Evaluation of the Burnout Levels of Health Care Workers During the Pandemic in Pediatric and Adult Emergency Services

Introduction:During the Coronavirus disease-2019 (COVID-19) pandemic, the emergency services provide seven days/24-hour regular health care, while the risk of burnout is gradually increasing among healthcare workers struggling with the increasing workload. Few studies monitored the mental health of doctors, nurses, and allied health personnel working in emergency departments to support frontline health workers and more data is needed.Methods:The Maslach burnout scale (MBI) was administered voluntarily to doctors, nurses, and allied health personnel in the pediatric emergency and adult emergency services in May 2020 and December 2020. A socio-demographic information form containing questions about the institution, profession, and working conditions was distributed. The socio-demographic data of the same participants on both dates were compared with the effects of the pandemic on their daily lives, working conditions, and subscales of MBI (emotional exhaustion, depersonalization, and personal achievement scores) with an interval of six months (May 2020-December 2020).Results:One hundred seventeen health personnel participated in our study in May 2020 and 122 in December 2020. 95.7% of respondents (112/117) in May 2020; in December 2020, 69.9% (84/122) of them met the criteria in two or more of the subscales of MBI (high emotional exhaustion and depersonalization scores, low personal achievement scores) and were found to be exhausted. In a six-month comparison, it was found that physicians, among physicians, pediatric assistants working in the pediatric emergency department, and healthcare workers aged 29 and younger were better able to cope with burnout.Conclusion:Considering the known harmful effects of burnout on patient care and the well-being of healthcare workers, frontline personnel in emergency services may need more mental support during and after the COVID-19 pandemic. There is a need for more preventive, descriptive, protective, and remedial studies on frontline health workers’ physical and mental health

A hypokalemic muscular weakness after licorice ingestion: a case report

A 21-year-old male presented to the emergency department with the complaint of muscle weakness. The patient had used a powderized over-the-counter product named 'Tekumut' for 2 weeks to quit smoking. The granulated product was studied and determined to contain 'licorice' containing glycyrrhizic acid

Tren Kazalarının 10 Yıllık Değerlendirilmesi

BACKGROUND Although less frequent than automobile accidents, train accidents have a major impact on victims' lives. METHODS Records of patients older than 16 years of age admitted to the Adult Emergency Department of Hacettepe University Medical Center due to train accidents were retrospectively evaluated. RESULTS 44 patients (30 males, 14 females) with a mean age of 31.8 +/- 11.4 years were included in the study. The majority of the accidents occurred during commuting hours. 37 patients were discharged, 22 of them from the emergency department. The mortality rate was 7/44 (16%). Overall mean Revised Trauma Score (RTS) was 10.5 (3 in deaths and 11.9 in survivors). In 5 patients, the cause of death was pelvic trauma leading to major vascular injury and lower limb amputation. In 1 patient, thorax and abdomen trauma and in 1 patient head injury were the causes of mortality. Primary risk factors for mortality were alcohol intoxication (100%), cardiopulmonary resuscitation on admittance (100%), recurrent suicide attempt (75%), presence of psychiatric illness (60%), and low RTS. CONCLUSION In this study, most train accidents causing minor injuries were due to falling from the train prior to acceleration. Nevertheless, train accidents led to a mortality rate of 16% and morbidity rate of 37%. These findings draw attention to the importance of developing preventive strategies

The acute effect of systemic blood pressure reduction on intraocular pressure in hypertensive patients

OBJECTIVES: Previous studies have shown an association between systemic hypertension and intraocular pressure (IOP). We analyzed the relationship between the decreases of the blood pressure (BP) and IOP in hypertensive patients. METHODS: The study includes a total of 214 patients: 158 hypertensive and 56 normotensive patients as study and control groups, respectively. The IOP of each eye in both the groups was measured once with a noncontact tonometer at presentation and an hour after BP reduction to normal in the study group. We analyzed the reduction in IOP with decreasing BP. RESULTS: In the study group, the mean IOP was 15.29 ± 4.05 mmHg in the right and 15.11 ± 3.78 mmHg in the left eyes. The mean IOP measured an hour after the patients became normotensive was 13.78 ± 4.06 mmHg in the right and 13.51 ± 3.82 in the left eyes. There was a statistically significant decrease in the IOPs (P < 0.001). The mean IOP in the control group was 13.54 ± 3.51 mmHg in the right and 13.20 ± 3.33 mmHg in the left eyes. The mean IOP at presentation in the study and control groups was found to be significantly different (P < 0.001). CONCLUSIONS: Patients in the study group showed a significantly higher IOP compared to patients in the normotensive group. Furthermore, patients in the study group showed a significant reduction in IOP after BP reduction. This may indicate that uncontrolled hypertension poses a risk for prolonged higher IOP. Prolonged higher IOP can be considered a risk factor for the glaucoma

Evaluation of Blood Product Requests in the Emergency Department: A Prospective Observational Study

Objective: Emergency department (ED) blood product requests are rising, but it is unclear if they are excessive. We aimed to examine the blood product requests and usage rates made by emergency physicians to determine whether the requests for blood products are excessive. Material and Method: This prospective, observational, and single-center study analyzed demographic data indications for blood transfusion, and transfusion rates of patients aged 18 years and older admitted to a tertiary adult emergency department in five months. Results: One thousand four hundred seventy-five blood product requests (with a mean of 6.92 units per patient) were examined. Of 63.1%, these requests were not used. The transfusion rates were 40.89 % for erythrocyte suspension, 25.61% for thrombocyte suspension, and 44.34% for fresh frozen plasma. The main indications for requesting blood products were gastrointestinal bleeding and anemia. Specifically, 30.04% of erythrocyte suspensions, 31.9% of thrombocyte suspensions, and 60.56% of fresh frozen plasma were used for patients with gastrointestinal bleeding. In trauma patients, 12.75% of requested erythrocyte suspensions, 0.083% of thrombocyte suspensions, and 13.89% of fresh frozen plasma were utilized. Conclusion: Excessive requests for blood products in the emergency department can misuse resources. The transfusion committee should develop specialized strategies and increase physician awareness to reduce unnecessary requests and optimize resource utilization

Accuracy of Fever Perception and Estimation of Fever By Touching

Objective: Fever is one of the most common causes of hospital admissions. In presence of fever, a number of laboratory tests, radiological imaging and treatment are considered. The aim of this study is to investigate the accuracy of subjective fever perception and estimation of fever by touching by the health personnel. Material and Methods: Sixteen years and above patients with or without fever who were admitted to Hacettepe University Medical Faculty Emergency Department whose fever was not measured with a termometer before coming to hospital were included in the study between February 1, 2010 and April 30, 2010. The study was double blind and prospective. Results: A total of 390 patients, 213 (55%) with fever and 177 (45%) without fever participated in the study. Of subjective fever perception of patients, sensitivity was 88%, selectivity was 51%, positive predictive value (PPV) was 68%, negative predictive value (NPV) was 78%, accuracy was 71%. For accurate estimation of fever with 0.5 degrees C of difference by touching, sensitivity was 85%, selectivity was 91%, PPV was 92%, NPV was 84% for specialists; sensitivity was 87%, selectivity was 92%, PPV was 93%, NPV was 86% for nurses; sensitivity was 84%, selectivity was 90%, PPV was 91%, NPV was 82% for resident doctors; sensitivity was 80%, selectivity was 91%, PPV was 91%, NPV was 79% for interns. Ratio of accurate estimation of fever was 89% for nurses, 88% for specialists, 87% for resident doctors, 85% for interns, and there was not a significant difference between them (p=0.356). Conclusion: Because of high PPV and NPV values, both subjective perception of the patient and estimation of fever by touching by health personnel may be taken into consideration for decision of diagnosis and treatment initiation when a termometer cannot be used, for example in case of infections and rheumatic diseases involving skin and joints.WoSScopu

NEDOCS: is it really useful for detecting emergency department overcrowding today?

The Emergency Department (ED) overcrowding is an ongoing problem all over the world. The scoring systems are available for the detection of this problem. This study aims to test the applicability of the National Emergency Department Overcrowding Study (NEDOCS) scoring system, one of the scoring systems that evaluate the ED overcrowding. In this prospective observational study, the survey was applied on on-duty doctors, nurses, paramedics, intern doctors, and ward persons working in a University Adult Emergency Department and agreed to participate in the study, between certain hours during the day and the NEDOCS score was calculated simultaneously. The demographic characteristics of the on-duty staff, overcrowding of ED, and the number of the on-duty staff members were recorded in the questionnaires. During the study, 153 measurements were performed, and 3221 questionnaires were filled. The NEDOCS mean score was determined as 101.59 and the most reached result was extremely busy but not overcrowded (32%). The ED was rated mostly as busy (33.7%) by the on-duty staff. A significant difference was found between ED overcrowding and NEDOCS score. There is a significant difference between ED overcrowding and on-duty emergency nurse and intern doctor count. The NEDOCS score is not suitable for evaluating ED overcrowding. Accurate determination of the ED overcrowding is very important to avoid the negative consequences of the ED overcrowding. Increasing emergency nurse and intern doctor count will decrease ED overcrowding. Also, there is an urgent need to constitute local hospitals and also public health policies to satisfy the increasingly ED's presentations.WOS:0005575114000092-s2.0-85088052251PubMed: 3266405