Aims: In our study, it was aimed to compare the effectiveness of a diffuser mask (Oxymaskjavascript: addsym('%C2%AE');) and a simple nebulizer set oxygen mask on the blood gas values of patients with the diagnosis of chronic obstructive pulmonary disease (COPD) exacerbation who presented to the emergency department.
Materials and Methods: Our research is a prospective, single-blind, randomized controlled study conducted in the Emergency Department of Atatürk University Medical Faculty Hospital. Our study was completed with 213 patients after the exclusion criteria were applied. Of these patients, 93 were administered breathing treatment with a diffuser mask, and 120 were given treatment with a simple nebulizer set oxygen mask.
Results: After the treatment of COPD exacerbation the SO2 and PO2 values of the diffuser mask group were found to be significantly higher than those in the simple oxygen mask group (p<0.05). After the treatment, the PCO2 values of the diffuser mask group were significantly lower than those in the simple oxygen mask group (p<0.05). The diffuser mask also reduced the hospitalization rate of the patients.
Conclusion: We suggest that a diffuser mask, which provides better oxygenation in the blood and lowers the carbon dioxide concentration in the blood to a higher extent, can be used in administering breathing treatment to COPD patients with exacerbation who present to the emergency department with dyspnea.

Although pituitary adenomas and meningiomas are among commonly encountered benign tumors, the co-existence of these tumors is rare. One of the most important complications of pituitary adenomas is the development of apoplexy, often resulting in death if left untreated. In this article, we presented a patient admitted to the emergency department with complaints of sudden onset headache, nausea, vomiting, and optic nerve paralysis. On examination, the case was found to have parietal lobe meningioma and pituitary adenoma. So, the case underwent emergent transsphenoidal surgery considering pituitary apoplexy and was treated with l-thyroxine and hydrocortisone in the post-operative period. Although the co-existence of a pituitary adenoma and a meningioma is known in the literature, such a co-existence with apoplexy is the first case to be described in the literature.

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Aim: Renal colic is a urological emergency usually caused by urolithiasis and manifested by severe pain. Emergency treatment's main purpose is to effectively relieve pain and urinary obstruction without impaired renal function. We aimed to measure the efficacy and safety of intravenous (IV) ibuprofen on renal colic pain.
Materials and Methods: 235 patients who were admitted to the emergency department between 01.01.2016-30.06.2017 and were suspected of renal colic that scored at least 2 points on the Visual Analog Scale or FLACC scale were included in the study after obtaining detailed consent. 154 patients whose diagnoses were confirmed radiologically, included in the study as GroupA (dexketoprofen) (n=35), GroupB (ibuprofen400mg) (n=37), GroupC (ibuprofen800mg) (n=44), GroupD (fentanyl) (n=38). VAS and FLACC scales were re-evaluated on the 20th, 40th, and 60th minutes after drug administration.
Results: 64.9% of the patients were male and 35.1% were female, and the mean age was 42.31 (±15.46). It was observed that all 4 of the medications given to patients who applied to the emergency department with flank pain provided effective analgesia, but the drugs could not establish a statistically significant advantage over each other.
Conclusion: İntravenous administration of ibuprofen is considered to be an effective and safe alternative in the treatment of renal colic pain in the emergency department.

Aim: Thrombocytopenia is common in Intensive Care Units (ICU) and associated with high mortality. The aim of this study was to determine the incidence of thrombocytopenia in patients diagnosed with sepsis and its relationship with mortality and morbidity.
Materials and methods: This study was conducted in the Reanimation ICU of a university hospital. Patients followed and diagnosed with sepsis between January 2014 and January 2018 were collected and the recorded data analyzed retrospectively. Demographic data, comorbidities, disease severity scores, hematological laboratory values and ioutcome were recorded. Thrombocytopenia was defined as the platelet count to be less than 100 x 103 /µL. Patients were divided into two groups as with or without thrombocytopenia and statistical analysis was performed.
Results: The number of patients followed with the diagnosis of sepsis was 299. The median age of the patients was 68 years and 62.9% (n: 188) was male. The rate of invasive mechanical ventilation was 97.7%. Thrombocytopenia was detected in 36.8% of patients. The SOFA score was higher in the thrombocytopenia group (p<0.0001). Additionally, the rate of acute renal failure was 24.1% which was higher in the thrombocytopenia group (p=0.011). In thrombocytopenia group, the blood product transfusion rates were higher (p=0.004). Median ICU hospitalization time was 15 (6-28) days. While the total mortality of sepsis patients was 43.1%, this rate was higher in thrombocytopenia group (p=0.011).
Conclusion: Thrombocytopenia, which is commonly seen in ICU’ s and especially in the septic patients, is thought to be associated with mortality and morbidity.

Aim: To demonstrate the efficacy of single-person bedside Ultrasound Guided (USG) Popliteal-Sciatic Nerve Block (PSNB) using minimal equipment in the ED for the management of below-knee trauma. Materials & Methods: This single-centre retrospective analysis was done at the emergency department of a tertiary care centre in southern India from 1/12/2021 to 31/06/2022. The charts of all adult patients who received the block were reviewed and the reduction in pain score after the block, block success rate and incidence of side effects were analysed. Results: 103 patient records were reviewed during the study period. 98 males (95.1%) and 5 females (4.9%) had received the block. 87.4% of patients were road accident victims. The block was given by a single operator under ultrasound guidance with the stylet of an 18 gauge IV cannula mounted on a syringe filled with 1% lidocaine. The mean pain score before and 10 minutes after administering the block was 8.85 (SD ±0.78) and 2.06 (SD ±1.75) respectively. The block success rate was found to be 93.2%. Except for 7 failed blocks, there were no adverse events following the block. Conclusion: USG PSND in the emergency department technique is a safe, consistent and relatively long lasting anaesthetic technique in management of below-knee trauma.

AIM: We aimed to describe the demographic and etiological characteristics of drug-induced intoxication cases who were admitted to the adult emergency department of our hospital between 01.01.2017 and 31.12.2017 and how much they cost to the Social Security Institution.
MATERIAL AND METHOD: This was descriptive research, and the records of the patients who were admitted to the adult emergency service and diagnosed with drug intoxication between 01 January 2017 and 31 December 2017 were obtained from the automation system and analyzed retrospectively.
RESULTS: The data of 83 patients were evaluated in our study. 63.9% (n=53) of the patients were female and 36.1% (n=30) were male. Intoxications were most common in the 18-24 age group (48.2%; n=40). 92.8% (n=77) of the patients took the drug to commit suicide, and the majority of the intakes (60.2%; n=50) were due to single drug intake. The most common used drugs are antidepressants. The treatment costs increased significantly in the cases of suicidal intake (p=0.038) and multiple drug intake (p=0.035).
CONCLUSION: Most of the drug-induced intoxications occurred as a result of suicidal intake. An important part of the drugs used for this purpose are psychiatric drugs. Therefore, the presence of psychiatric symptoms should be investigated in patients diagnosed with drug intoxication and psychological support should be provided when necessary.

Necrotizing fasciitis is an uncommon, severe, life-threatening soft tissue infection involving the subcutaneous tissue. Immunocompromised and diabetic patients are at a higher risk of developing necrotizing fasciitis. One of the pathophysiologic mechanism of necrotizing fasciitis is subcutaneous arteries thrombosis and tissue ischemia. Bevacizumab, one of the agents used in cancer treatment, blocks the activity of vascular endothelial growth factor (VEGF) receptor. In recent years, it is used in combination with paclitaxel and carboplatin due to increase survival rate. The frequent use of this combination caused patients to apply to the emergency department with some side effects. Necrotizing fasciitis is one of the rare side effects of this combination. Here, we present a patient with ovarian cancer who was admitted to the emergency department with severe leg pain, whose initial examination and tests were normal, and then NF developed within hours and then arrested.

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Aim: Emergency surgery can be defined as surgical interventions and operations necessary to deal with an acute threat to life, organ, limb, or tissue. Our study aimed to examine the impact of the COVID-19 pandemic on emergency surgical operations (ESOs) performed in state hospitals in Türkiye.
Materials and Methods: In this national, retrospective, and descriptive study, ESOs performed in 2nd and 3rd-level state hospitals in Türkiye in 2021 were recorded for the study. ESOs performed in 2019 were taken as the control group, and the changes between the two groups were examined.
Results: A total of 1,822,075 ESOs were included in the analysis. There was a 7.6% decrease in ESOs in 2021 compared to 2019. In both 2019 and 2021, cesarean section, surgical treatment of upper/lower extremity fractures and dislocations, and cholecystectomy were the most frequently performed ESOs. An increase in the number of ESOs in 2021 compared to 2019 was observed only in the urology department (7.1%) and orthopedics & traumatology department (2.7%). The surgical departments with the greatest decreases were thoracic surgery (-43.5%), neurosurgery (-28.1%), and general surgery (-16.9%).
Conclusion: During the COVID-19 pandemic, the number of ESOs performed in 2nd and 3rd-level state hospitals in Turkey decreased compared to the previous year.

Objective: To evaluate the degree of agreement between emergency physicians (EP) and cardiologists in measuring pulmonary arterial pressure(PAP) (measurement with simplified Bernoulli equation).
Materials and methods: This prospective observational study was conducted between January 2020 and January 2022 in the Emergency Clinic of Antalya Training and Research Hospital, a tertiary hospital. Sample Size calculation: According to Kappa (2 raters) - Hypothesis Testing method; Assuming minimum acceptable kappa 0.6 and Expected kappa 0.85, Significance level 0.05, and Power 90%, including the Expected dropout rate of 10% in the study, 117 patients were included in the study. Demographic findings, personal history, laboratory tests, PAP values of the patients calculated by the emergency physicians and cardiologists were recorded.

Results: The study included 117 patients who attended the emergency department with shortness of breath or chest pain complaints. While 72.6% of them are female, 27.4% are male patients. The age of the patients included in the study was a minimum of 33 and a maximum of 80. Their mean age and deviation were 59.6±10.6. According to the criteria for PAP measurement ≤20 and >20, a significant and almost perfect agreement was found between the measurements of the cardiologist and the emergency physicians (Cohen's Kappa Coefficient 0.86; <0.0001).
Conclusion: We found near-perfect agreement between cardiologists and emergency room physicians trained in focused cardiac ultrasound (FOCUS) in detecting normal or increased PAP.

Objective: to investigate factors affecting bacteremia and contamination in patients admitted to the pediatric emergency room.
Materials and methods: This retrospective study focused on patients 1 month to 18 years of age who underwent blood culture tests at the XX Hospital from 2013 to 2017. We performed a history and physical examination and noted the presence of fever, pediatric assessment triangle findings on admission, laboratory characteristics, and outcomes associated with true bacteremia and contamination. Patients with no growth in blood culture were excluded from the study.
Results: A total of 449 patients were included in the study. Culture results of 165 patients (36.7%) were defined as indicative of true bacteremia and those of 284 patients (63.2%) as contamination. Patients with true bacteremia were more likely to have fever (81.4% vs 64.5%, p<0.001), underlying risk factors (61.9% vs 23.5%, p<0.001), and longer hospital stays (11 days vs 7 days, p<0.001). Patients with bacteremia had higher white blood cell counts (13,900 vs 11,300, p<0.001), C-reactive protein (CRP; 38.5 vs 6.3, p<0.001), and procalcitonin (1.04 vs 0.18, p<0.001). In the multivariable logistic regression analysis, fever on admission (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.037–5.524; p= 0.041), male sex (OR, 2.2; 95% CI, 1.066–4.716; p= 0.033), and CRP (OR, 1.0; 95% CI, 1.003–1.017; p= 0.005) were significantly associated with true bacteremia.
Conclusion: The presence of fever on admission and high CRP levels may be good indicators of which patients require BCs.

Aims: To validate the ability of NEWS2 for predicting the severity of COVID-19. Additionally, we also intend to examine the impact of pre-existing comorbidities to produce an advanced COVID-19 disease.

Method: A multicenter prospective cohort was performed on 108 patients suffering from moderate intensity COVID-19 infection during October 2020 and November 2021. NEWS2 parameters were recorded on admission to generate an output score which then classified in accordance with NEWS2 reference scale into low, medium and high-risk categories. Each patient was followed till discharge or death for clinical progression of COVID-19 disease. The measures of validity and area under the curve for NEWS2 threshold scores were calculated to predict the clinical deterioration of COVID-19 disease.

Results: Overall 29.6% patients developed an advanced disease, out of which 21.8% patients died during treatment. NEWS2 score of 6 or more showed highest sensitivity (78.1%), specificity (94.8%) and the area under the curve (0.838) for predicting an adverse outcome. Among comorbidities, majority showed increased risk of clinical deterioration.

Conclusion: NEWS2 score of 6 or more at baseline showed good predictive ability to stratify patients with poor outcome who may later require an escalated care. However, we recommend more research to confirm our findings.