The efficacy and application of tranexamic acid in emergency medicine: Emergency Medicine Association of Türkiye clinical policy- 2024.

The clinical policy of the Emergency Medicine Association of Türkiye (EMAT) provides guidance on the use of tranexamic acid (TXA) in emergency settings. TXA, an antifibrinolytic drug, is used to control bleeding by inhibiting plasminogen. Its applications have expanded from hemophilia and severe menstrual bleeding to include various forms of trauma and surgery-related bleeding.

The utility of heart-type free fatty-acid binding-protein (HFABP) levels for differentiating acute ischemic stroke from stroke mimics.

Background: Heart-type fatty acid-binding protein (HFABP) is found in the myocardium, brain, and some organs and is rapidly released from damaged cells into the circulation in case of ischemia.

Aims: We aimed to determine the diagnostic utility of HFABP levels in patients suggesting acute ischemic stroke (AIS).

Methods: This study was a prospective, single-center, observational diagnostic accuracy study with a nested cohort design.

Prediction of nipple involvement in breast cancer after neoadjuvant chemotherapy: Should we rely on breast MRI to preserve the nipple?

Background: Indications for nipple sparing mastectomy (NSM) is extending to post-neoadjuvant chemotherapy (NAC) setting. Eligibility for NSM with an optimum tumor-nipple distance (TND) after NAC is unclear. We examined predictive factors for nipple tumor involvement in patients undergoing total mastectomy following NAC.

Emergency Medicine Association of Turkey Disaster Committee Summary of Field Observations of February 6th Kahramanmaraş Earthquakes.

An earthquake measuring 7.7 magnitude on the Richter scale occurred at 04:17am on February 6, 2023 in the Pazarcık district of Kahramanmaraş province Turkey. In the hours following the 7.

User's guide to sample size estimation in diagnostic accuracy studies.

Sample size estimation is an overlooked concept and rarely reported in diagnostic accuracy studies, primarily because of the lack of information of clinical researchers on when and how they should estimate sample size. In this review, readers will find sample size estimation procedures for diagnostic tests with dichotomized outcomes, explained by clinically relevant examples in detail. We hope, with the help of practical tables and a free online calculator (https://turkjemergmed.

2021 Guideline for the Management of COPD Exacerbations: Emergency Medicine Association of Turkey (EMAT) / Turkish Thoracic Society (TTS) Clinical Practice Guideline Task Force.

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.

Perfusion index: Could this be a new triage tool for upper gastrointestinal system bleeding in the emergency department? A prospective cohort study.

Background: Many scoring systems for predicting mortality, rebleeding and transfusion needs among patients with upper gastrointestinal bleeding (UGIB) have been developed. However, no scoring system can predict all these outcomes.

Objective: To show whether the perfusion index (PI), compared with the Rockall score (RS), helps predict transfusion needs and prognoses among patients presenting with UGIB in emergency departments.

An analysis of 1344 consecutive acute intoxication cases admitted to an academic emergency medicine department in Turkey.

Objective: One of the major causes of emergency department (ED) visits is acute poisoning. Acute intoxications occur soon after either single or multiple exposures to toxic substances, and they started to be a more serious problem in developing countries. The objective of this study was to investigate the local patterns of acute intoxications, as well as clinical and sociodemographic characteristics of patients with acute poisoning, admitted to our hospital's ED.

The middle cerebral artery density and ratio for the diagnosis of acute ischaemic stroke in the Emergency Department.

Purpose: Non-contrast computed tomography (ncCT) is the first-line imaging modality for acute ischaemic stroke diagnosis. Recognition of the early diagnostic signs of a stroke on computed tomography (CT) is crucial. The hyperdense middle cerebral artery (MCA) sign is one of these findings.

Association of acute phase reactants with prognostic scores in community acquired pneumonia.

Objective: To investigate the association of C-reactive protein and procalcitonin with commonly used prognostic scoring systems, hospitalisation and mortality in cases of community-acquired pneumonia.

Methods: The prospective study was conducted from April 2014 to April 2015 at the emergency department of Marmara University Pendik Research and Training Hospital, Turkey, and comprised community-acquired pneumonia patients diagnosed according to the British Thoracic Society criteria. Prognosis was estimated using confusion, urea, respiratory rate, blood pressure and age >65, Pneumonia Severity Index-Pneumonia Patient Outcome Research Team score, and severe community-acquired pneumonia scores.

Diagnostic Accuracy of the Electrocardiography Criteria for Left Ventricular Hypertrophy (Cornell Voltage Criteria, Sokolow-Lyon Index, Romhilt-Estes, and Peguero-Lo Presti Criteria) Compared to Transthoracic Echocardiography.

Objective/aim: We aimed to evaluate the diagnostic utility of the widely used left ventricular hypertrophy (LVH) electrocardiography (ECG) criteria (Cornell Voltage Criteria [CVC], Sokolow-Lyon Index [SLI], Romhilt-Estes [REC], and Peguero-Lo Presti [PLP] Criteria) compared with the left ventricular mass measured by echocardiography.

Methods: In this prospective diagnostic accuracy study, we screened all consecutive adults (18 to 65 years) who presented to our academic emergency department (ED) with increased blood pressure (≥130/85 mmHg) between January 2016 and January 2017, and we enrolled a convenience sample of 165 patients in our study. The attending emergency physician managed all patients as per their primary complaint.

Variables Affecting Mortality Among COVID-19 Patients With Lung Involvement Admitted to the Emergency Department.

Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome.

Methods: In this retrospective chart review, we screened patients admitted to the emergency department with severe acute respiratory infection due to coronavirus disease 2019 (COVID-19) between March 15, 2020 and April 30, 2020.

Isopropyl alcohol nasal inhalation for nausea in the triage of an adult emergency department.

Objectives: Nausea and vomiting (N&V) are among the most common complaints in the emergency department (ED). However, low acuity is assigned to most of these patients at the triage, and waiting for long hours without medication decreases patient safety and satisfaction. We aimed to compare the inhalation of isopropyl alcohol (IPA) with placebo (P) to treat nausea at the triage area of an ED.

The Diagnostic Accuracy of Ultrasonography for the Diagnosis of Rib Fractures in Patients Presenting to Emergency Department With Blunt Chest Trauma.

Background: Rib fractures are the most common complications of blunt chest trauma (BCT). Computed tomography (CT) is the modality of choice for BCT, but with several disadvantages. Ultrasonography (US) is an inexpensive, readily available, and relatively harmless imaging alternative.

Treatment of carbon monoxide poisoning: high-flow nasal cannula versus non-rebreather face mask.

Objective: In this study, the aim was to compare the rate of decrease in carboxyhemoglobin (COHb) values at consecutive time points and calculate the half-life of COHb (COHb ½) in patients admitted to the emergency department (ED) with carbon monoxide (CO) poisoning and treated with either high flow nasal cannula oxygen therapy (HFNC) or non-rebreather face mask (NRFM).

Methods: This retrospective, cohort study with historical controls was performed over a 2-year period and included adult patients with CO poisoning, whose COHb values were checked. The HFNC group consisted of patients admitted to the ED with CO poisoning when HFNC was available in the hospital, while the NRFM group consisted of patients who presented to the ED with CO poisoning before the availability of HFNC.

Initial and Sustained Response Effects of 3 Vagal Maneuvers in Supraventricular Tachycardia: A Randomized, Clinical Trial.

Background: For acute termination of supraventricular tachycardia (SVT), vagal maneuvers, including the standard Valsalva maneuver (sVM), modified Valsalva (mVM) maneuver, and carotid sinus massage (CSM), are first-line interventions. There is no criterion standard technique.

Objective: This prospective, randomized study was aimed at analyzing the success rates of these 3 vagal maneuvers as measured by sustaining sinus rhythm at the fifth minute and SVT termination.

User's guide to correlation coefficients.

When writing a manuscript, we often use words such as perfect, strong, good or weak to name the strength of the relationship between variables. However, it is unclear where a good relationship turns into a strong one. The same strength of r is named differently by several researchers.

Prognostic value of 2-hour lactate level and lactate clearance for 30-day mortality and comparison with trauma scores in multi-trauma patients.

Objective: Trauma scores are prone to misreading. Therefore, a readily available, objective way to estimate the mortality of the trauma patients is needed. We aimed to evaluate the prognostic utility of lactate levels, and clearance for 30-days mortality, and compare with the physiological trauma scores.

Initial inferior vena cava and aorta diameter parameters measured by ultrasonography or computed tomography does not correlate with vital signs, hemorrhage or shock markers in trauma patients.

Background: Ultrasonography (US) is noninvasive, readily available, and cheap. The diameter of inferior vena cava (dIVC) and its respiratory variation were proposed as a good surrogate of the hemodynamic state. However, recent studies have shown conflicting results, and the value of IVC-derived parameters in the estimation of fluid status and hemorrhage remains unclear.

Which is more effective for the treatment of Acute Migraine Attack: Dexketoprofen, Ibuprofen or Metoclopramide?

Objective: The aim of this study was head-to-head comparison of the efficacy and rate of adverse events of metoclopramide, ibuprofen and dexketoprofen for the acute treatment of migraine attack in the real-life conditions of a busy emergency department (ED).

Methods: This was a prospective, observational, cross-sectional study. All patients who presented to the ED with a headache fulfilling the inclusion criteria were enrolled.

Diagnostic utilities of tracheal ultrasound and USB-endoscope for the confirmation of endotracheal tube placement: A cadaver study.

Objectives: Confirmation of the endotracheal tube placement (CoETP) has the utmost importance in the management of an airway. Visualization of tracheal rings or carina with a fiber-optical bronchoscope (FOB) has considered to be a reliable method for the CoETP. However, FOB is expensive, time-consuming, and not always practical.

Diagnostic accuracy of the Extended Focused Abdominal Sonography for Trauma (E-FAST) performed by emergency physicians compared to CT.

Introduction: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe.