Yıl: 2021 Cilt: 4 Sayı: 3 Sayfa Aralığı: 96 - 101 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Review of Patients who are Hospitalized by Emergency Medicine Specialist

Öz:
Aim: Although some of the patients admitted to the emergency room (ER) have a clinical indication for hospitalization, they may not have a confident diagnosis of which branch they will be admitted to. Therefore, this research intended to present the undiagnosed patients' features whom emergency medicine specialists (EMS) hospitalized. Material and Methods: This research is a retrospective, crosssectional and descriptive study. Patients admitted to Sakarya Training and Research Hospital's ER and hospitalized by EMS on behalf of a branch were included in the study. Data obtained from the study were analysed using IBM SPSS Statistics 21. Results: The mean age of 57 patients was 70 (min: 56 - max: 80), and 30 (52.6%) of the cases were men. In the departmentbased evaluation of the consultations, it was ascertained that an average of 2.49 (SD=1.17) branch consultations was requested for each patient, and the average number of consultations per case was 4.16 (SD=2.09). As the number of consultations raised, the time between the emergency service application and the hospitalization decision increased statistically significantly (p<0.016). It was observed that most hospitalizations were because the departments did not make the decision to be hospitalized (n: 40, 70.2%); furthermore, the most hospitalizations were made to the internal medicine department (n: 28, 49.1%), and the majority of the cases were admitted to the service. It was observed that only one patient needed intensive care after hospitalization (n: 1, 1.8%), and there was no interdepartmental patient turnover and mortality after the hospitalization. Conclusion: The main reason for the EMS' hospitalization arrangement was the refusal of other branches to determine hospitalization. Therefore, it was perceived that the emergency specialists' hospitalization decisions were essentially accurate.
Anahtar Kelime: consultation hospitalization Emergency room

Acil Tıp Uzmanı Tarafından Yatırılan Hastaların İncelenmesi

Öz:
Amaç: Bu çalışmada, AS sorumlu uzman tabiplerince değerlendirilen ve tıbbi durumunun gerektirdiği en uygun uzmanlık dalına ait kliniğe yatışı yapılan hastaların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma 01.01.2019 - 30.04.2021 dönemini kapsayan retrospektif, kesitsel ve tanımlayıcı nitelikte bir çalışmadır. Çalışma örneklemi, Sakarya Eğitim ve Araştırma Hastanesi (SEAH) AS'ne başvuran ve AS sorumlu uzman tabiplerince yatırılan vakalardır. Tanılar International Classification of Diseases10 (ICD-10) tanı kodlama sistemi kullanılarak kategorize edildi. Hastalara ilişkin veriler hastane otomasyon sisteminden elde edilerek kayıt altına alınmıştır. Bulgular: Yatış kararı verilen 57 hastanın ortalama yaşları 70,00 (min: 56 - max: 80) olup, hastaların 30 (%52,6)’u erkek idi. Konsültasyonların bölüm bazlı değerlendirmesinde her hasta için ortalama 2,49 (SD=1,17) konsültasyon istendiği ve hasta başına yapılan ortalama konsültasyon sayısının ise 4,16 (SD=2,09) olduğu tespit edildi. Konsültasyon istem sayısı arttıkça başvuru ile yatış kararı verilmesi arasında geçen sürenin istatistiksel olarak anlamlı derecede arttığı saptandı (p<0,016). Yatışların en fazla bölümlerin yatış kararı vermemesinden kaynaklandığı (n: 40, %70,2), yatışın en fazla dahili branşlarda iç hastalıklarına (n:28, %49,1), hastaların büyük bir çoğunluğunun servise yatırıldığı, yatış sonrası yalnızca bir (n: 1,%1,8) hastada yoğun bakım ihtiyacının olduğu, servisler arası hasta devrinin ve mortalitenin olmadığı saptandı. Sonuç: AS sorumlu uzman tabiplerince verilen resen yatış kararının özellikle tanısı konulmuş ancak ilgili bölümlerin yatış kararı vermemesinden kaynaklandığı ve yatış kararının doğru ve yerinde olduğunu olduğu anlaşılmaktadır
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Dönmez SS, Durak VA, Torun G, ve ark. Acil serviste gerçekleştirilen konsültasyon sürecinin incelenmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2017;43(1):23-28.
  • 2. Chan T, Orlich D, Kulasegaram K, et al. Understanding communication between emergency and consulting physicians: A qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner. CJEM. 2013;3(15):42–51. doi: 10.2310/8000.2012.120762
  • 3. Guertler AT, Cortazzo JM, Rice MM. Referral and consultation in emergency medicine practice. Acad Emerg Med Off J Soc Acad Emerg Med. 1994;1(6):565–71. doi: 10.1111/j.1553-2712.1994.tb02557.x
  • 4. Lee RS, Woods R, Bullard M, et al. Consultations in the emergency department: A systematic review of the literature. Emerg Med J. 2008;25(1):4–9. doi: 10.1136/emj.2007.051631
  • 5. Weston K. Cause for concern ensuring adequate and timely oncall physician coverage in the emergency department. Watch. 2000;4:1–36.
  • 6. Hexter DA, Henry GL. Working with consultants. Foresight risk manangement. Emerg Physicians. 2002;1(7):303–6.
  • 7. Başbakanlık Mevzuatı Geliştirme ve Yayın Genel Müdürlüğü [Internet]. [cited 2021 May 5]. Available from: https://www.resmigazete.gov.tr/eskiler/2018/02/20180220-4.htm
  • 8. Ospina MB, Bond K, Schull M, et al. Measuring overcrowding in emergency departments: a call for standardization. Technol Rep. 2006;(67.1).
  • 9. AJ Drummond. No room at the inn: overcrowding in Ontario's emergency departments. CJEM. 2002 ;4(2):91-7. doi: 10.1017/s1481803500006187
  • 10. T.C. Resmî Gazete [Internet]. [cited 2021 May 24]. Available from: https://www.resmigazete.gov.tr/eskiler/2007/03/20070315-6.htm
  • 11. Gomes JCP, Dias RD, de Barros JV, et al. The growing impact of older patients in the emergency department: a 5-year retrospective analysis in Brazil. BMC Emerg Med. 2020 Jun 11;20(1):47.
  • 12. Kılıçaslan İ, Göksu E. Türkiye’de Acil Servise Başvuran Hastaların Demografik Özellikleri. Turk J Emerg Med. 2005; 5(1): 5-13
  • 13. Pinto Júnior D, Salgado P de O, Chianca TCM. Validez predictiva del protocolo de clasificación de Riesgo de Manchester: evaluación de la evolución de los pacientes admitidos en un pronto atendimiento. Rev Lat Am Enfermagem. 2012;20(6):1041–7.
  • 14. Carpenter CR, Hammouda N, Linton EA, et al. Delirium prevention, detection, and treatment in emergency medicine settings: A geriatric emergency care applied research (GEAR) network scoping review and consensus statement. Acad Emerg Med. 2021;28(1):19–35.
  • 15. Kekeç Z, Koc A, Buyuk S. Review of Geriatric Patients Hospitalization in Emergency Department. Eurasian J Emerg Med . 2009;8(3):21-24.
  • 16. Bilgili MA, Öncü MR. Evaluation of Geriatric Patients Applying to the Emergency Department. Van Med J. 2021;28(1):77–83.
  • 17. Yildiz S, Bi ̇lgi ̇li ̇N. Acil servise başvuran yaşlı hastaların bireysel özellikleri ve başvurularının değerlendirilmesi evaluatıng ındıvıdual characterıstıcs and applıcatıons of elderly patıents presented to emergency servıce. Gazi Sağlık Bilim Derg. 2016;1(1):15-31.
  • 18. Alhawas AY, Alaska Y, Almohaimede K, et al. To what extent the emergency physicians in Riyadh City are aware of patient radiation exposure from diagnostic ımaging requested in the emergency department. Cureus. 2020; 15;12(6):e8623. doi: 10.7759/cureus.8623
  • 19. Durmuş E, Güneysu F. Acil Servis Hekimlerinin Bilgisayarlı Tomografi tetkikine yaklaşımlarının değerlendirilmesi. Klin Tıp Bilim. 2020 Aug 1;8(1):1–10.
  • 20. Bellolio MF, Heien HC, Sangaralingham LR, et al. Increased Computed Tomography utilization in the emergency department and ıts association with hospital admission. West J Emerg Med. 2017;18(5):835–45.
  • 21. Şengül H, Bulut A, Kaşikçi ÖH. Acil doktorları perspektifinden acil servisler: Bir İçerik Analizi Çalışması. Van Sag Bil Derg. 2020;13(3):55-66:12.
  • 22. Eshıkumo IS. Acil hekimlerinin konsültasyon sürecinde yaşadıkları zorlukların değerlendirilmesi. Başkent Üniversitesi Tıp Fakültesi, Acil Tıp ABD, Tıpta Uzmanlık Tezi. 2017,37.
  • 23. Karakuş V, Giden A, Soysal DE ve ark. Erişkin hastalarda anemi etiyolojisi, risk faktörleri ve nüksün değerlendirilmesi. MMJ. 2016; 3(1): 1-6.
  • 24. Sarı İ, Altuntaş F. Transfüzyon ilkeleri ve erken komplikasyonlar. Türk Hematoloji Derneği - Hematolojide Destek Tedavileri Ve İnfeksiyonlar Kursu. 2007;64-77
  • 25. Shenvi CL, Platts-Mills TF. Managing the Elderly Emergency Department Patient. Ann Emerg Med. 2019;73(3):302–7.
  • 26. Adam P, Tejada JM, Malady D.An approach to the older patient in the emergency department. Clin Geriatr Med. 2018;34(3):299-311. doi: 10.1016/j.cger.2018.03.001
  • 27. Singer AJ, Jr HCT, Viccellio P, et al. The Association Between Length of Emergency Department Boarding and Mortality. Acad Emerg Med. 2011;18(12):1324–9.
  • 28. Pines JM, Hollander JE. Emergency department crowding ıs associated with poor care for patients with severe pain. Ann Emerg Med. 2008 Jan 1;51(1):1–5.
  • 29. Shen Y, Lee LH. Improving the wait time to admission by reducing bed rejections. BMJ Open Qual. 2019;8(3):e000710.
  • 30. Aydemir İ. Bir Kamu Hastanesinde Yatak Kullanım Etkinli ̇ ğinin Değerlendirilmesi. Usaysad Derg, 2019; 5(2 ):230-242:13.
APA ASLAN N, Durmuş E, Güner N, Güneysu F, ÇATAL F, YURUMEZ Y (2021). Review of Patients who are Hospitalized by Emergency Medicine Specialist. , 96 - 101.
Chicago ASLAN NURAY,Durmuş Ensar,Güner Necip Gökhan @,Güneysu Fatih,ÇATAL Fatih,YURUMEZ YUSUF Review of Patients who are Hospitalized by Emergency Medicine Specialist. (2021): 96 - 101.
MLA ASLAN NURAY,Durmuş Ensar,Güner Necip Gökhan @,Güneysu Fatih,ÇATAL Fatih,YURUMEZ YUSUF Review of Patients who are Hospitalized by Emergency Medicine Specialist. , 2021, ss.96 - 101.
AMA ASLAN N,Durmuş E,Güner N,Güneysu F,ÇATAL F,YURUMEZ Y Review of Patients who are Hospitalized by Emergency Medicine Specialist. . 2021; 96 - 101.
Vancouver ASLAN N,Durmuş E,Güner N,Güneysu F,ÇATAL F,YURUMEZ Y Review of Patients who are Hospitalized by Emergency Medicine Specialist. . 2021; 96 - 101.
IEEE ASLAN N,Durmuş E,Güner N,Güneysu F,ÇATAL F,YURUMEZ Y "Review of Patients who are Hospitalized by Emergency Medicine Specialist." , ss.96 - 101, 2021.
ISNAD ASLAN, NURAY vd. "Review of Patients who are Hospitalized by Emergency Medicine Specialist". (2021), 96-101.
APA ASLAN N, Durmuş E, Güner N, Güneysu F, ÇATAL F, YURUMEZ Y (2021). Review of Patients who are Hospitalized by Emergency Medicine Specialist. Anatolian Journal of Emergency Medicine, 4(3), 96 - 101.
Chicago ASLAN NURAY,Durmuş Ensar,Güner Necip Gökhan @,Güneysu Fatih,ÇATAL Fatih,YURUMEZ YUSUF Review of Patients who are Hospitalized by Emergency Medicine Specialist. Anatolian Journal of Emergency Medicine 4, no.3 (2021): 96 - 101.
MLA ASLAN NURAY,Durmuş Ensar,Güner Necip Gökhan @,Güneysu Fatih,ÇATAL Fatih,YURUMEZ YUSUF Review of Patients who are Hospitalized by Emergency Medicine Specialist. Anatolian Journal of Emergency Medicine, vol.4, no.3, 2021, ss.96 - 101.
AMA ASLAN N,Durmuş E,Güner N,Güneysu F,ÇATAL F,YURUMEZ Y Review of Patients who are Hospitalized by Emergency Medicine Specialist. Anatolian Journal of Emergency Medicine. 2021; 4(3): 96 - 101.
Vancouver ASLAN N,Durmuş E,Güner N,Güneysu F,ÇATAL F,YURUMEZ Y Review of Patients who are Hospitalized by Emergency Medicine Specialist. Anatolian Journal of Emergency Medicine. 2021; 4(3): 96 - 101.
IEEE ASLAN N,Durmuş E,Güner N,Güneysu F,ÇATAL F,YURUMEZ Y "Review of Patients who are Hospitalized by Emergency Medicine Specialist." Anatolian Journal of Emergency Medicine, 4, ss.96 - 101, 2021.
ISNAD ASLAN, NURAY vd. "Review of Patients who are Hospitalized by Emergency Medicine Specialist". Anatolian Journal of Emergency Medicine 4/3 (2021), 96-101.