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Aim: In the last decade, news regarding violence of the 112 emergency service staff that is frequently revealed in visual and written media in our country has increased. In this study, we investigated the characteristics that led to the incidence of violence against the 112 emergency service staff, the extent to which these events have been reported by staff, and the work satisfaction of staff. Materials and Methods: Data regarding face-to-face interviews with all staff on duty across the city were obtained. Staff who suffered verbal and physical violence in the last year and during their work period were examnined. Staff who did not wish to participate in the study, who served in the 112 emergency service for less than one year, and who were on an annual leave or leave without pay during the study were excluded. Results: One hundred and forty-one eligible staff participated in this study. Of the total participants, 73\% (n= 103) were emergency medical technicians and paramedics. The average work period in the 112 emergency medical services was 4.9 +/- 2.8 (min: 1, max: 23) years. The staff's exposure to verbal and physical violence over the last year was 51.8\% (n = 73) and 8.5\% (n = 12), respectively. Rates increased by 77.3\% (n = 109) and 24.8\% (n = 35), respectively, when investigation was conducted in the absence of time limitation. Of the total participants, 85.1\% (n = 120) were found to not formally report the attacks. A large percentage (95.2\%) of reported incidents involved physical violence. Finally, the participants levels of work satisfaction in the 112 emergency service was high (90.8\%, n = 128). Conclusion: Violence against the 112 emergency service staff is greater than estimated because there were not sufficiently reported. Trainings must be organized for staff working in prehospital medical care regarding how to protect and cope from violence.

Pain management is one of the essentials of emergency care. Renal colic secondary to urinary stone disease forms one of the most intense pain types. The present study aimed to compare the effect of intravenous ibuprofen to paracetamol in ceasing renal colic. This randomised double-blind study was composed of two intervention arms, intravenous paracetamol and intravenous ibuprofen. Study subjects were randomised to receive a single dose of either paracetamol, 1 g in 100 ml normal saline, or ibuprofen (800 mg in 100 ml normal saline) in a blinded fashion. Subjects reported pain intensity on a visual analogue scale with lines intersection multiples of ten just before the drug administration, 15 and 30 min after the study drug administration. Two hundred patients were randomised to either of two study arms: however, 97 patients in ibuprofen group and 99 patients in paracetamol groups were included into 30 minute analysis. Differences of pain improvements between two groups was 9.5 (5.4–13.7) at 15 min (p = 0.000) and 17.1 (11.9–22.5) at 30 min, those both favouring ibuprofen over paracetamol (p = 0.000). Although ten (10.1%) patients in paracetamol group needed rescue drug, there were only two (2%) patients in ibuprofen group (difference: 8%; 95% CI 0.7–16%, p = 0.02). Intravenous 800 mg ibuprofen is more effective than IV paracetamol in ceasing renal colic at 30 min. © 2017, Springer-Verlag GmbH Germany.

Study objective The objective of this study was to determine the analgesic efficacy and safety of intravenous, single-dose paracetamol versus dexketoprofen versus morphine in patients presenting with mechanical low back pain (LBP) to the emergency department (ED). Methods This randomised double-blind study compared the efficacy of intravenous 1 gm paracetamol, 50 mg dexketoprofen and 0.1 mg/kg morphine in patients with acute mechanical LBP. Visual analogue scale (VAS) was used for pain measurement at baseline, after 15 and after 30 min. Results A total of 874 patients were eligible for the study, and 137 of them were included in the final analysis: 46 patients from the paracetamol group, 46 patients in the dexketoprofen group and 45 patients in the morphine group. The mean age of study subjects was 31.5±9.5 years, and 60.6% (n=83) of them were men. The median reduction in VAS score at the 30th minute for the paracetamol group was 65 mm (95% CI 58 to 72), 67 mm (95% CI 60 to 73) for the morphine group and 58 mm (95% CI 50 to 64) for the dexketoprophen group. Although morphine was not superior to paracetamol at 30 min (difference: 3.8±4.9 (95% CI -6 to 14), the difference between morphine and dexketoprofen in reducing pain was 11.2±4.7 (95% CI 2 to 21). At least one adverse effect occurred in 8.7% (n=4) of the cases in the paracetamol group, 15.5% (n=7) of the morphine group, and 8.7% (n=4) of the dexketoprophen group (p=0.482). Conclusions Intravenous paracetamol, dexketoprofen and morphine are not superior to each other for the treatment of mechanical LBP in ED.

BACKGROUND This study was conducted as a survey including work-related injuries (WRI) of workers in the textile and clothing industry admitted to the emergency department (ED). METHODS This prospective study included patients with WRI reportedly occurring in the textile and clothing industry over a two-year period. The study sample comprised only the casualties occurring at the workplace and while working de facto. RESULTS A total of 374 patients were eligible for the study. More than three-fourths of the study sample were females (76.2\%, n=285). A significant proportion of the patients were between 14 and 24 years of age (44.7\%, n=167). Approximately two-thirds reported that this was their first admission to a hospital related to WRI (65.8\%, n=246). WRIs occurred most frequently between 07:00-09:00 (27.3\%) and 23:00-01:00 (17.9\%). ``Carelessness{''} and ``rushing{''} were the most commonly reported causes of WRIs from the patients' perspective (40.6\% and 21.4\%, respectively). Three-fourths of the patients reported that they were using protective equipment (74.3\%, n=278). With respect to injury types, laceration/puncture/ amputation/avulsion injuries accounted for 55.6\% (n=208) of the sample. Trauma to the upper extremities was the main type of injury in 75.1\% (n=281) of the cases. CONCLUSION Broad population-based studies are needed to define the situation as a whole in WRIs in the textile and clothing industry in the country. Strict measures should be undertaken and revised accordingly to prevent WRIs in these growing sectors.

Objective To determine the analgesic efficacy and safety of intravenous single-dose paracetamol versus morphine in patients presenting to the emergency department with renal colic. Methods A randomised double-blind study was performed to compare the efficacy of intravenous paracetamol (1 g) and 0.1 mg/kg morphine in patients with renal colic. The efficacy of the study drugs was measured by a visual analogue scale and a verbal rating scale at baseline and after 15 and 30 min. The adverse effects and need for rescue medication (1 μg/kg intravenous fentanyl) were also recorded at the end of the study. Results 133 patients were eligible for enrolment in the study, with 73 patients included in the final analysis (38 in the paracetamol group and 35 in the morphine group). The mean±SD age of the subjects was 30.2±8.6 years and 51 (70%) were men. The mean reduction in scores at 30 min after study drug administration was 63.7 mm (95% CI 57 to 71) for paracetamol and 56.6 mm (95% CI 48 to 65) for morphine. The difference between pain reduction scores for the two groups at 30 min was 7.1 mm (95% CI −18 to 4), demonstrating no statistical or clinical significance. Two adverse events (5.3%) were recorded in the paracetamol group and five (14.3%) in the morphine group (difference 9%, 95% CI −7% to 26%). Conclusion Intravenous paracetamol is effective in treating patients presenting with renal colic to the emergency department. Clinical trials registration no ClinicalTrials.gov ID number NCT01318187.

Objective Migraine is a common form of headache that is a major burden for patients who often seek emergency care. The goal of this study was to compare the effectiveness of intravenous non-steroidal anti-inflammatory medication (dexketoprofen) with paracetamol (acetaminophen) in the treatment of an acute migraine attack. Materials and methods This prospective, randomised, double blind, controlled study was conducted in a tertiary care emergency unit. Study patients were randomised into two groups to receive either 50 mg of dexketoprofen trometamol or 1000 mg of paracetamol intravenously by rapid infusion in 150 mL of normal saline. Pain reduction was measured at baseline, and after 15 and 30 min, using a Visual Analogue Scale (VAS)) as the primary outcome. VAS is a measurement tool ranging from 0 (no pain) to 100 mm (worst pain). Results 200 patients were included in the final analysis. Mean (SD) age of the study subjects was 30.1±11 years and 81% (n=162) were women. Median reduction in VAS score at 30 min was 56 (IQR 30–78.5) for the paracetamol group and 55 (IQR 34–75) for the dexketoprofen group, with a difference of 1 mm (95% CI −7 to 10) between the two groups. Conclusions Intravenous paracetamol and dexketoprofen appear to produce equivalent pain relief for migraine in the emergency department. ClinicalTrials.gov No NCT01730326.

Self-mutilation is a general term for a variety of forms of intentional self-harm without the wish to die. Although there have been many reports of self-mutilation injuries in the literature, none have reported self-cannibalism after self-mutilation. In this article we present a patient with self-cannibalism following self-mutilation. A 34-year-old male patient was brought to the emergency department from the prison with a laceration on the right leg. Physical examination revealed a well-demarcated rectangular soft tissue defect on his right thigh. The prison authorities stated that the prisoner had cut his thigh with a knife and had eaten the flesh. [West J Emerg Med. 2014;15(6):-0]

Introduction: Noromyelitis optica is an acute demyelination illness that is rarely seen. In this study a patient who came to the emergency service having a complaint of sudden loss of vision is introduced with an account of investigations, Noromyelitis Optica (NMO) was diagnosed., Case Report: The 38-year-old woman patient sometimes had a complaint of not seeing clearly for a week and applied to our emergency service with the symptom of loss of vision. In the emergency service, we initially carried out cranial computed tomography scanning. There were no pathological results. It was suspected that the patient has optical neuritis, but in her history, there was no reported use of toxical matter or medicine. The results of a cranial magnetic resonance survey revealed some hyperintense lesions (demyelination areas), predominantly on the T2 segment around the optic chiasma and optic nerves., Conclusion: Thus, even in rare cases, emergency service doctors must take demyelination illnesses such as multiple sclerosis (MS) or NMO into consideration in the differential diagnosis of acute loss of vision.

Objective: Patients for whom emergency department physicians in a University Training and Research Hospital asked for plastic surgery consultation were evaluated retrospectively., Material and Methods: Data files were reviewed for patients who were admitted for trauma and for whom a plastic surgery consultation was requested over a four year period (January 2007-January 2011)., Results: It was determined in the study group that the majority of cases were male patients (70.8%, n=807). Injuries from piercing-cutting objects were found to be the most common; this was followed by work and traffic accidents, respectively. Consultation was often requested between 20: 00 and 24: 00 (n=495, 43.4%). When the injury regions were examined, the region that was most commonly injured was identified to be the upper extremity (n=849, 74.5%). This was followed by the head and neck region (n=236, 20.7%), lower extremities (n=39, 3.4%) and the body (n=16, 1.4%). It was found that consultations were often carried out for tendon injuries caused by piercing-cutting objects in the upper extremity, and cases were mainly from the paediatric age group in consultations requested due to facial injuries., Conclusion: The team in the emergency department should be composed of people with specialised training in the field of emergency medicine or receiving this training. Aleviating the concerns of a family may reduce improper consultation requests.

The spleen is an organ that often ruptures after blunt abdominal trauma. Unlike traumatic splenic rupture, spontaneous (atraumatic) splenic rupture is a rare and life- threatening condition. In the present study, a case who was admitted to the emergency depertment with complaints of abdominal pain, nausea and vomiting was diagnosed as spontaneous rupture of spleen. This case is dicussed in light of the literature.

Electrical injury can cause cardiac problems and various electrocardiographic (ECG) changes. It has been suggested that an electrical current may permanently damage the cardiac conduction tissue and predispose to late dysrhythmia. Less serious transient ECG changes have also been described after electrical injury, such as ST segment elevation. Electrical injuries can cause delayed cardiac problems. In the emergency department, a patient who has chest pain and ECG changes should be investigated through his history about any previous electrical injury, so that we can differentiate myocardial infarction and other cardiac problems mimicking it.

In our country, linseed and oil are used for a number of different medical purposes (constipation, high cholesterol, menopause, etc.). In recent years, there have been reports of a feeling of fullness associated with increasing use among those who diet. In this case report, severe allergic reaction after chewing linseed is discussed.

Objective: In this study, we aimed to identify the properties of patients who visited the emergency department and left of their own accord., Material and Methods: Patients who visited the emergency department and left by their own choice for any reason were evaluated retrospectively., Results: In this study, 1140 patients (57.7% male) were enrolled with a mean age of 40.5 +/- 14.9 years. Patients were admitted due to poisoning, abdominal pain and chest pain at rates of 23.2%, 16.4% and 15.1% respectively. It was found that 673 patients (59.0%) left because of being denied medical observation or treatment, and 215 patients (18.9%) left because of consultants running late., Conclusion: Necessary arrangements must be put in place to reduce the number of patients who leave the emergency department by choice, prior to being discharged by a clinician.

Abdominal pain accompanied with diarrhea may be seen in a simple gastroenteritis, as well as necrosis during mesenteric ischemia and the acute appendicitis cases, such as to require emergency surgery. In this article, a retrocecal appendicitis case admitted to the emergency department with diarrhea was presented and, diagnostic methods are discussed in light of the current literature.

BACKGROUND: Domestic accidents (DA) are preventable and untoward events occurring in a house, pool or garage. Those events constitute a major issue in the context of public health. The objective of this study was to highlight the characteristics of female involvement in DA and their level of knowledge regarding first aid. METHODS: Adult female relatives of patients presenting at the university-based emergency department within the six-month study period comprised the study sample. They were asked to answer a 23-item self-reported questionnaire, and the responses were analyzed. RESULTS: A total of 1017 women (mean age: 29.2±11.1 years) were enrolled in the study. Hand lacerations (n=924, 90.8%), sprain and contusions (n=904, 88.8%) and burns (n=803, 78.9%) were the most commonly reported types of DA. The children were reported to suffer mostly from hits, sprains and contusions (n=478, 91.7%), followed by falls and slipping (n=452, 86.7%). The telephone number of emergency medical services was recalled most frequently (n=871, 85.6%), while that of the poison control center was known least commonly (n=48, 4.7%). The group with the highest level of education had a significantly higher mean number of correct answers than that of the group with the lowest level of education (p=0.001). The knowledge level of the women who worked was significantly lower than that of the unemployed women (p=0.02). CONCLUSION: Extensive training of women on DA should be undertaken and the mass media should be utilized to achieve this goal. Language: tr