Search

INTRODUCTION: The aim of this study is to examine the story, clinical findings, initial computed tomography (CT) findings and reverse transcription-polymerase chain reaction (RT-PCR) results and evaluate the consistency of this data. METHODS: This is a multi-center retrospective study and out of patients aged 18 and over who were evaluated for COVID-19 in the emergency department between 01.04.2020 and 01.05.2020. Data regarding the patients such as age, gender, comorbidity, COVID-19 contact, symptoms, vital findings, laboratory parameters, CT findings, hospitalization status and case fatality rate (CFR) were examined. RESULTS: 62.4% of 687 patients were male, the mean age was 49.7.49.9% of patients had at least one comorbidity. The most common symptoms were fever (61.6%), cough (56.5%), dyspnea (33.2%). 33.9% of patients had RT-PCR positivity, 69.9% had CT positivity, and 72.5% had both RT-PCR and CT positivity. Sensitivity of CT was 72.5, its specificity was 31.5% and its accuracy was 45.5%. Most common CT pattern was pure GGO (47.9%). CFR was 6% and it was significantly higher in both RT-PCR and CT positive patients (p=0.01). According to logistic regression analysis, male gender (p=0.037;OR: 0.385;95% CI, 0.157-0.943), higher age (p=0.000;OR: 1.068;95% CI, 1.031-1.106) and comorbidity presence (p=0.008;OR: 5.374;95% CI, 1.539-7.618) were found to be associated with mortality. DISCUSSION AND CONCLUSION: In our study, we found that using RT-PCR and CT together and supporting them with clinical data was the strongest approach in the diagnosis of COVID-19 cases.

Rectus sheath hematoma (RSH) is one of the reasons for acute abdominal pain in patients using low-molecular-weight heparin. The diagnosis can be confused with other diseases or even can be missed if not brought to notice. RSH may be fatal in the case of misdiagnosis or delayed treatment. Therefore, these cases are specific for emergency medicine practices. Recent studies and case series about RSH were mostly published by general surgery clinics. Emergency department is the first place where patients with RSH visit. However, limited case reports from the emergency departments have been published. This study highlights the importance of diagnosis and proper management of rectus hematomas in emergency clinics in the light of the three presented cases.

BACKGROUND This study aimed to investigate the compliance between electroencephalogram monitoring (Bispectral Index, BIS) and Ramsay Sedation Scale (RSS) to measure the depth of sedation in patients who underwent procedural sedation and analgesia (PSA) in an emergency department. This study also aimed to investigate the usefulness of this compliance for early diagnosis of complications. METHODS A total of 54 consecutive patients during PSA in the emergency department were included in this study. The BIS and RSS scores at regular intervals and also all complications and interventions of these patients were evaluated. The compliance between the BIS and the RSS score was evaluated. The BIS scores of cases with complication and without complication were compared. RESULTS The BIS and RSS scores exhibited a high correlation was detected between the average BIS and RSS scores at each time interval (r=-0.989, p

Severe cardiac effects, including cardiac arrest, are a rare complication of high-dose propafenone intake. Among patients who experience cardiac arrest, the survival rate is low. This report presents the case of a young female patient who developed cardiac arrest linked to propafenone intake. While spontaneous circulation was restored with cardiopulmonary resuscitation, vital signs did not recover despite supportive treatment. However, after the administration of intravenous lipid emulsion (ILE), vital signs and cardiac functions resolved and the patient survived. This case is the second to describe the successful use of ILE for propafenone intoxication. However, as all of the findings of this patient were clearly linked to propafenone, we believe the benefits of ILE were more clearly defined in this case than in the other.