The impact of changes in cardiopulmonary resuscitation practices on survival in in-hospital cardiac arrest patients during the COVID-19 pandemic

The Covid-19 pandemic has caused changes in cardiopulmonary resuscitation applications as well as in all practices. In this research, we evaluated the effects of these changes on the management and outcomes of in-hospital cardiac arrest cases. Our study is a single-center, retrospective, observational study. It was conducted with 628 patients with in-hospital arrest who met the study criteria between January 1, 2018, and January 1, 2022. The cases were evaluated in two groups as pre-guideline period and post-guideline period interventions according to the cardiopulmonary resuscitation algorithm published on October 21. Study data were obtained from the hospital automation system, patient files, and clinical data. In the results of the study, the confidence interval was 95% and the statistical significance level was accepted as p [Med-Science 2023; 12(2.000): 352-6

A fatal rabies case and experiences of a mass post exposure prophylaxis among healthcare workers

NATe aimed to monitor the adverse effects (AE) and efficacy of post exposure prophylaxis (PEP) in health care workers (HCWs) exposed to a rabies patient. In this study 109 HCWs and eight household contacts were PEP candidates. Contact persons without infection control precautions were in Group I (high risk-82 cases). HCWs indirectly exposed to environmental surfaces were classified in Group 11 (low risk-35 cases). PEP schedule was rabies vaccine (RBV) + equine rabies immunoglobulin (eRIG) in Group I and only RBV in Group II. Local and systemic AE were observed in all cases. Efficacy of post exposure prophylaxis (PEP) was determined by rabies development in a six month follow-up. 585 doses of RBV have been used in 117 cases and eRIG has been used in 82 cases. 32 Nurses (39%); 22 emergency medicine technicians (26.8%); 12 doctors (14%); six laboratory technicians (0.07%); six radiology technicians (0.07%); four cleaners (0.05%) were in Group I (82 cases), respectively. One doctor, laboratory technician, nurse and radiology technician (0.02%); two emergency medicine technicians (0.04%) and nine cleaners (25.7%) were in Group II (35 cases), respectively. Routes of transmission were blood in five (0.06%); saliva in 14 (17%); sweat in 50 (61%); CSF/serum in five (0.06%); sexual intercourse in one (0.01%); personal equipment in seven (0.09%) in Group I, respectively. Indirect contact was the only route in Group II. The most common local and systemic AE were seen in Group I; pain at injection side (19 cases) and fever (13 cases). Both of them showed statistically significant difference (P<0.05). Allergic rash has been seen at only one case. PEP failed in one case where the possible exposure way was sexual intercourse. PEP is the safest way to prevent rabies. Infection control precautions were still not enough applied. eRIGs are also safe and have rare AE

The Analysis of Poisoning Cases Presented to the Emergency Department within a One-Year Period

SUMMARY: Objectives: Intoxication is the emergence of unwanted signs and symptoms in an organism after exposure to potentially harmful chemical, physical or organic materials. In our study, we evaluated demographic and etiological factors of adult patients admitted to the emergency department with suicidal or accidental poisoning. Methods: This study was conducted retrospectively by using data from the forensics books, protocol notebooks and patient files. Patients over the age of 14 years that were admitted to the Goztepe Training and Research Hospital during a 1-year period (September 2011-September 2012) with poisoning were included in the study. Results: A total of 430 patients were included in the study and 278 of those patients were females (64.7%). The male/female (F/M) ratio was 1.82/1 and the mean age of the patients was 27.4±11.75 years. The analyses showed that in 348 patients (80.93%) the cause of poisoning was medicine, in 39 patients (9.06%) alcohol and drugs, in 37 patients (8.6%) rat poison, in 4 patients (0.93%) a caustic substance and organophosphates in 2 patients (0.46%). The highest rate of admittance due to poisoning was seen in July, followed by August and September. When the frequency of admittance was evaluated in terms of seasons: summer had the highest frequency with 35.6%, then autumn with 29.1%, spring with 19.8% and winter with 15.6%. Conclusions: The results of our studies are similar to previously reported studies in Turkey. Poisoning cases are more common in women and the most common way of poisoning is by medication. Unlike previous reports from the literature, we found that poisoning was most frequent in the summer. ÖZET: Amaç: Zehirlenme potansiyel olarak zarar verebilen herhangi bir kimyasal, fiziksel veya organik maddeye maruziyet sonrası organizmada bazı istenmeyen belirti ve bulguların ortaya çıkmasıdır. Biz bu çalışmamızda intihar amaçlı veya kazara zehirlenme nedeniyle acil servisimize başvuran erişkin hastaların demografik ve etiyolojik faktörlerini araştırdık. Gereç ve Yöntem: Çalışma geriye dönük bir çalışma olup veriler adli defter, protokol defteri ve hasta dosyalarından elde edilmiştir. Bir yıllık süre içerisinde (Eylül 2011-Eylül 2012) Göztepe Eğitim ve Araştırma Hastanesi'ne zehirlenme ile başvuran 14 yaş üstü hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya toplam 430 hasta dahil edildi. Olguların 278'i kadın (%64.7), 152'si erkekti (%35.3). Kadın/erkek (K/E) oranı 1.82/1, yaş ortalaması 27.4±11.75 idi. Zehirlenme nedeni incelendiğinde; 348'inin (%80.93) ilaç, 39'unun (%9.06) alkol ve ilaç, 37'sinin (%8.6) fare zehiri, dördünün (%0.93) kostik madde, ikisinin (%0.46) organofosfat olduğu görüldü. En yüksek başvurunun sırasıyla temmuz, ağustos, eylül aylarında olduğu görüldü. Mevsimlere göre başvuru sıklığına bakıldığında %35.6 yaz, %29.1 sonbahar, %19.8 ilkbahar ve %15.6 kışın başvuru olduğu tespit edildi. Sonuç: Çalışmamızın sonuçları literatürde Türkiye'de daha önce yapılan çalışmalarla benzerlik göstermektedir. Zehirlenme olguları kadınlarda daha sık olup en sık ilaç alımı yolu ile olmaktadır. Literatürden farklı olarak en sık yaz mevsiminde zehirlenme tespit edildi. Key words: Emergency services, poisoning, suicide, Anahtar sözcükler: Acil servis, zehirlenme, intiha