Work-related injuries sustained by emergency medical technicians and paramedics in Turkey.

BACKGROUND: Evaluated in the present study were locations, descriptions, and results of work-related injuries (WRIs) sustained by emergency medical technicians (EMTs) and paramedics in Turkey's most crowded city, Istanbul. METHODS: After the present study had been accepted by the urban health authority, a questionnaire was emailed to the healthcare personnel of Istanbul's 195 ambulance stations. RESULTS: Included in the present study were the responses of 901 members of staff (660 EMTs and 241 paramedics), with a mean age of 29.5±6.1 (min: 18; max: 61). The majority of participants (94.9%) had encountered verbal abuse from the public, and 39.8% had encountered physical violence from patients' relatives. Levels of satisfaction with work in emergency medical services (EMS) was also evaluated, and 510 participants (57.6%) were unhappy. Regarding gender, female employees were more likely to be verbally attacked (p=0.01), while males were more likely to be physically attacked (p=0.001). It was reported that motor vehicle accidents (MVAs) were the most common cause of WRIs (81.4%), followed by needle-stick injuries (52.2%), ocular exposure to blood and other fluids (30.9%), and sharp injuries (22.5%). Only 10.5% (n=95) of WRIs were reported to authorities; 488 (54.2%) of participants just attended to the practice to prevent possible WRIs. CONCLUSION: For paramedics and EMTs, risk of WRI is obviously high. Strategies to decrease and prevent verbal and physical violence should be developed.

To decide medical therapy according to ECG criteria in patients with supraventricular tachycardia in emergency department: adenosine or diltiazem.

UNLABELLED: The aim of this study is to investigate the effect of ECG criteria which are used for the distinction between AVNRT and AVRT for the choice of treatment in patients with Supraventricular Tachycardia (SVT). The 77 patients with narrow QRS complex SVT which was treated with Adenosine or Diltiazem in the Emergency Department were evaluated retrospectively. All 12-lead ECG during tachycardia were blindly reviewed according to ECG criteria (Pseudo-r` in V1, Pseudo-S-wave in the inferior leads, Visible P-wave, aVL notch) by a cardiologist and an emergency physician. In this study, while 59.6% of the patients returned to normal sinus rhythm (NSR) after the first dose 6 mg, 64.91% of them after the first dose 12 mg and 71.92% of them after the second dose of 12 mg adenosine, 95% of the patients returned to NSR after the 0.25 mg/kg diltiazem. The most visible ECG findings were visible P waves and the least visible ECG findings were Pseudo-S waves in the inferior leads. It was statistically significant between converted by adenosine to NSR and converted by diltiazem to NSR to the presence of visible P-wave and the aVL lead notch in their ECG findings. CONCLUSION: The rate of return to NSR through diltiazem was found higher than that of adenosine in narrow complex SVT patients. Also, diltiazem may be the first medication to be preferred in the presence of retrograt P wave and aVL notch in the ECG of the patients with narrow QRS complex stable SVT.