Evaluation of Emergency Interhospital Patient Transfers from Province of Mardin to Out-of-Province Hospitals in a Year

Abstract Objective: This study aimed to assess patients who were transferred from emergency services throughout the province of Mardin to out-of-province hospitals by ambulance in a year. Material and Methods: In this study, all patients transferred from emergency services in the province of Mardin to out-of-province hospitals via ambulances by the Patient Referral Assessment Committee, founded under the Provincial Directorate of Health, between the dates of December 31, 2010 and December 31, 2011 were evaluated retrospectively. No exclusion criteria were used. Patients were grouped and analyzed according to their demographic characteristics, transport properties, and reasons for referral. Results: The total number of the patients included in the study was 1518 (55.8% males, 41±27 mean age). Of all, 621 patients (40.9%) were transferred from the center of Mardin province, and the other patients were transferred from 8 district hospitals and two private hospitals. It was found that the patients were transferred to 37 hospitals in 8 provinces, and a total of 562 patients (37%) were transferred to private hospitals. Cardiology (23.3%), pediatrics (11.5%), and obstetrics and gynecology (8.8%) departments were the first three clinics that patients were transferred to frequently, respectively. In total, 274 patients (18.1%) were transferred inappropriately. There was a statistically significant difference between patients' transfer hospitals (state hospital/private hospital) and the age of the patients (younger than 18 years/18 years or older) (p<0.001). In addition, the rate of adult patients' transfers to tertiary healthcare centers was significantly higher (p<0.001). Conclusion: In Mardin, cardiology, pediatrics and obstetrics and gynecology patients are the most common group of emergency patients transferred by 112 ambulances to out-of-province hospitals. Approximately 40% of the patients were transferred to private hospitals. Inappropriate patient transfers seem to be a major problem in this study, as in other studies conducted in Turkey. (JAEM 2014; 13: 62-6

Assessment of the knowledge level of police officers before and after first aid education in Denizli

Ülkemizde trafik kazaları, ölüm nedenlerinin başında gelmektedir. Trafik kazaları sonucunda her yıl yaklaşık dört bin kişi kaybedilmektedir. Bilinçli bir ilk yardımla bu ölüm oranları %20 kadar azaltılabilir. Bu çalışmamızda, olay yerine ilk ulaşan birimlerden olan polislerin ilk yardım bilgi düzeylerini tespit etmeyi amaçladık. Bu çalışmaya Denizli il merkezinde görev yapan 85 polis alındı. Katılımcılara eğitim öncesi bilgi düzeylerini ölçmek için 18 soruluk çoktan seçmeli bir test yapıldı. Verilen teorik ve pratik eğitim sonrası aynı soruların tekrar cevaplandırılması istendi. Eğitim öncesi ve sonrası bilgi düzeyleri karşılaştırıldı. Katılımcıların eğitim öncesinde genel olarak soru gruplarının hemen hepsinde önemli derecede eksikliklerinin olduğu, eğitim sonrasında ise bilgi düzeylerinde eğitim öncesine göre anlamlı oranda artışının olduğu tespit edildi (p<0.001). Çalışmamızda, 40 ve üstü yaş grubunun diğer yaş gruplarına göre eğitim sonrasında eğitim öncesine göre daha başarılı oldukları gözlendi (p=0.005). Cinsiyet, çalışma yılı ve daha önce ilk yardım eğitimi alıp almamasına göre polislerin eğitim öncesi ve sonrasındaki bilgi düzeylerinde anlamlı bir fark tespit edilmedi (sırasıyla p=0.067, p=0.061, p=0.609). Bilinçsiz hastaya yaklaşım, solunum, dolaşım, havayolu, boğulma, kırık çıkık ile ilgili sorularda da eğitim öncesi ve sonrasında anlamlı fark tespit edildi (tümünde p<0.001). Polislerin olay yerine ilk ulaşan ekiplerden olması nedeniyle ilk yardım eğitimleri ciddi bir şekilde organize edilmelidir. Polislerin ilk yardım konusundaki bilgi ve becerileri hizmet içi eğitim programlarıyla geliştirilmeli, eğitim sonrasında belirli periyotlarla bilgilerin güncel tutulması sağlanmalıdır.Traffic accidents are one of the leading cause of death in our country. Every year four thousand people die in traffic accidents. With adequate first aid death rates can be reduced up to % 20. In this study we aimed to identify the level of knowledge of first aid for police officers, who reach primarily to the scene. 85 police officers who work in Denizli included for his study. Participants tested with a test formed 18 multiple choice questions to measure level of knowledge. After theorical and practical education participants asked to answer same questions. The knowledge levels, before and after education are compared. Almost in all questions, participants had severe lack of knowledge but after education there is significant increase in level of knowledge (p<0.001). In our study, 40 and over age group was more succesful after education than other groups (p=0.005). There were no significant difference determined in levels of knowledge before and after education based on gender, working year and first aid training before (respectively; p=0.067, p=0.061, p=0.069). There were no significant difference on approach to the unconcious patient, airway and breathing, circulation, choking, fractures and dislocations after education (p<0.001) First aid education of police officers have to be organized severely due to they are one of the team that first reaches. First aid knowledge and skills of police officers have to be developed by service training programs and should be kept up to date in specific periods after training