QT dispersion in carbon monoxide poisoning.

BACKGROUND: Carbon monoxide (CO) poisoning are serious health problems, and effect of reducing the blood's oxygen carrying capacity. Deaths due to CO poisoning are mostly related to myocardial injury and central nervous system pathologies. AIM: The objective of this study was to determine the relationship between carbon monoxide intoxication, QT dispersion, and cardiac markers. MATERIALS AND METHODS: Patients with possible CO intoxication symptoms were evaluated to be eligible for the study. Patients' demographic data, carboxyhemoglobin levels, cardiac markers and QT interval measurements were recorded to the study form. RESULTS: A total of 127 patients (79 CO intoxicated and 48 controls) were included into the study with a mean age of 38.6 +/- 14.1 years and 62.2% of them were female. Average levels of patient's carboxyhemoglobin were 21.3 +/- 9. QT dispersion (39.0 +/- 10.8 vs 24.4 +/- 6.2; p < 0.001) and corrected QT dispersion (46.2 +/- 14.7 vs. 25.3 +/- 6.2; p < 0.001) were longer than the control group. Both QT dispersion (39.0 +/- 10.8 vs. 23.6 +/- 7.0; p < 0.001) or corrected QT dispersion (46.2 +/- 14.7 vs. 27.1 +/- 8.7; p < 0.001) were also decreased after one week later from the admission. CONCLUSION: Carbon monoxide intoxication is related to increased QT dispersion. Emergency physicians should measure QT dispersion in CO intoxicated patients in order to predict the electrical instability in myocardium and future adverse events.

Elderly trauma: the two years experience of a university-affiliated emergency department.

OBJECTIVE: The elderly population is steadily increasing in the modern world. The aging of the population has led to an increase in geriatric trauma. Elderly trauma patients present unique challenges and face more significant obstacles in recovery compared to younger patients. This study is designed to determine the epidemiologic data of trauma in elderly patients and to contribute to the national trauma database. MATERIALS AND METHODS: We prospectively collected the data of trauma patients, aged 65 and older, presenting to our Emergency Department. Patients' data, including demographic data, diagnosis, prognosis, trauma scores [Glasgow coma scale (GCS), injury severity score (ISS)], mortality, body regions of injury and outcomes were analyzed. RESULTS: During the study period, 407 patients, of whom 63.9% were males and 36.1% females, were admitted to our Emergency Department. The mean age of, the patients was 73.14 +/- 7.14 years. Falls (59%) accounted for the most common cause of injury. The mean GCS and mean ISS were 14.39 and 10.69, respectively. Trauma to extremities was the most frequent body region of injury (56.3%). A total of 149 patients were hospitalized. The mean hospital length of stay was 11.07 +/- 14 days. The mortality rate was found to be 6.4%. Head trauma was the most common cause in mortality. CONCLUSIONS: The risk of trauma in the elderly population is higher. As a result of the decrease in physiological reserve and lack of adaptation to trauma, elderly trauma patients require more aggressive management and a multidisciplinary approach. Further studies are needed for data of elderly trauma patients.

Narrowing of airway caused by ingestion of methyl ethyl ketone peroxide.

Although ingestion of methyl ethyl ketone peroxide (MEKP) is rare, it carries a high risk of morbidity and mortality. This paper reports the first such case from Turkey in which a 70-year-old man unintentionally ingested MEKP in his kitchen. The patient was brought into the emergency department (ED) within 1 hour of ingestion, with the symptoms of sore throat, shortness of breath, nausea and vomiting. Visual examination of the oropharynx revealed minor burns and uvular edema. A laryngoscope examination performed in the ED showed superficial mucosal injury with edema of the oropharynx, uvula, posterior pharynx, epiglottis, arytenoids and vocal cords. Lateral cervical radiography revealed a narrowing of airway due to a thickened epiglottis. After the diagnostic evaluation was completed, the patient was admitted to the gastroenterology intensive care unit for monitoring of adverse reactions. During follow-up, the patient made an uneventful recovery. Ingestion of MEKP generally results from accidental ingestion from a container. Therefore, these containers should be kept in safe places. In addition, the priority following the ingestion of MEKP should be given to maintain open and adequate airway in the ED.