Person: ÖZDEMİR, FATMA
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ÖZDEMİR
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FATMA
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Publication Comparison of ice and lidocaine-prilocaine cream mixture in the reduction of pain during peripheral intravenous cannulation in emergency department patients(Galenos Yayıncılık, 2013-03-01) Aygün, Hüseyin; Armağan, Erol; Özdemir, Fatma; Köse, Ataman; Selimoğlu, Kerem; Köksal, Özlem; Aydın, Şule Akköse; Aygün, Hüseyin; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Köse, Ataman; Selimoğlu, Kerem; KÖKSAL, ÖZLEM; AYDIN, ŞULE; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-3635-7282; AAK-8332-2020; AAI-2164-2021; AAH-8846-2021; AAM-7896-2020; JKT-3402-2023; JPE-0854-2023; CDS-3299-2022Objective: We aimed to compare the efficacies of ice, lidocaine-prilocaine mixture cream and the classical method in reduction of the pain observed during intravenous cannulation, which is the most frequently performed procedure in emergency departments and to define the most effective method.Material and Methods: One hundred-twenty patients who applied to the emergency department of Uludag University Faculty of Medicine were included in this presented study. Cannulations were performed after one minute application of ice package in the ice group. Patients who applied to emergency only for blood transfusion were chosen for the lidocaine-prilocaine group and their cannulations were performed at the 60th minute of cream mixture application. Finally, no applications before cannulation were used for the control group. All cannulations were performed from antecubital region and 18 G cannula were used. Visual analog scale ( VAS) and patient satisfaction were scored.Results: VAS scores for ice, lidocaine-prilocaine and control groups are 2.8 +/- 1.7, 4.1 +/- 1.8, 4.4 +/- 1.9, respectively. VAS score in the ice group was significantly lower than both lidocaine-prilocaine and control groups. In addition, there was no statistically significant difference between lidocaine-prilocaine and control groups.Conclusion: Ice application method before intravenous cannulation, in addition to its advantages such as being inexpensive, easy to obtain and apply, is more effective than lidocaine-prilocaine cream.Publication Clinical probability and risk analysis of patients with suspected pulmonary embolism(Zhejiang Univ Press, 2014-12-01) Yetgin, Gülden Özeren; Aydın, Şule Akköse; Köksal, Özlem; Özdemir, Fatma; Mert, Dilek Kostak; Torun, Gökhan; AYDIN, ŞULE; KÖKSAL, ÖZLEM; ÖZDEMİR, FATMA; Mert, Dilek Kostak; Torun, Gökhan; AAI-2164-2021; AAA-2367-2020; AAK-8332-2020BACKGROUND: Pulmonary embolism (PE) is one of the most frequent diseases that could be missed in overcrowded emergency departments as in Turkey. Early and accurate diagnosis could decrease the mortality rate and this standard algorithm should be defined. This study is to find the accurate, fast, non-invasive, cost-effective, easy-to-access diagnostic tests, clinical scoring systems and the patients who should be tested for clinical diagnosis of PE in emergency department.METHODS: One hundred and forty patients admitted to the emergency department with the final diagnosis of PE regarding to anamnesis, physical examination and risk factors, were included in this prospective, cross-sectional study. The patients with a diagnosis of pulmonary embolism, acute coronary syndrome or infection and chronic obstructive pulmonary disease (COPD) were excluded from the study. The demographics, risk factors, radiological findings, vital signs, symptoms, physicallaboratory findings, diagnostic tests and clinical scoring systems of patients (Wells and Geneva) were noted. The diagnostic criteria for pulmonary emboli were: filling defect in the pulmonary artery lumen on spiral computed tomographic angiography and perfusion defect on perfusion scintigraphy.RESULTS: Totally, 90 (64%) of the patients had PE. Age, hypotension, having deep vein thrombosis were the risk factors, and oxygen saturation, shock index, BNP, troponin and fibrinogen levels as for the biochemical parameters were significantly different between the PE (+) and PE (-) groups (P<0.05). The Wells scoring system was more successful than the other scoring systems.CONCLUSION: Biochemical parameters, clinical findings, and scoring systems, when used altogether, can contribute to the diagnosis of PE.Publication Is there a relationship between the diameter of the inferior vena cava and hemodynamic parameters in critically ill patients?(Medknow Publications, 2015-11-01) Aydın, Şule A.; Özdemir, Fatma; Taşkın, G.; Ocakoğlu, Gökhan; Yıldırım, H.; Köksal, Özlem; AYDIN, ŞULE; ÖZDEMİR, FATMA; Taşkın, G.; OCAKOĞLU, GÖKHAN; KÖKSAL, ÖZLEM; Tıp Fakültesi; Acil Servis Bölümü; 0000-0002-1114-6051; AAH-5180-2021; AAK-8332-2020; HLG-6346-2023; AAI-2164-2021; IOY-2055-2023; GHW-4797-2022Introduction: The early detection of critically ill patients together with the rapid initiation of effective treatment in emergency departments(ED) increase the survival rates.Aim: This study investigated whether a correlation exists between haemodynamic parameters of critically ill patients and the diameter of the inferior vena cava (IVC).Materials and Methods: A cross-sectional study was performed included patients aged >= 18 years with an unstable haemodynamic and/or respiratory status who were referred to the ED for non-traumatic issues. IVC diameters were measured by ultrasound (US) and then central venous pressures (CVP) were measured. Anteroposterior (AP) and mediolateral (ML) diameters of the IVC, both in the inspirium (IAP, IML) and expirium (EAP, EML), were measured by US.Results: 102 patients were evaluated with a median age of 59. The relationship between the diameters of IVC and CVP was evaluated and significant correlation was found in IAP, EAP according to CVP values (p<0.001). ROC analyses were performed and significant relationship was found between the EAP diameter with haemoglobin (Hmg), haemotocrit (Hct), and central venous oxygen saturation (ScvO2) and also significant correlation was detected between the IAP diameter and white blood cell (WBC).Discussion: We detected significant correlation between the CVP and the IVC diameter in our study compatible with recent studies besides, significant correlation was found between the diameter of the IVC and CVP values as well as between the EAP diameter and Hmg, Hct, ScvO2 levels.Conclusion: Measurement of IVC diameters, especially EAP may be useful at the monitoring of critically ill patients in ED.Publication Patients over the age of 15 years admitted for attempted suicide to the emergency department and the psychosocial support unit(Emergency Medicine Physicians Assoc Turkey, 2012-12-01) Köse, Beril; KÖKSAL, ÖZLEM; ARMAĞAN, EROL; Köse, Ataman; Eraybar, Suna; AYDIN, ŞULE; Aydın, Şule Akköse; Armağan, Erol; ÖZDEMİR, FATMA; Özdemir, Fatma; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-4306-9262; CAF-5149-2022; HIK-0672-2022; L-7334-2015; AAM-7896-2020; AAH-8846-2021Objective: This study aimed to evaluate the demographic characteristics, methods of suicide and its causes in patients over the age of 15 years admitted to the emergency service for attempted suicide. The importance of the psychosocial support unit that has recently become active in the emergency department is emphasized.Material and Methods: In our study, we retrospectively evaluated the "Suicide Attempt Feedback Forms" of patients over the age of 15 years who were admitted to the emergency service of the Van Education and Research Hospital for suicide attempts between February and November 2009.Results: A total of 112 cases were enrolled in the study, of whom 92 were female ( 82.2%) and 20 were male ( 17.8%). The most prominent age range for suicide attempts was between 15-24 years of age ( 71.4%). In both sexes, the most common suicide attempt method was drug use, and family problems were the most common cause of suicide. Nearly all patients had made suicide attempts with the use of drugs/toxic substances. Suicide attempts were most commonly seen in March, April and October.Conclusion: Considering the number of patients in the emergency department, a team working as a psychosocial support and crisis intervention unit with experience in suicide attempts and enough time to address this issue is important for patients to receive adequate and appropriate service. Implementation of this mechanism in an uninterrupted manner in the emergency department can contribute to the prevention of recurrent suicide attempts.Publication Paraquat intoxication: A case report(Aves Press Ltd, 2011-07-01) Eraybar, Suna; Köse, Ataman; Aydın, Şule Akköse; AYDIN, ŞULE; Özdemir, Fatma; ÖZDEMİR, FATMA; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-4306-9262; HIK-0672-2022; AAM-7896-2020; L-7334-2015Paraquat, a widely used herbicide, causes high morbidity and mortality in people when taken accidentally or for suicidal intent. In this study our aim is to present the treatment and follow up of a 23 years old young lady after a history of suicide attempt in the emergency department after taking large amount of paraquat. The patient was initially asymptomatic and in follow up care gastrointestinal, renal and liver toxicity developed. Patients with severe paraquat poisoning may be asymptomatic after ingestion, but may deteriorate rapidly within a few hours. Therefore, in the case of taking high dose paraquat, the patient needs long term follow up for liver, kidney and lung effects even if he is asymptomatic.Publication Snakebite cases admitted to uludag university faculty of medicine emergency department and current management of snake bite(Aves, 2009-03-01) ÖZDEMİR, FATMA; Eren, Sebnem; Özdemir, Fatma; Köksal, Özlem; KÖKSAL, ÖZLEM; Durmuş, Oya; Esen, Mehmet; Akköse, Şule Aydın; AYDIN, ŞULE; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2180-6946; HHN-5686-2022; AAK-8332-2020; AAX-5571-2021Background: The purpose of this study is to analyse the characteristics of snakebite cases' epidemiology, clinic, treatment and prognosis and to investigate the current first aid and treatment methods.Methods: The snakebite cases admitted to our emergency department (ED) between 01.01.1995-31.12.2004 were investigated retrospectively. Demographic data, procedures and biochemical tests in the ED, prognosis of the hospitalized patients, the treatment given in the hospital and the complications were recorded.Results: The average age of the totally 48 (M/F: 27/21) patients was 40.4 year. 11 cases were discharged, 21 cases were transferred to other hospitals and 16 of them were hospitalized. Majority of the patients admitted in spring and summer. Among the 24 patients whom files had been obtained, 12 patients' snakebite was on the lower extremity, and 12 patients' was on the upper extremity. Antivenom was applied to 17 of these 24 patients. Systemic symptoms were seen in 6 patients. As an abnormal biochemical test only leucocytosis was seen in 7 patients. Faciotomy was applied to 25% of the patients with the diagnosis of compartment syndrome. The average hospitalization time was 4.2 day and there were no deaths and no extremity amputation among these patients.Conclusion: Most of the snakebites occur in the spring and summer season. Poisonous snakebites can cause severe systemic and local complications like compartment syndrome. ED approach includes close following of the vital signs, basic laboratory tests, tetanus prophylaxis, diagnosis of compartment syndrome and systemic complications. Patients should be examined in terms of antibiotherapy and antivenin.Publication Discharge of emergency patients to the clinical wards or intensive care units: An assessment of complications and possible shortcomings(Elsevier, 2015-07-01) Durak, Vahide Aslıhan; Armağan, Erol; Özdemir, Fatma; Kahriman, Nezahat; DURAK, VAHİDE ASLIHAN; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Kahriman, Nezahat; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; AAE-9483-2021; Y-3674-2018; AAH-8846-2021; IOY-2055-2023; CXL-2354-2022Objective: We aimed to evaluate the most common complications and possible shortcomings in the emergency patients who were admitted to the clinical wards or intensive care units.Materials and methods: 1000 patients were included in this study. The patients's complication rates were compared with the clinical diagnosis, age groups, the section of the emergency department initially managed the patients, the time of the shift (daytime or night), the accompanying medical staff and specific type of patient populations. Also the interventions of the complications were recorded.Results: 37.5% of the patients who were included in the study were female and 62.5% were male. The median age of the patients was 54.2 year (min: 1 max:92). The vital signs that were recorded prior to transport of the patients did not interfere with the complication rates (p > 0.05). Complication rates in the night were found to be higher as more admissions took place during the night shift (p < 0.05). The complication rates were found higher in patients who were admitted to coronary care unit. The most frequent complication was the dislocation of the intravenous catheter. Replacing the dislocated intravenous catheter was the most frequently noted intervention. However, initiating inotropic agents to the hypotensive patients was done more frequently in the admitted clinical departments.Conclusion: The overall complication rate was low in this series of patients. The majority of them can be prevented by having in house guidelines. (C) 2015 Elsevier Ltd. All rights reserved.Publication Analysis of acute adult poisoning cases among patients admitted to the emergency department in Bursa, Turkey(Galenos Yayınevi, 2009-01-01) Demircan, Celaleddin; Kahveci, Ferda; Engindeniz, Zülfi; Kıyıcı, Murat; Girgin, Nermin Kelebek; Ercan, İlker; Tekce, Hikmet; Özdemir, Fatma; Özyurt, Gurayten; DEMİRCAN, CELALEDDİN; KAHVECİ, FERDA ŞÖHRET; Engindeniz, Zülfi; KIYICI, MURAT; KELEBEK GİRGİN, NERMİN; ERCAN, İLKER; Tekce, Hikmet; ÖZDEMİR, FATMA; Özyurt, Gurayten; Tıp Fakültesi; Dahili Tıp Bilimleri Ana Bilim Dalı; 0000-0003-4820-2288; 0000-0003-1874-5097; 0000-0002-3208-6211; 0000-0002-2382-290X; HJZ-4470-2023; AAG-9356-2021; JBJ-5787-2023; AAI-4213-2021; AAH-7250-2019; ABF-2367-2020; JGP-4019-2023; JKS-7683-2023; JKO-9428-2023Purpose: The aim of this study was to define the epidemiological features such as age, sex, toxic substance, suicide, and mortality rates of the adult poisoning cases among patients admitted to the Emergency Department (ED) of Uludag University Medical Faculty Hospital.Materials and Methods: Records of acute adult poisoning cases at the ED within a one-year period (June 1, 2002 - May 31, 2003) were evaluated retrospectively. Data were compared to those of similar studies from Turkey and around the world.Results: In total 430 (1.96%) of 21,934 patients admitted to the ED during the study period suffered acute poisoning. Of these patients 259 (60.2%) were women and 171 (39.8%) were men and the mean age of the patients was 29.9. Patients were exposed to different types of toxic substances: drugs (47.4%), pesticides (10.7%), toxic gases (10%), corrosives (6.5%), alcohol (3.5%), food (15.8%), toxic substances of animal origin (3.0%), and others (3.0%). In all, 29.8% of the patients were admitted to hospital, 22.3% were transferred to other hospitals, and 47.9% were discharged from the ED, and the overall mortality rate was 1.2%. In addition, 54.9% of the poisonings were suicide attempts and within this group the women to men ratio was 2.2 and the most common toxic substance was a drug (85.2%).Conclusion: Our results were similar to those of previous studies from this country as acute poisonings are more common in women and younger ages, most of them were suicide attempts, and the mortality rate was low. Our transfer rate was high and this may necessitate the organization of short-term observation of these patients.Publication A case report of ammonium sulfate inhalation(Aves, 2011-12-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Almacıoğlu, Meral Leman; ÖZDEMİR, FATMA; Aydın, Şule Akköse; AYDIN, ŞULE; Bulut, Mehtap; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAK-8332-2020; AAX-5571-2021; HHN-5686-2022Ammonium sulfate is widely used in agriculture and the leather trade in many countries. Although it is reported to have potential effects on respiratory, gastrointestinal systems and the skin, there are a few case reports and toxicological studies about ammonium sulfate intoxication after ingestion and there is no case about ammonium sulfate inhalation. Thus, we report the clinical and laboratory findings of a patient who inhaled ammonium sulfate gas due to a work accident and was brought to our emergency department directly from the factory. When he arrived, loss of consciousness, cyanosis, tachypnea and metabolic acidosis were observed and convulsions were reported before arrival at the emergency department. After intubation and mechanical ventilator support in the emergency department, he was admitted to the intensive care unit, was given a T tube - mechanic ventilator support and was discharged in a healthy condition on the 8th day of admission. Ammonium sulfate intoxication should be suspected for the patients which brought from the leather industry or an agricultural environment, who inhaled bad or dense odored material, and had loss of consciousness, convulsions, acidosis and respiratory failure.Publication Is routine pregnancy test necessary in women of reproductive age admitted to the emergency department?(Zhejiang Univ Sch Medicine, 2013-09-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Özdemir, Fatma; ÖZDEMİR, FATMA; Armağan, Erol; ARMAĞAN, EROL; Öner, Nuran; Sert, Pınar Çınar; Sığırlı, Deniz; SIĞIRLI, DENİZ; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAH-8846-2021; AAK-8332-2020; AAA-7472-2021BACKGROUND: This study aimed to determine the necessity of pregnancy test in women of reproductive age admitted to emergency department (ED) in routine practice.METHODS: We retrospectively reviewed the records of patients who presented to the ED between January 1, 2006 and December 31, 2010 and received a pregnancy test.RESULTS: The median age of 1 586 patients enrolled into the study was 27 years. Of these patients, 19.55% had a positive result of pregnancy test. The most common complaint at admission was abdominal pain in 60.15% of the patients, and pregnancy test was prescribed. 15.83% of the patients with abdominal pain had a positive result of pregnancy test. Of the patients, 30.64% had nausea-vomiting at admission, and 11.52% had a positive result of pregnancy test. When other complaints were considered, the most commonly observed complaints were non-specific symptoms such as dizziness, malaise and respiratory problems. Of the patients, 70.93% were not remembering the date of last menstruation, and 9.51% showed a positive result of pregnancy test. Urinary tract infection (UTI) was commonly diagnosed with an incidence of 17.65%, which was followed by nonspecific abdominal pain (NSAP) (16.77%) and gastrointestinal disorders such as gastritis and peptic ulcer (6.87%). Of the patients, 88.40% were discharged from ED, and 11.60% were hospitalized.CONCLUSION: Pregnancy test should be given to women of reproductive age as a routine practice in ED in developing countries like Turkey.