Browsing by Author "Yaylaci, Serpil"

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Abusive Head Trauma in Turkey and Impact of Multidisciplinary Team Establishment Efforts on Case Finding and Management: Preliminary Findings
(AVES, 2016-01-01) Yaylaci, Serpil; Dallar, Yildiz; Sayar, Yavuz; Tasar, Medine Aysin; Tiras, Ulku; Tekin, Deniz; Unlu, Agahan; Ulukol, Betul; Beyaztas, Fatma Yucel; Butun, Celal; Ozum, Unal; Buken, Bora; Kandemir, Ferhan; Gokoglu, Ahmet; Kondolot, Meda; Menku, Ahmet; Patiroglu, Turkan; Tunc, Aydin; Yagmur, Fatih; Yikilmaz, Ali; Akar, Taner; Beyazova, Ufuk; Degirmenci, Bulent; Iseri, Elvan; Sahin, Figen; Isir, Aysun Baransel; Bilen, Ayse Gul; Oral, Resmiye; Gazioglu, Nurperi; Balci, Yasemin; Eryuruk, Mesut; Karagoz, Feyza
Aim: Abusive head trauma (AHT) is the most common cause of death as the result of child abuse. A task force is planned to provide training on AHT to professionals in different disciplines on clinical presentation, diagnostic workup, and organization of multidisciplinary evaluation at the hospital and community levels. This study reports on the preliminary findings of the pre-intervention phase of a larger study. Materials and Methods: This is a descriptive, retrospective study exploring the rates of documentation of relevant data in charts, including risk factors for abuse, family demographics, completeness of diagnostic workup, and case finding. Results: Overall, 345 cases were found in hospital databases that were eligible for the retrospective study from 10 participating hospitals. In total, 305 cases (88.4\%) were younger than 2 years of age. The most common documented risk factors were low parental education level in 82 families (23.8\%), more than three children under 7 years of age in 76 families (22.0\%), and bad child temper in 16 families (4.6\%), among others. The rate of complete diagnostic workup in hospitals with a multidisciplinary team (MDT) (25.7\%) was statistically significantly higher than in hospitals without an MDT (2.9\%) (p=0.001). Etiology was identified as inflicted in 78 cases (22.6\%), possibly inflicted in 24 (7.0\%), undetermined in 79 (22.9\%), and accidental in 164 (47.5\%) by the researchers, compared to only three cases (0.8\%) diagnosed as inflicted by the treating physicians (p<0.0001). In two of the three cases, the perpetrator was convicted
An assessment of emergency department visits for cardiovascular diseases in the early phase of the COVID-19 pandemic in Istanbul
(MRE PRESS, 2021-01-01) Yasin, Yesim; Yaylaci, Serpil; Eren, Berna; Cosgun, Erdal
Objectives: The coronavirus disease (COVID-19) pandemic has had a severe impact with an excess of one hundred million cases and over two million deaths worldwide. Countries have adopted different paths toward `flattening the curve'
Comparison of self versus expert-assisted feedback for cricothyroidotomy training: a randomized trial
(BMC, 2022-01-01) Aldinc, Hasan; Gun, Cem; Yaylaci, Serpil; Senuren, Cigdem Ozkaya; Guven, Feray; Sahiner, Melike; Kayayurt, Kamil; Turkmen, Suha
Background The self-video feedback method may have the potential to provide a low-cost alternative to physician-driven simulation-based training. This study aimed to assess the utility of two video feedback methods by comparing the improvement in performing cricothyroidotomy procedure following self video feedback (trainees review their performance by themselves) and expert-assisted video feedback (trainees review their performance while an emergency physician provides additional feedback). Methods This study was pretest-posttest and two-group designed research performed at a university simulation center with 89 final-year medical students and used a cricothyroidotomy simulation model. After seeing an educational presentation and a best practice video, trainees were randomized into two groups
Comparison of the efficacy of ShotBlocker and cold spray in reducing intramuscular injection-related pain in adults A prospective, randomized, controlled trial
(SAUDI MED J, 2019-01-01) Bilge, Sedat; Aydin, Attila; Gun, Cem; Aldinc, Hasan; Acar, Yahya A.; Yaylaci, Serpil; Cinar, Orhan; Balci, Veysel
Objectives: To compare the efficacy of ShotBlocker and cold spray in reducing intramuscular (IM) injection-related pain in adults. Methos: A prospective, randomized, controlled study carried out between January 2018 and March 2018 at the Department of Emergency Medicine, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey. Adult patients receiving IM injection of diclofenac sodium (75 mg/3 ml) were included. The patients were randomized into 3 groups: ShotBlocker, cold spray, and control. Each group comprised 40 patients. Patients were instructed to rate the intensity of IM injection-related pain using a 100-mm visual analog scale (VAS). Visual analog scale scores of the patients were statistically analyzed. Results: Visual analog scale scores were lower in the ShotBlocker (11 mm) and cold spray (10 mm) groups than in the control group (31 mm) (p=0.001). There were no significant differences in VAS scores between the ShotBlocker and cold spray groups. The operators' responses revealed that ShotBlocker was more difficult to administer than cold spray. Conclusion: ShotBlocker is an effective nonpharmacological method that reduces IM injectionrelated pain and is similar in efficacy, to cold spray.
Developing Cricothyroidotomy Skills Using a Biomaterial-Covered Model
(ELSEVIER SCIENCE INC, 2020-01-01) Senuren, Cigdem Ozkaya; Yaylaci, Serpil; Kayayurt, Kamil; Aldinc, Hasan; Gun, Cem; Simsek, Perihan; Tatli, Ozgur; Turkmen, Suha
Introduction-Cricothyroidotomy is an advanced and life-saving technique, but it is also a rare and a difficult procedure. The purpose of the present study was to produce a low-cost simulation model with realistic anatomic features to investigate its effectiveness in developing cricothyroidotomy skills. Methods-This study was performed at a university simulation center with 57 second-year student paramedics and a cricothyroidotomy simulation model. Total scores were assessed using a checklist. This consisted of 13 steps and was scored as misapplication/omission=0, correct performance and timing with hesitation=1, and correct performance and timing without hesitation=2. One of these steps, local anesthesia of the area if time is available, was not performed owing to time limitations. The highest possible score was 24. Data are presented as mean +/- SD with range, as appropriate. Normal distribution was evaluated using the Kolmogorov-Smirnov test, Student t test, and Mann-Whitney U test, and correlation analysis was used for statistical analysis. Results-Students completed the cricothyroidotomy procedure steps in 116 +/- 46 (55-238) s. At performance assessment, the score achieved was 12 +/- 5 (2-24). The highest total score of 24 was achieved by 3 students (5\%). Total scores exhibited negative and significant correlation with procedure time (r=-0.403, P=0.002). Conclusions-The model developed in this study is an inexpensive and effectivemethod that can be used in cricothyroidotomy training for student paramedics. We think that repeating the cricothyroidotomy procedure on the model will increase success levels.
Effect of harmless acute pancreatitis score, red cell distribution width and neutrophil/lymphocyte ratio on the mortality of patients with nontraumatic acute pancreatitis at the emergency department
(ZHEJIANG UNIV SCH MEDICINE, 2015-01-01) Gulen, Bedia; Sonmez, Ertan; Yaylaci, Serpil; Serinken, Mustafa; Eken, Cenker; Dur, Ali; Turkdogan, Figen Tunali; Sogut, Ozgur
BACKGROUND: Harmless acute pancreatitis score (HAPS), neutrophile/lymphocyte ratio and red blood cell distribution width (RDW) are used to determine the early prognosis of patients diagnosed with nontraumatic acute pancreatitis in the emergency department (ED). METHODS: Patients diagnosed with acute pancreatitis (K 85.9) in the ED according to the ICD10 coding during one year were included in the study. Patients with chronic pancreatitis and those who had missing data in their files were excluded from the study. Patients who did not have computed tomography (CT) in the ED were not included in the study. RESULTS: Ultimately, 322 patients were included in the study. The median age of the patients was 53.1 (IQR=36-64). Of the patients, 68.1\% (n=226) had etiological causes of the biliary tract. The mortality rate of these patients within the first 48 hours was 4.3\% (n=14). In the logistic regression analysis performed by using Balthazar classification, HAPS score, RDW, neutrophile/lymphocyte ratio, age, diabetes mellitus and systolic blood pressure, the only independent variable in determining mortality was assigned as Balthazar classification (OR: 15
Handlebar Trauma Causing Small Bowel Hernia with Jejunal Perforation
(WESTJEM, 2014-01-01) Yaylaci, Serpil; Ercelik, Hasan; Seyit, Murat; Kocyigit, Ali; Serinken, Mustafa
If There Is No Trauma History, What's Happened?
(AVES, 2014-01-01) Yaylaci, Serpil; Serinken, Mustafa
Introduction: Shaken baby syndrome (SBS) is probably an underestimated diagnosis. It is the leading cause of death from child abuse. Crying is thought to contribute to the act of shaking. Case Report: A4-month-old girl presented to the emergency room with convulsions. She was unconscious with dilated pupils. In the detailed physical examination, she did not have any head or body trauma signs. The eye fundus examination showed extended retinal hemorrhagic areas. Her brain computerized tomography examination revealed a subdural hematoma at the posterior fossa near the posterior cerebellum at the level of the cisterna magna. The girl was admitted to the extensive care unit, where she died after 5 days. Her mother confessed that she had shaken the baby. Conclusion: Shaken baby syndrome should be kept in mind with a baby with no trauma history and no trauma signs in the physical examination. An inconsistent history must alert for emergency physicians.
Importance of Clinical Suspicion in Rapid Diagnostic Test Negativity in Malaria: Two Case Reports
(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2020-01-01) Gun, Cem; Aldinc, Hasan; Yaylaci, Serpil; Ustun, Cemal; Barbur, Erol
Introduction: Malaria is a life-threatening disease caused by infection with Plasmodium parasites. Rapid diagnostic tests (RDTs) have been used for the diagnosis of malaria without special equipment by unskilled personnel over the last 15 years. The treatment should only be given after the clinical diagnosis confirmed by RDT or microscopy. RDTs' specificity and sensitivity have been reported as >95\% by the World Health Organization - Foundation for Initiative New Diagnostics (WHO-FIND). Case report: A 30-years-old male and a 23-years-old female presented to our emergency department with fever and history of a visit to a malaria-endemic country. Plasmodium trophozoites were seen in the blood smear samples via light microscopy. However, RDTs were negative. The patients were treated according to their pathogens. Conclusion: Rarely, RDT might result in a false negative in the diagnosis of malaria. People travelling to endemic areas should be closely monitored. Emergency department physicians should not neglect microscopy which is the gold standard for diagnosis of malaria.
Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp
(BMC, 2021-01-01) Yaylaci, Serpil; Ulman, Yesim Isil; Vatansever, Kevser; Senyurek, Gamze; Turkmen, Suha; Aldinc, Hasan; Gun, Cem
Background Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns' patient management skills, ethical decision-making, and reflection skills. Methods A multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group's performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students' performances, and common achievements and mistakes of students. Results 133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill. Conclusion The multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context.
Rate of Exposure to Violence in 112 Staff in Denizli City
(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2015-01-01) Yilmaz, Atakan; Dal, Onur; Yaylaci, Serpil; Uyanik, Emrah
Aim: In the last decade, news regarding violence of the 112 emergency service staff that is frequently revealed in visual and written media in our country has increased. In this study, we investigated the characteristics that led to the incidence of violence against the 112 emergency service staff, the extent to which these events have been reported by staff, and the work satisfaction of staff. Materials and Methods: Data regarding face-to-face interviews with all staff on duty across the city were obtained. Staff who suffered verbal and physical violence in the last year and during their work period were examnined. Staff who did not wish to participate in the study, who served in the 112 emergency service for less than one year, and who were on an annual leave or leave without pay during the study were excluded. Results: One hundred and forty-one eligible staff participated in this study. Of the total participants, 73\% (n= 103) were emergency medical technicians and paramedics. The average work period in the 112 emergency medical services was 4.9 +/- 2.8 (min: 1, max: 23) years. The staff's exposure to verbal and physical violence over the last year was 51.8\% (n = 73) and 8.5\% (n = 12), respectively. Rates increased by 77.3\% (n = 109) and 24.8\% (n = 35), respectively, when investigation was conducted in the absence of time limitation. Of the total participants, 85.1\% (n = 120) were found to not formally report the attacks. A large percentage (95.2\%) of reported incidents involved physical violence. Finally, the participants levels of work satisfaction in the 112 emergency service was high (90.8\%, n = 128). Conclusion: Violence against the 112 emergency service staff is greater than estimated because there were not sufficiently reported. Trainings must be organized for staff working in prehospital medical care regarding how to protect and cope from violence.
Self-Cannibalism: The Man Who Eats Himself
(WESTJEM, 2014-01-01) Yilmaz, Atakan; Uyanik, Emrah; Sengul, Melike C. Balci; Yaylaci, Serpil; Karcioglu, Ozgur; Serinken, Mustafa
Self-mutilation is a general term for a variety of forms of intentional self-harm without the wish to die. Although there have been many reports of self-mutilation injuries in the literature, none have reported self-cannibalism after self-mutilation. In this article we present a patient with self-cannibalism following self-mutilation. A 34-year-old male patient was brought to the emergency department from the prison with a laceration on the right leg. Physical examination revealed a well-demarcated rectangular soft tissue defect on his right thigh. The prison authorities stated that the prisoner had cut his thigh with a knife and had eaten the flesh.
The immediate effect of deliberate practice and real-time feedback on high-quality CPR training in intern doctors, acute care providers, and lay rescuers
(MRE PRESS, 2022-01-01) Yaylaci, Serpil; Kayayurt, Kamil; Aldinc, Hasan; Gun, Cem; Sekuri, Alphan
The quality of cardiopulmonary resuscitation (CPR) is the main determinant of survival in cardiac arrest, so high-quality CPR (HQ-CPR) from bystanders is essential. The best instructional model for HQ-CPR performed by bystanders remains under investigation, and an instructional model's effect on various learner types is unknown. This study examined the immediate effect of a brief, blended instructional design that combines deliberate practice (DP) with real-time feedback (RTF) on the booster training of intern doctors (IDs) and acute care providers (ACPs) as well as on the skills acquisition training of lay rescuers (LRs). This cohort crossover study was conducted in a university-affiliated hospital in January 2020. Just-in-time training on HQ-CPR that featured a popular song was provided to IDs (n = 24), ACPs (n = 29), LRs (n = 25)
The Reliability of Turkish ``Basic Life Support'' and ``Cardiac Massage'' Videos Uploaded to Websites
(AVES, 2016-01-01) Elicabuk, Hayri; Yaylaci, Serpil; Yilmaz, Atakan; Hatipoglu, Celile; Kaya, F. Gokhan; Serinken, Mustafa
Objective: In this study, the reliability of Turkish cardiac massage and Basic Life Support (BLS) videos, which have already been downloaded from three website such as YouTube, Google, Yahoo following the publication of 2010 cardiopulmonary resuscitation (CPR) guideline and their suitability to the same guideline were researched. Materials and Methods: The videos uploaded to the three website to search videos on internet were queried by using the keywords ``cardiac massage{''} and ``basic life support{''}. Videos that had been uploaded between January 2011 and July 2014 were analyzed and scored by two experienced emergency specialists. Results: A total of 1126 videos were obtained. 1029 of the videos (91.4\%) were excluded by researchers. 97 videos were detected to accord with study criteria. Despite most of the videos were found on Google website by keywords, the enormous part of videos proper to criteria were sourced from YouTube website (n=65, 67.0\%). One fourth of the videos (24.7\%) were observed to not be suitable for 2010 CPR guideline. AED usage was mentioned slightly in the videos (14.4\%). Median score of the videos is 5 (IQR: 4-6). The rate and scores of the videos uploaded by official institution or association were significantly higher than others (p=0.007 and 0.006, respectively). Moreover, scores of the videos compatible with guidelines uploaded by official institution or association and medical personal were also found higher (p=0.001). Conclusion: Eventually, all the data obtained in this study support that Turkish videos were not reliable on the subject of BLS and cardiac massage. It is promising that videos with high followup rates also have been scored higher.