An analysis of carbon monoxide poisoning cases in Bursa, Turkey.

Carbon monoxide (CO) poisoning from coal and gas heaters is a public health concern in Turkey. This study estimated the prevalence, mortality rate and clinical predictors of severity of CO poisoning cases treated at the emergency unit of the Uludag University Medical School, Bursa from 1996 to 2006. Of 305 patients treated over a 10-year period, only 1 case was recorded as suicide. The CO source was a coal heater in 85.9% of cases. Mean Glasgow coma score (GCS) on admission was 12.8 (SD 0.2) and mean carboxyhaemoglobin level was 21.6% (SD 0.92%). There were statistically significant associations between higher GCS score, older age and higher HbCO level. Better education of the public is vital for the prevention of these injuries.

Medical experience of a university hospital in Turkey after the 1999 Marmara earthquake.

OBJECTIVES: This study aimed to provide an overview of morbidity and mortality among patients admitted to the Hospital of the Medicine Faculty of Uludag University, Bursa, Turkey, after the 1999 Marmara earthquake. METHODS: Retrospective analysis of the medical records of 645 earthquake victims. Patients' demographic data, diagnosis, dispositions, and prognosis were reviewed. RESULTS: A total of 330 patients with earthquake related injuries and illness admitted to our hospital were included and divided into three main groups: crush syndrome (n = 110), vital organ injuries (n = 57), and non-traumatic but earthquake related illness (n = 55). Seventy seven per cent of patients were hospitalised during the first three days after the earthquake. The rate of mortality associated with the crush syndrome, vital organ injury, and non-traumatic medical problems was 21% (23/110), 17.5% (10/57), and 9% (5/55), respectively. The overall mortality rate was 8% (50/645). CONCLUSIONS: In the first 24-48 hours after a major earthquake, hospital emergency departments are flooded with large numbers of patients. Among this patient load, those patients with crush syndrome or vital organ injuries are particularly at risk. Proper triage and prompt treatment of these seriously injured earthquake victims may decrease morbidity and mortality. It is hoped that this review of the challenges met after the Marmara earthquake and the lessons learned will be of use to emergency department physicians as well as hospital emergency planners in preparing for future natural disasters.

Fatal descending necrotising mediastinitis.

Descending necrotising mediastinitis rarely develops and this variety of mediastinitis is a highly lethal disease. A case is reported of descending necrotising mediastinitis caused by an odontogenic infection. The importance is emphasised of prompt diagnosis and aggressive surgical mediastinal drainage for the survival of these patients. Most acute mediastinal infections result from oesophageal perforation, either secondary to oesophagoscopy or tumour erosion. Mediastinitis occasionally develops as descending necrotising mediastinitis originating from the complications of cervical or odontogenic infections. Descending necrotising mediastinitis usually has a fulminant course, leading commonly to sepsis and death.

[The analysis of traumatized patients who were admitted to the Uludag University Medical School Hospital after the Marmara earthquake]. / Marmara depremi sonrasi Uludag Universitesi Tip Fakültesi hastanesine basvuran travmali olgularin analizi.

The aim of this study was to analyze the victims of the Marmara earthquake who injured, especially had the crush syndrome. Our hospital received a total of 645 victims after the earthquake and admitted 330. Victims were classified into five different groups according to their diagnosis (crush syndrome, vital organ injury, vertebral and pelvic injuries, others and unknown) and their mortality rates were determined. Mortality was highest (21%) in the crush syndrome group. Second and third highest mortality were in the unknown (20%) and vital organ injury (20%) groups. The overall mortality rate was 8%. In conclusion the earthquake victims with crush syndrome and vital organ injury had the highest mortality and morbidity rates. Because of that so many departments (General Surgery, Emergency Medicine, Orthopedics Surgery, Plastic Surgery, Nephrology, Infection Disease etc.) had to be study in a great harmonious.

[Do emergency departments comply with the rules of patient transportation?]. / Hastaneler arasi sevklerde kurallara uyuluyor mu?

Emergency departments must comply with the rules of patient transportation. The aim of this study was to find out the compliance of the emergency departments in our region with patient transport the rules and regulations. 180 patients transported to our emergency department by an ambulance from another hospital, between 01.05.1999-01.07.1999 were analyzed. ACEP's (American College of Emergency Physicians) patient transportation rules were taken as a reference for comparison. Our findings have shown that the compliance to these rules is insufficient. Results of the study, will be presented to our colleagues working in the emergency departments in our region, in one of our monthly trauma meetings. State Department of health in the city, two state hospitals and Social Security hospitals in the region will also be informed about the results so that certain guidelines for better patient transportation can be established in the region.