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    Effects of drug use on the development of Diabetic Ketoacidosis
    (A. CARBONE Editore, 2015) Koyuncu, M.; Ozturk, D.; Altinbilek, E.; Yapar, N.; Karakisa, H.; Kavalci, C.; Ikizceli, I.
    Introduction: Diabetic Ketoacidosis (DKA) is a condition in which the body must use adipose and protein deposits as intracellular energy sources due to a lack of insulin. In the current study, we aimed to investigate the effects of drug use on the development of DKA and on clinical parameters in patients who presented to the Emergency Department (ED) with the diagnosis of DKA. Materials and methods: This study was retrospectively conducted in Sisli Etfal Training and Research Hospital between October 1, 2011 and March 31, 2013. The following parameters were recorder for each patient: age, gender, complaints, history of drug use, cause of DKA, pH, HCO3 levels, time spent in the ED, treatment outcomes and hospitalization durations. Results: The mean age of the patients was 42.6±18.6 years, and 58% (n=43) of them were female. 20.3% (n=15) of the patients were drug free. 63.5% (n=47) of the patients were followed up with in the ward, 12 (16.5%) were followed up with in the ED and 20% (n=15) were followed up with in the intensive care unit (ICU). The mean duration of stay in the ED was 15 hours, and the mean hospitalization time was 10 days. The mortality rate was 2.7% (n=2). When the effects of the drug use on DKA were examined, there were no statistically significant differences between the patients in terms of acidosis condition, mortality, clinic of hospitalization and durations of follow-up and treatment (p > 0.05). The most important factor causing ketoacidosis was the presence of infection (40.5%, n=30), while the most common symptom was nausea/vomiting (51.4%, n=38). Conclusion: We observed that in patients with DKA, drug use does not affect mortality and morbidity.
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    When should cardiopulmonary resuscitation be stopped: Opinions of the emergency medicine physicians in Turkey
    (Ondokuz Mayis Universitesi, 2015) Koyuncu, M.; Duman, A.; Ozturk, D.; Ipekci, A.; Altinbilek, E.; Topal, F.E.; Turkdogan, K.A.
    We aimed to define point of view of the Emergency Medicine Physicians (EMPs) working in emergency services in Turkey about the duration of cardiopulmonary resuscitation (CPR) and to determine whether a standardization could be developed for CPR duration in the light of this information. After approval of the ethics committee, a survey form was prepared using Google Document and internet access address was sent to 1.404 EMPs via mail. A total of 428 persons responded the survey and 426 appropriate responses were assessed. Of the EMPs, 64.2% suggested that the persons who perform and/or manage CPR must make the decision for the duration. The participants stated that CPR time should be longer at younger ages and shorten with aging and that duration of CPR must be shorter in patients with the end-stage. The decision for Do Not Attempt Resuscitation (DNAR) can not be made in our country. Legal studies must be conducted for law, regulations and notification in order to made decision for DNAR only in terminal stage patients. Therefore there must not be a law, regulation or CPR guide including exact duration for CPR. © 2015 OMU.