Ahmet Baydin

Aim People particularly choose video-sharing platforms for medical information. In this study, we aimed to evaluate the scientific correctness of videos uploaded to one of the most popular video-sharing website, YouTube. Methods This research was performed by entering the keyword “Cardiopulmonary Resuscitation” to the YouTube platform on March 10th, 2024. Of the videos; download date, views, type of videos (lecture, scenario, narrative, animation and manikin), number of likes and duration of the videos were determined. Then the modified DISCERN Score (mDS) and Global Quality Scale Criteria (GQS) were applied to the videos by the authors. Results Eighty relevant videos were included in the study. The types of videos were: 20 lecture videos,19 scenario videos, 15 manikin videos, 14 narrative videos and 12 were animation videos. The manikin videos were the most viewed (186,905 times, mean: 12,460) and liked (1,510 times, mean: 100.6). Animation videos had the highest scores for both mDS and GQS criteria (4, 4.2, respectively). No statistical significance was determined in terms of video types and mDS/GQS scores. Conclusion Using manikins may be a useful method for basic life support and cardiopulmonary resuscitation education of the public.

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.

Aim: In this study it is aimed to investigate the general characteristics of the patients of mushroom poisoning in the emergency department and to determine the possible prognostic factors. Material and Methods: This study was conducted by retrospectively examining the records of patients who applied to the emergency department of a university hospital in Samsun, Turkey, with mushroom poisoning in 6 years. Patients were grouped using models that predict mortality and the severity of poisoning. Model for end stage liver diseases (MELD) scoring and poisoning severity score (PSS) were used for this purpose. All data obtained from this study were analyzed using the Statistical Package for Social Sciences (SPSS) for Windows 15.0 package program. Results: Liver failure developed in 16 of 471 patients who applied with mushroom poisoning. The median symptom onset time was 2 hours in 455 patients who did not develop liver failure, and the median symptom onset time was 9.5 hours in 16 patients who developed liver failure. When the patients were classified according to PSS, 91.1% of patients applied with PSS 1, while 2.1% of them applied with severe symptoms. 93.6% of the patients were with a mild MELD score. Conclusion: The most common clinical finding is nausea and vomiting. The appearance of symptoms within 2 hours is an indicator of a good prognosis. According to the MELD score, the severity of the disease increases as the BUN value increases. At the same time, high BUN and amylase levels mean a life-threatening poisoning according to PSS.

Objective. Bedside ultrasonography (US) is a new imaging modality that has begun to be used in the Pediatric Emergency Unit to evaluate inferior vena cava (IVC) diameter for intravascular volume status. In this article, we aimed to evaluate IVC diameter with bedside US before and after the fluid therapy in dehydrated children. Methods. A total of 124 dehydrated patients were enrolled, aged 8 months to 17 years. The maximum diameters of the IVC and aorta (AO) were measured. IVC/AO ratio and IVC collapsibility index IVCCI were calculated before and after the fluid therapy and correlation with the degree of dehydration and laboratory parameters was investigated. Results. Of the 124 patients, 49.2 (n=61) were male, the mean age was 7.5±4.94 years. The IVC/AOs ratio was increased in mild and moderate/severe groups after fluid therapy compared to before fluid administration. While the mean rate of heart rate, blood urea nitrogen (BUN), creatinine, and uric acid values were higher in the moderate/severe group, potassium and HCO₃ were lower. There was no significant change in AO diameter and IVCCI after fluid therapy in all groups. When the factors affecting the IVC/AOs ratio were analyzed with the logistic regression backward model; the IVC/AO ratio was found to increase as the degree of dehydration decreased (Adj.β=0.318) and as the age (Adj.β=0.242) and CRP (Adj.β=0.186) value increased. Conclusion. The IVC/AO ratio can be a promising index for the assessment and grading of dehydration in children, and cutoff values that vary according to age are necessary for a more objective assessment of dehydration.

Amaç: Bu çalışmada acil servise (AS) karın ağrısı nedeni ile başvuran hastalarda cerrahi (CNKA) ve cerrahi nedenli olmayan karın ağrılarının (CNOKA) karşılaştırılması amaçlanmıştır. Materyal ve Metod: Bu çalışma prospektif olarak CNKA ve CNOKA olan 200 hasta ile gerçekleştirildi. Hastaların demografik özellikleri, klinik prezantasyonları, laboratuvar analizleri, görüntüleme yöntemleri, konsültasyonlar ve hasta bakım maliyetleri incelenmiştir. Bulgular: Çalışma grubunun ortalama yaşı 50,8±20,1 yıl ve hastaların %52’sinin CNKA’sı olduğu tespit edildi. CNKA olgularda 75 yaş ve üzeri hastaların ilk sırada yer aldığı, fizik muayenede hassasiyet-defans ve rebound birlikteliği ve ortalama 15,27±4,10 bin/UL ile beyaz küre yüksekliği tespit edildi. AS doktorlarınca öykü ve fizik muayene ile değerlendirme sonrasında konulan ön tanıları ve laboratuvar bulguları ile radyolojik görüntüleme yöntemleri sonrasında konulan son tanıların uyum yüzdesinin 71,7 olduğu saptandı. CNKA’lı olgularda, yaşlı hastalarda ve konsültasyon istenenlerde AS kalış süresi ve maliyetin yüksek olduğu saptandı. Sonuç: AS’lere karın ağrısı ile başvuran hastalarda anamnez ve fizik muayene mutlaka yapılmalı, sürecin hızlandırılması ve maliyetlerin azaltılmasına yönelik olarak özellikle CNKA düşünülen hastalarda ileri görüntüleme yöntemleri erken dönemde istenmelidir. Ancak bu sonucu destekleyecek ilave çalışmalar yapılmasına ihtiyaç vardır.

Introduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up. Materials and Methods: This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017. The clinical research was planned as observational, multicenter, cross-sectional. Results: A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the "0" the worst probability "5" being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r: -0.488; p< 0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% Cl: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively. Conclusion: In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician's opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters.

Brain death is defined as the irreversible loss of brain function following various pathophysiological changes. In many countries, the brain death diagnosis is carried out in conjunction with organ transplant programs. In Turkey, at third level health institutions in particular, healthcare units established entities that follow similar procedures. The increased number of patients waiting for organs and donor discovery studies have enhanced the public’s interest in this topic. Since the emergency department is usually the first line in admitting patients, its staff must have the firsthand knowledge of managing brain death and organ donation process. In this article, we present three clinical cases that we followed and diagnosed with brain death in our emergency department. Due to the lack of studies addressing brain death procedures in the emergency service, we believe that this report will greatly contribute to our awareness and handling of brain death treatment.

Preparedness for bioterrorist attacks and early recognition of specific agents are essential for public health. Emergency departments may play an important role in this field. The large spectrum of bioterrorism involves not only disastrous terrorism with mass casualties, but also microevents using low technology but producing civil unrest, disruption, disease, disabilities, and death. It aims not only to cause mortality and morbidity, but also to lead to social and political disruption. Preparedness appears to be the most potent defense against possible bioterrorist events. In this article, we aim to create awareness against biological agents and underline the importance of emergency departments in this public health problem.