ABSTRACT
BACKGROUND: Cardiac arrests in hospital areas are common, and hospitals have rapid response teams or "blue code teams" to reduce preventable in-hospital deaths. Education about the rapid response team has been provided in all hospitals in Turkey, but true "blue code" activation is rare, and it is abused by medical personnel in practice. This study aimed to determine the cases of wrong blue codes and reasons of misuse. METHODS: This retrospective study analyzed the blue code reports issued by our hospital between January 1 and June 1 2012. A total of 89 "blue code" activations were recorded in 5 months. A "blue code" was defined as any patient with an unexpected cardiac or respiratory arrest requiring resuscitation and activation of a hospital alert. Adherence to this definition, each physician classified their collected activation forms as either a true or a wrong code. Then, patient data entered a database (Microsoft Excel 2007 software) which was pooled for analysis. The data were analyzed by using frequencies and the Chi-square test on SPSSv16.0. RESULTS: The patients were diagnosed with cardiopulmonary arrest (8), change in mental status (18), presyncope (11), chest pain (12), conversive disorder (18), and worry of the staff for the patient (22). Code activation was done by physicians in 76% of the patients; the most common reason for blue code was concern of staff for the patient. CONCLUSION: The findings of this study show that more research is needed to establish the overall effectiveness and optimal implementation of blue code teams.
ABSTRACT
BACKGROUND: Some honey types in certain geographical regions may cause toxic effects on people. This type of honey is known as "mad honey" in Turkey. The toxic ingredient of this honey is called Grayanotoxin I. The consumption of mad honey can cause severe bradycardia, hypotension, dizziness, nausea and vomiting. AIMS: Our study is aimed at analysing patients diagnosed with mad honey poisoning and their behaviour towards the consumption of this honey after diagnosis. STUDY DESIGN: Cross sectional study. METHODS: This cross-sectional study was based on complaints and findings of mad honey poisoning. Patient information and findings at the time of admission were compared with those at one month after discharge through telephone interviews. They were asked if either they or their relatives had continued consuming the same honey. Frequency data such as gender, purpose of honey consumption, first complaints and continuance of honey consumption are shown as number (n) and percentage (%). A Chi Square test was conducted to determine the difference between groups. RESULTS: 38 patients were participated in this study; 18 of the patients had to be followed up in a coronary intensive care unit. We were able to reach 34 patients by phone after discharge. It was found that 12 of 16 patients discharged after emergency unit observation or their close relatives were continuing to consume mad honey, whereas 16 (88.9%) of the 18 patients under coronary intensive care had discontinued consuming mad honey. The difference in the continuation of mad honey consumption between patient groups followed-up in the intensive care unit and those discharged after emergency observation was statistically significant. CONCLUSION: Hazards associated with and serious consequences following the consumption of mad honey must be clearly explained to patients who are found to be consuming mad honey.
ABSTRACT
OBJECTIVE: To identify the proportion of patients who were taken into the emergency room on the basis of legal regulations and non-urgent medical procedures. METHODS: This prospective study was conducted in the Emergency Department, Toros State Hospital, Mersin, Turkey. Data were collected over 4 weeks (January 2011) and then analyzed using the Kolmogorov-Smirnov, Analysis of Variance, and Kruskal-Wallis H tests. RESULTS: During the study period, 21,014 patients visited the Emergency Department. The applications were measured during a 3-shift schedule (08-16, 16-00, 00-08 hours). The total number of ordinary emergency admissions was 16,370. Of the total, 4,644 (22.1%) of the visits were evaluated as inappropriate. According to our study, inappropriate use of the emergency department was 51.1% more frequent during the 08-16 hours shift than the others. CONCLUSION: Inappropriate use of EDs with non-urgent applications makes it difficult to guarantee access for real emergency cases, decreases the readiness for care, and produces negative spillover effects on the quality of emergency services.
