2014.358","url":null,"abstract":"","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85751399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Aksoy, M. Ayan, Tufan Alatlı, F. Şahin, M. Ozdemir, B. Çevik, S. Kurt
Objective: Stroke is an important cause of morbidity and mortality and has an increasing trend in the emergency department. It has become crucial to treat ischemic stroke with thrombolytic therapy. We reviewed the findings of the initial examinations, arrival times, clinical and demographic characteristics of stroke patients in our emergency department. Material and Methods: One hundred forty-seven stroke patients who registered at the emergency department within the first 24 hours were included in this study. Parameters, such as stroke type, age, gender, medical history, arrival complaints, application time, hospitalization department, and time, were recorded. Results: Patients’ mean age was 66.01±13.07 years (ischemic stroke: 85.7%, hemorrhagic stroke: 14.3%). No significant difference was observed between the ages, arrival complaints, and stroke types. The main risk factor was hypertension. While ischemic stroke patients were typically brought in the morning time, the hemorrhagic stroke patients were brought in the afternoon. While the common complaint of ischemic stroke patients was hemiparesis/plegia, hemorrhagic stroke patients mostly complained of impairment/loss of consciousness. Conclusion: The majority of stroke patients came with numerous clinical hallmarks that help in the diagnosis. Since early medical intervention is life-saving, evaluation of these clinical clues of the patient in a short time is the key to lifesaving treatment. (JAEM 2014; 13: 135-8)
{"title":"Clinical and Demographic Properties of the Acute Stroke Patients Admitted to Emergency Department of a Tertiary Referral Center","authors":"D. Aksoy, M. Ayan, Tufan Alatlı, F. Şahin, M. Ozdemir, B. Çevik, S. Kurt","doi":"10.5152/JAEM.2014.233","DOIUrl":"https://doi.org/10.5152/JAEM.2014.233","url":null,"abstract":"Objective: Stroke is an important cause of morbidity and mortality and has an increasing trend in the emergency department. It has become crucial to treat ischemic stroke with thrombolytic therapy. We reviewed the findings of the initial examinations, arrival times, clinical and demographic characteristics of stroke patients in our emergency department. Material and Methods: One hundred forty-seven stroke patients who registered at the emergency department within the first 24 hours were included in this study. Parameters, such as stroke type, age, gender, medical history, arrival complaints, application time, hospitalization department, and time, were recorded. Results: Patients’ mean age was 66.01±13.07 years (ischemic stroke: 85.7%, hemorrhagic stroke: 14.3%). No significant difference was observed between the ages, arrival complaints, and stroke types. The main risk factor was hypertension. While ischemic stroke patients were typically brought in the morning time, the hemorrhagic stroke patients were brought in the afternoon. While the common complaint of ischemic stroke patients was hemiparesis/plegia, hemorrhagic stroke patients mostly complained of impairment/loss of consciousness. Conclusion: The majority of stroke patients came with numerous clinical hallmarks that help in the diagnosis. Since early medical intervention is life-saving, evaluation of these clinical clues of the patient in a short time is the key to lifesaving treatment. (JAEM 2014; 13: 135-8)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76683013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bifurcation of Carotico-Subclavian Artery Injury due to Central Venous Catheterization","authors":"Erhan Hafız, V. Sarıçiçek, A. Ozkur, H. Deniz","doi":"10.5152/JAEM.2014.179","DOIUrl":"https://doi.org/10.5152/JAEM.2014.179","url":null,"abstract":"","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"16 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88918690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Ahmedali, A. Şener, H. S. Kavakli, Gülhan Kurtoğlu Çelik, F. Icme, Yavuz Otal, A. Kahraman, Y. Sezgin
Objective: The aim of this study is to determine the accuracy and reliability of the interpretation of electrocardiography (ECG) findings by emergency medicine resident physicians (EMPs) and to provide training recommendations in line with emerging deficiencies. Material and Methods: This research depended on the data from a questionnaire that we conducted among EMPs in Ankara. The survey included multiple-choice questions, selected through conceived cases presented in major textbooks or congresses. EMP ECG assessment levels were compared according to the duration of residency education and the presence of ECG education. The data were evaluated by using the Statistical Package for Social Sciences 17.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 112 volunteers participated. Mean age was 29.6±4.4; also, 47 were female and 65 were male. When all of the questions were taken into account, the mean number of total correct answers was higher for those who had received ECG training than who had not received it, those who underwent more training than those who underwent less training, and those whose duration of assistantship was longer than those whose duration was shorter. Conclusion: The results of our study revealed that the evaluation of ECG is improved by increasing clinical knowledge and training. Depending on these results, we suggest that effective and practical ECG courses and training programs should be organized for EMPs. (JAEM 2014; 13: 108-11)
目的:本研究的目的是确定急诊医学住院医师(EMPs)解释心电图(ECG)结果的准确性和可靠性，并根据新出现的缺陷提供培训建议。材料和方法:本研究依赖于我们在安卡拉的emp中进行的问卷调查的数据。调查包括多项选择题，从主要教科书或大会上提出的构思案例中选出。根据住院医师教育时间和有无心电图教育比较EMP心电图评估水平。使用SPSS Inc.， Chicago, IL, USA的Statistical Package for Social Sciences 17.0对数据进行评估。结果:共有112名志愿者参与。平均年龄29.6±4.4岁;女性47人，男性65人。当考虑到所有的问题时，接受过心电图训练的人比没有接受过心电图训练的人、接受过更多训练的人比接受过更少训练的人、以及持续时间较长的人比持续时间较短的人的平均总正确答案数要高。结论:通过增加临床知识和培训，心电图的评价得到了提高。根据这些结果，我们建议应该为emp组织有效和实用的ECG课程和培训计划。(JAEM 2014;13: 108 - 11)
{"title":"Determination of the Level of Emergency Medicine Resident Physicians to Recognize the Electrocardiography Findings","authors":"A. Ahmedali, A. Şener, H. S. Kavakli, Gülhan Kurtoğlu Çelik, F. Icme, Yavuz Otal, A. Kahraman, Y. Sezgin","doi":"10.5152/JAEM.2014.16769","DOIUrl":"https://doi.org/10.5152/JAEM.2014.16769","url":null,"abstract":"Objective: The aim of this study is to determine the accuracy and reliability of the interpretation of electrocardiography (ECG) findings by emergency medicine resident physicians (EMPs) and to provide training recommendations in line with emerging deficiencies. Material and Methods: This research depended on the data from a questionnaire that we conducted among EMPs in Ankara. The survey included multiple-choice questions, selected through conceived cases presented in major textbooks or congresses. EMP ECG assessment levels were compared according to the duration of residency education and the presence of ECG education. The data were evaluated by using the Statistical Package for Social Sciences 17.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 112 volunteers participated. Mean age was 29.6±4.4; also, 47 were female and 65 were male. When all of the questions were taken into account, the mean number of total correct answers was higher for those who had received ECG training than who had not received it, those who underwent more training than those who underwent less training, and those whose duration of assistantship was longer than those whose duration was shorter. Conclusion: The results of our study revealed that the evaluation of ECG is improved by increasing clinical knowledge and training. Depending on these results, we suggest that effective and practical ECG courses and training programs should be organized for EMPs. (JAEM 2014; 13: 108-11)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91321659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Akdağ, R. Dursun, A. Gül, S. Hattapoğlu, F. Meriç, İ. Topçu
Objective: The aim of this study is to analyze the demographic and diagnostic characteristics of patients presenting to the emergency clinic with nasal trauma. Material and Methods: Data analysis was performed with imaging tests on the files of 77 patients presented to the emergency clinic between 2012 and 2013. Results: In order of prevalence, nasal fractures were caused by falls from heights, violence, trauma, sports injuries and traffic accidents. Physical examination findings in patients with nasal fracture were sensitivity, nose swelling, nasal mucosal hemorrhage and septal deviation. Fracture was also determined at physical examination in 26 (86.6%) of the 30 patients with fracture detected at tomography. In the analysis, approximately 26% were multiple depressed fractures, while linear fracture along a single line was determined in 31%, with fissure-type fracture in the remaining 43%. Pathologies such as septal edema or hemorrhage were present in 30 of the 77 patients, while the septum was mobile and dislocated in approximately 16 of these patients (33.7%). Conclusion: Falls from heights were the most common cause in patients with nasal fracture, and although the most common imaging technique employed was x-ray, tomography provided more detailed information concerning rhinorrhea, smell perception disorders, maxillofacial traumas and multiple nasal fractures. (JAEM 2014; 13: 139-42)
{"title":"Retrospective Analysis of Nasal Fractures in the Emergency Clinic","authors":"M. Akdağ, R. Dursun, A. Gül, S. Hattapoğlu, F. Meriç, İ. Topçu","doi":"10.5152/JAEM.2014.266","DOIUrl":"https://doi.org/10.5152/JAEM.2014.266","url":null,"abstract":"Objective: The aim of this study is to analyze the demographic and diagnostic characteristics of patients presenting to the emergency clinic with nasal trauma. Material and Methods: Data analysis was performed with imaging tests on the files of 77 patients presented to the emergency clinic between 2012 and 2013. Results: In order of prevalence, nasal fractures were caused by falls from heights, violence, trauma, sports injuries and traffic accidents. Physical examination findings in patients with nasal fracture were sensitivity, nose swelling, nasal mucosal hemorrhage and septal deviation. Fracture was also determined at physical examination in 26 (86.6%) of the 30 patients with fracture detected at tomography. In the analysis, approximately 26% were multiple depressed fractures, while linear fracture along a single line was determined in 31%, with fissure-type fracture in the remaining 43%. Pathologies such as septal edema or hemorrhage were present in 30 of the 77 patients, while the septum was mobile and dislocated in approximately 16 of these patients (33.7%). Conclusion: Falls from heights were the most common cause in patients with nasal fracture, and although the most common imaging technique employed was x-ray, tomography provided more detailed information concerning rhinorrhea, smell perception disorders, maxillofacial traumas and multiple nasal fractures. (JAEM 2014; 13: 139-42)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86676222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Editor,We read with great interest the article by Uyanik et al., entitled “Delayed ST-Segment Elevation Due to Electrical Injury Mimicking Acute Myocardial Infarction,” which was published recently in this journal. This case report was mentioning a young patient admitted with late-onset chest pain and ST-segment elevation following ele-ctrical injury (1). Although the case was presented precisely, some points merit further highlighting.Abnormal electrocardiography (ECG) may be found in approxi-mately 31% of patients following an electric shock (2). Non-specific ST-segment changes and sinus tachycardia are the most commonly reported ECG findings; QT prolongation, bundle branch block, atrial and ventricular fibrillation, and atrial and ventricular premature con-tractions are also detected. As referred to in this case report, ST-seg-ment elevation with or without myocardial involvement may follow electrical injury.In a clinical setting, ST-segment elevation on ECG may be related with many conditions, such as myocardial infarction, early repolariza -tion, electrolyte imbalance, and pericarditis. In this case, myocardial infarction may easily be excluded, since cardiac biomarkers are nor-mal and ST elevation is not consistent with myocardial infarction. In this case, ECG shows diffuse and concave ST elevation (elevated at the J point) with the exception of V1 and aVR. In acute myocardial infarction, ST elevation is also accompanied by reciprocal ST depres-sions. In the case of early repolarization, ST elevation is most often present in the mid- to lateral chest leads (V3-V6), and the majority of subjects with early repolarization has no ST deviations in the limb leads. So, early repolarization would be excluded in this patient, who has pronounced ST elevation on D2, D3, and aVF.Zeana describes a 65-year-old electrocuted subject who experi-enced precordial pain, serous enzymes of negative myocardial necro -sis, and ST elevation during 2 weeks of hospitalization (3). These fin-dings suggest the possibility of widespread pericardial involvement. In the case presented by Uyanik et al., pericardial involvement seems to be the most possible cause of ST changes in the admission ECG. This ECG shows us sinus bradycardia with diffuse concave ST elevati-on except for V1 and aVR. ST depression in V1 and aVR is also a typical finding for acute pericarditis. Late-onset chest pain also supports this condition. However, addition of a follow-up ECG of the patient to the report would be more valuable for confirmation of this diagnosis. In our opinion, pericarditis deserves discussion as a possible diagnosis in the aforementioned case.
{"title":"Electricity, Heart and ST-Segment Elevation: A Closer Look","authors":"S. Duyuler, A. Çoner, P. Bayır","doi":"10.5152/JAEM.2014.78736","DOIUrl":"https://doi.org/10.5152/JAEM.2014.78736","url":null,"abstract":"Dear Editor,We read with great interest the article by Uyanik et al., entitled “Delayed ST-Segment Elevation Due to Electrical Injury Mimicking Acute Myocardial Infarction,” which was published recently in this journal. This case report was mentioning a young patient admitted with late-onset chest pain and ST-segment elevation following ele-ctrical injury (1). Although the case was presented precisely, some points merit further highlighting.Abnormal electrocardiography (ECG) may be found in approxi-mately 31% of patients following an electric shock (2). Non-specific ST-segment changes and sinus tachycardia are the most commonly reported ECG findings; QT prolongation, bundle branch block, atrial and ventricular fibrillation, and atrial and ventricular premature con-tractions are also detected. As referred to in this case report, ST-seg-ment elevation with or without myocardial involvement may follow electrical injury.In a clinical setting, ST-segment elevation on ECG may be related with many conditions, such as myocardial infarction, early repolariza -tion, electrolyte imbalance, and pericarditis. In this case, myocardial infarction may easily be excluded, since cardiac biomarkers are nor-mal and ST elevation is not consistent with myocardial infarction. In this case, ECG shows diffuse and concave ST elevation (elevated at the J point) with the exception of V1 and aVR. In acute myocardial infarction, ST elevation is also accompanied by reciprocal ST depres-sions. In the case of early repolarization, ST elevation is most often present in the mid- to lateral chest leads (V3-V6), and the majority of subjects with early repolarization has no ST deviations in the limb leads. So, early repolarization would be excluded in this patient, who has pronounced ST elevation on D2, D3, and aVF.Zeana describes a 65-year-old electrocuted subject who experi-enced precordial pain, serous enzymes of negative myocardial necro -sis, and ST elevation during 2 weeks of hospitalization (3). These fin-dings suggest the possibility of widespread pericardial involvement. In the case presented by Uyanik et al., pericardial involvement seems to be the most possible cause of ST changes in the admission ECG. This ECG shows us sinus bradycardia with diffuse concave ST elevati-on except for V1 and aVR. ST depression in V1 and aVR is also a typical finding for acute pericarditis. Late-onset chest pain also supports this condition. However, addition of a follow-up ECG of the patient to the report would be more valuable for confirmation of this diagnosis. In our opinion, pericarditis deserves discussion as a possible diagnosis in the aforementioned case.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83663065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Ertok, Gülhan Kurtoğlu Çelik, H. S. Kavakli, N. Doğan, F. Icme, Sinan Becel, A. Ahmedali
Objective: Our purpose in this study was to determine the accuracy and reliability of interpretation of basic arterial blood gas (ABG) values and ABG values related to metabolic and respiratory disease by emergency medicine residents (EMRs). We also aimed to determine their deficiencies and create a basis for training during patient care. Material and Methods: This study was carried out through a survey taken by EMRs in training/research and university hospitals located in Ankara. The levels of knowledge of EMRs on ABG evaluation were compared based on the institution, duration of residency, and training. A 14-question test about ABG knowledge was also applied to residents. Results: The study was conducted with 25 EMRs in university hospitals (UH) and 88 EMRs in training/research hospitals (TRH); a total of 113 residents participated to the survey. There was no statistical significant difference between training/research and university hospitals according to the number of correct answers given. Year of residency did not affect the number of correct answers; however, residents who had training on ABG analysis in the residency period had more correct answers. Also, in a small study group (n=17), a significant improvement of the number of correct answers was observed with a short institutional course. Conclusion: According to the results, ABG evaluation improves with personal training in the residency period independently of residency years. Based on this result, training should be given in and out of institutions, and EMRs should be encouraged to personally study ABG evaluation. (JAEM 2014; 13: 100-3)
{"title":"Evaluation of Emergency Medicine Residents' Level of Knowledge of Arterial Blood Gases","authors":"I. Ertok, Gülhan Kurtoğlu Çelik, H. S. Kavakli, N. Doğan, F. Icme, Sinan Becel, A. Ahmedali","doi":"10.5152/JAEM.2014.74830","DOIUrl":"https://doi.org/10.5152/JAEM.2014.74830","url":null,"abstract":"Objective: Our purpose in this study was to determine the accuracy and reliability of interpretation of basic arterial blood gas (ABG) values and ABG values related to metabolic and respiratory disease by emergency medicine residents (EMRs). We also aimed to determine their deficiencies and create a basis for training during patient care. Material and Methods: This study was carried out through a survey taken by EMRs in training/research and university hospitals located in Ankara. The levels of knowledge of EMRs on ABG evaluation were compared based on the institution, duration of residency, and training. A 14-question test about ABG knowledge was also applied to residents. Results: The study was conducted with 25 EMRs in university hospitals (UH) and 88 EMRs in training/research hospitals (TRH); a total of 113 residents participated to the survey. There was no statistical significant difference between training/research and university hospitals according to the number of correct answers given. Year of residency did not affect the number of correct answers; however, residents who had training on ABG analysis in the residency period had more correct answers. Also, in a small study group (n=17), a significant improvement of the number of correct answers was observed with a short institutional course. Conclusion: According to the results, ABG evaluation improves with personal training in the residency period independently of residency years. Based on this result, training should be given in and out of institutions, and EMRs should be encouraged to personally study ABG evaluation. (JAEM 2014; 13: 100-3)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89476644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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