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It’s known that head computed tomography (CT) is used excessively to exclude intracranial hemorrhage in patients with hepatic encephalopathy (HE) in the emergency department. However, the independent risk factors for abnormal head CT in patients with HE have not been studied extensively to date. In this retrospective study, patients with an ammonia level of >90 U/L who were clinically considered HE and had head CT were included. The characteristics of patients with abnormal head CT and independent risk factors for abnormal CT were investigated. Three hundred seventy-eight patients were included in the study. CT findings of 18 (4.8%) of the patients were abnormal: 12 had intracranial hemorrhage, 1 had an ischemic stroke, and 5 had an intracranial mass. Intracranial hemorrhage (odds ratio [OR] 12.5), history of recent trauma (OR 23.4), history of active malignancy (OR 10.3), thrombocyte count 1.5.

Aim: We aimed to determine the incidence of post-contrast acute kidney injury (PC-AKI), the demographic characteristics of patients, and the reasons that facilitate the development of PC-AKI in patients who were admitted to the emergency department and underwent computed tomography (CT) with intravascular contrast media. Material and Methods: This study is a retrospective, cross-sectional and analytical study. Patients over the age of 18 who underwent CT with intravascular contrast media and were hospitalized for at least 48 hours were included in this study. The development of PC-AKI and the clinical and demographic characteristics of the patients were evaluated.Results: A total of 816 patients were included in the study. Thirty-six (4.4%) patients developed PC-AKI. We found that the average length of hospital stay was 22.2 +/- 41.7 days. Patients with a history of hypertension (HT) and diabetes mellitus (DM) and who had hypotension on admission to the emergency department were found to have a higher risk of developing PC-AKI (p

Introduction Hypercapnic respiratory failure is defined as carbon dioxide (CO2) level >45 mmHg. High PaCO2 levels are related with increased mortality in acute exacerbation of COPD. In our study, we purposed to determine CO2 clearence value for predicting patients prognosis. Methods 68 patients were included in the study. Patients were divided in two groups according to outcome as good and bad prognosis group. Patients demographic information, comorbidities, vital parameters, on admission (first measurement) and in first sixth hour (second measurement) blood gas results, treatment given, and outcomes were saved to data form. Association between CO2 change and outcome was evaluated. Results There was no statistically significant difference in CO2 clearance and delta CO2 levels between the good and poor prognosis groups (11.7±12 vs 6.2 ± 23, p=0.205 and 11.8±12.9 mmHg vs -7.7±24.8 mmHg, p=0.281 respectively). NaHCO3 and pCO2 levels in second measurement was higher than first measurement in good prognosis group (23.9 ±5.3, 25.8±4.4, p

Background: Sepsis is a significant contributor of mortality all over the world. Emergency departments have a critical role for diagnosing a suspected sepsis in a patient, since early and proper administration of antibiotics may decrease mortality significantly. But, the unavailability of an objective and reliable diagnostic test is the major challenge of this critical issue. Aims: The aim of this study is to evaluate the prognostic value of a novel biomarker, the ischemia-modified albumin (IMA) in patients with sepsis and septic shock in emergency department. Subjects and Methods: This prospective, observational study included 81 patients with sepsis or septic shock and 75 controls. Sociodemographic characteristics of the patients, site of infection, IMA levels, other biomarkers (procalcitonin, pH, lactate), mortality at 24-h and 28-day were evaluated. Results: The serum IMA levels in patient and control groups were 117.8 +/- 85 IU/g and 115.8 +/- 134.0 IU/g, respectively (P = 0.072). There was a weak but statistically significant positive correlation between IMA and lactate levels (P = 0.009). The mortality rates of patient group at 24-h and 28 days were 21% and 79%, respectively, but serum IMA levels were not found to be a prognostic marker to predict mortality. Conclusion: The main reason for the similarity between groups regarding IMA levels was thought to be associated with the distribution of the acute and chronic health problems other than sepsis in the control group. Emergency department physicians should not only depend on serum IMA levels for predicting the prognosis of patients with sepsis or septic shock.

Chronic obstructive pulmonary disease (COPD) is an important public health problem that manifests with exacerbations and causes serious mortality and morbidity in both developed and developing countries. COPD exacerbations usually present to emergency departments, where these patients are diagnosed and treated. Therefore, the Emergency Medicine Association of Turkey and the Turkish Thoracic Society jointly wanted to implement a guideline that evaluates the management of COPD exacerbations according to the current literature and provides evidence-based recommendations. In the management of COPD exacerbations, we aim to support the decision-making process of clinicians dealing with these patients in the emergency setting.

Objective: The angle of the C-MAC D-Blade® videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. Methods: A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot® videolaryngoscope rigid stylet®; Group GEB, gum elastic bougie; and Group NS, no stylet. A manikin was used to simulate difficult intubation with a Storz C-MAC D-Blade® videolaryngoscope. The duration of each intubation stage was evaluated. Results: Participants in this study (33 anesthesiology residents and 20 anesthesiology experts) completed a total of 265 intubations. The number of attempts made using no stylet was significantly greater than those made for the other groups (p