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Article: Prehospital Emergency Service Use for Substance-Related Issues before and during COVID-19.

Kabadayi Sahin, Esra / Usul, Eren

2023 Volume 2023, Page(s) 8886832

Abstract: Objective: The COVID-19 pandemic disrupted the healthcare system and disproportionally affected individuals with substance use. This study aimed to evaluate the prehospital emergency medical service (EMS) use for substance-related health issues during ... ...

Abstract	Objective: The COVID-19 pandemic disrupted the healthcare system and disproportionally affected individuals with substance use. This study aimed to evaluate the prehospital emergency medical service (EMS) use for substance-related health issues during the COVID-19 pandemic period and compare the changes with the pre-COVID-19 period. Methods: The prehospital EMS calls due to substance-related problems in overall Turkiye were analyzed retrospectively. The applications were categorized into the pre-COVID-19 period (May 11, 2019, to March 11, 2020) and the COVID-19 period (March 11, 2020, to January 4, 2021). These two periods were compared to if there were any changes in sociodemographic features of the applicants, the reason for EMS calls, and the dispatch results of the calls. Results: There were 6,191 calls in the pre-COVID-19 period and 4,758 calls in the COVID-19 period. According to the age groups, the number of applications of 18 years and under decreased, while the application of people 65 years and over increased during the COVID-19 period ( Conclusions: This study shows that the elderly group is at higher risk for substance-related medical problems. Suicide is an important risk among individuals with substance use. The increase in demand for ambulance transfer services can place a significant burden on prehospital emergency care. There is a need for measures to provide emergency and transport services, especially for the elderly and suicide attempts during any future case of emergency.
Language	English
Publishing date	2023-04-17
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2596429-X
ISSN	2090-2859 ; 2090-2840
ISSN (online)	2090-2859
ISSN	2090-2840
DOI	10.1155/2023/8886832
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Article ; Online: Analysis of Suicide Cases from Ankara Province: A 3-year Emergency Medical Services Experience.

Usul, Eren / Şan, İshak / Korkut, Semih / Kayıpmaz, Selvi / Bekgöz, Burak

Acta bio-medica : Atenei Parmensis

2022 Volume 93, Issue 2, Page(s) e2022083

Abstract: Aim: While the term "completed suicide" refers to suicides that have resulted in death,"suicide attempts" refers to all attempts that do not result in death.Analyzing EMS cases is a reliable method of obtaining data on suicide attempts and completed ... ...

Abstract	Aim: While the term "completed suicide" refers to suicides that have resulted in death,"suicide attempts" refers to all attempts that do not result in death.Analyzing EMS cases is a reliable method of obtaining data on suicide attempts and completed suicides. We aimed to determine the relationship between the occurrence of cases on weekdays, weekends, public holidays or long holidays and case characteristics. Methodology: We evaluated EMS data of Ankara Province on completed suicide and suicide attempts including the date range 01.01.2017- 31.12.2019. We evaluated the data in terms of age, gender, mortality at the scene, and suicide method. In addition, we evaluated the data according to the hour, day, month, season, and year of the cases. We classified the suicide cases according to their occurrence on weekdays, weekends, public holidays or long holidays. Results: During the 3-year period included in the study, Ankara EMS assigned ambulances to a total of 940,546 cases. Of these cases, 8231 (0.875%) were suicide attempts and completed suicides. Suicide attempts were most frequent in males, in the 20-24 age group, in summer, in July, on Sundays, and between the hours 18:00 and 24:00. The most common method in suicide attempts was self-poisoning by drugs. Completed suicides were most frequent in males, in the 30-34 age group, in spring, in May, on Mondays and Tuesdays, and between the hours 18:00 and 24:00. Conclusion: We evaluated different characteristics of suicide cases of EMS. In Turkey, there are few studies in the EMS field on this issue. Therefore, we believe that this study will contribute to the epidemiological evaluation of suicides. We hope that results of this study will help to prevent both suicides and suicide attempts.
MeSH term(s)	Emergency Medical Services ; Humans ; Male ; Research Design ; Seasons ; Suicide, Attempted ; Turkey/epidemiology
Language	English
Publishing date	2022-05-11
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v93i2.10357
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Article: Manual cardiopulmonary resuscitation versus mechanical cardiopulmonary resuscitation: Which one is more effective during ambulance transport?

Şan, İshak / Bekgöz, Burak / Ergin, Mehmet / Usul, Eren

Turkish journal of emergency medicine

2021 Volume 21, Issue 2, Page(s) 69–74

Abstract: Objectives: Although studies in the field of emergency medical services (EMS) generally compare survival and hospital discharge rates, there are not many studies measuring the quality of cardiopulmonary resuscitation (CPR). In this study, we aimed to ... ...

Abstract	Objectives: Although studies in the field of emergency medical services (EMS) generally compare survival and hospital discharge rates, there are not many studies measuring the quality of cardiopulmonary resuscitation (CPR). In this study, we aimed to compare the mechanical chest compression device and paramedics in terms of CPR quality. Methods: This is an experimental trial. This study was performed by the EMS of Ankara city (capital of Turkey). Twenty (ten males and ten females) paramedics participated in the study. We used LUCAS™ 2 as a mechanical chest compression device in the study. Paramedics applied chest compression in twenty rounds, whereas mechanical chest compression device applied chest compression in another set of twenty rounds. The depth, rate, and hands-off time of chest compression were measured by means of the model's recording system. Results: The median chest compression rate was 120.1 compressions per minute (interquartile range [IQR]: 25%-75% = 117.9-133.5) for the paramedics, whereas it was 102.3 compressions per minute for the mechanical chest compression device (IQR: 25%-75% = 102.1-102.7) ( Conclusion: During patient transport, according to the chest compression performed by the health-care professionals, it was found that those performed by the mechanical chest compression device were more suitable than that performed by the guides in terms of both speed and duration.
Language	English
Publishing date	2021-02-12
Publishing country	India
Document type	Journal Article
ISSN	2452-2473
ISSN	2452-2473
DOI	10.4103/2452-2473.309135
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Article: Comparison of Trauma Severity Scores (ISS, NISS, RTS, BIG Score, and TRISS) in Multiple Trauma Patients.

Höke, Mehmet Hilmi / Usul, Eren / Özkan, Seda

Journal of trauma nursing : the official journal of the Society of Trauma Nurses

2021 Volume 28, Issue 2, Page(s) 100–106

Abstract: Background: Trauma severity scoring systems are routinely used to monitor trauma patient outcomes. Yet, the most accurate scoring system remains an elusive target.: Objective: We aim to compare trauma severity scales (ISS, NISS, RTS, TRISS, and BIG) ... ...

Abstract	Background: Trauma severity scoring systems are routinely used to monitor trauma patient outcomes. Yet, the most accurate scoring system remains an elusive target. Objective: We aim to compare trauma severity scales (ISS, NISS, RTS, TRISS, and BIG) in multitrauma patients and investigate BIG as one of the new trauma severity scoring systems. Methods: The demographic data of the patients, vital signs, injury mechanisms, body regions exposed to trauma, final diagnosis, the injury severity scales-Injury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS), base deficit, international normalized ratio, and Glasgow Coma Scale (BIG), and Trauma and Injury Severity Score (TRISS)-the length of stay in hospital, and the progress of the patients were examined. Results: A total of 426 cases were included in the study. The best performing score in determining mortality was TRISS (area under the curve [AUC]: 0.93, sensitivity 97.1% and specificity 76.7%). This was followed by the NISS, BIG, ISS, and RTS, respectively. For the prediction of intensive care unit admission, the NISS was the most successful with an AUC value of 0.81. There was a significant relationship in terms of the length of stay in all trauma scores (p < .05). Conclusions: The most successful score in predicting mortality in trauma patients was the TRISS, whereas the NISS was the most successful in predicting intensive care unit admission. The newly developed BIG score can be used as a strong scoring method for predicting prognosis in trauma patients.
MeSH term(s)	Glasgow Coma Scale ; Humans ; Injury Severity Score ; Multiple Trauma ; Predictive Value of Tests ; Retrospective Studies ; Trauma Severity Indices ; Wounds and Injuries
Language	English
Publishing date	2021-03-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1281159-2
ISSN	1078-7496
ISSN	1078-7496
DOI	10.1097/JTN.0000000000000567
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Article: The role of trauma scoring systems and serum lactate level in predicting prognosis in thoracic trauma.

Çınar, Eray / Usul, Eren / Demirtaş, Erdal / Gökçe, Anıl

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2021 Volume 27, Issue 6, Page(s) 619–623

Abstract: Background: Chest trauma constitutes 10% of admissions due to trauma and causes 25-50% of trauma-related deaths. It is important to evaluate the level of thoracic trauma in patients accurately and early, start the correct treatment, predict the need for ...

Title translation	Torasik travmada prognoz tahmininde travma puanlama sistemelerinin rolü ve serum laktat düzeyi.
Abstract	Background: Chest trauma constitutes 10% of admissions due to trauma and causes 25-50% of trauma-related deaths. It is important to evaluate the level of thoracic trauma in patients accurately and early, start the correct treatment, predict the need for intensive care and mortality, and prevent complications that may develop. In this study, the predictive efficiency of the serum lactate level, shock index, and scoring systems regarding the prognosis in patients with major thoracic trauma were compared. Methods: The files of the 683 patients who applied to the emergency department of our hospital due to trauma, between 2014 and 2020, were analyzed retrospectively. Patients with isolated thoracic trauma were included in the study. Results: A total of 683 patients were included in the study. Of the patients, 34 (5%) were in the non-survivor group and 649 (95%) were in the survivor group. There was no statistically significant difference between the systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, or shock index in either group (p>0.05). The Glasgow Come Scale (GCS) score in the non-survivor group was significantly lower than that in the survivor group (p=0.000). The lactate level, revised trauma score (RTS), injury severity score (ISS), and New ISS (NISS) in the non-survivor group were significantly higher than those in the survivor group. A significant difference was found in terms of age, lactate level, and the GCS, RTS, ISS, and NISS (p<0.05). In logistic regression analysis, it was found that a 1 unit increase in the lactate value increased the mortality rate by 1.19 times in terms of the effect of the trauma scores and numerical change in the lactate level on mortality. Conclusion: In patients with thoracic trauma, the NISS may be a useful factor that can be used in emergency rooms when a quick decision is required. However, increases in blood lactate levels during patient follow-up may also be a blood parameter that the clinician should pay attention to. In addition, further studies should be conducted on scoring in patients with thoracic trauma.
MeSH term(s)	Humans ; Injury Severity Score ; Lactates ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Trauma Severity Indices ; Wounds and Injuries
Chemical Substances	Lactates
Language	English
Publishing date	2021-11-23
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2253739-9
ISSN	1306-696X
ISSN	1306-696X
DOI	10.14744/tjtes.2021.22498
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Article ; Online: Role of hematological parameters in COVID-19 patients in the emergency room.

Usul, Eren / Şan, İshak / Bekgöz, Burak / Şahin, Ali

Biomarkers in medicine

2020 Volume 14, Issue 13, Page(s) 1207–1215

Abstract: Aim: ...

Abstract	Aim:
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Betacoronavirus/genetics ; Betacoronavirus/isolation & purification ; Biomarkers/blood ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/blood ; Coronavirus Infections/diagnosis ; Coronavirus Infections/virology ; Emergency Service, Hospital ; Female ; Hemoglobins/metabolism ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Neutrophils ; Pandemics ; Platelet Count ; Pneumonia, Viral/blood ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/virology ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; SARS-CoV-2 ; Turkey/epidemiology ; Young Adult
Chemical Substances	Biomarkers ; Hemoglobins
Keywords	covid19
Language	English
Publishing date	2020-07-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2481014-9
ISSN	1752-0371 ; 1752-0363
ISSN (online)	1752-0371
ISSN	1752-0363
DOI	10.2217/bmm-2020-0317
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Article ; Online: The Relationship of Lactate Levels with Carboxyhemoglobin Levels and Clinical Findings in Patients Admitted with Acute Carbon Monoxide Poisoning

Eren Usul / Ali Halıcı / Mehmet Hoke

Düzce Tıp Fakültesi Dergisi, Vol 23, Iss 1, Pp 41-

2021 Volume 46

Abstract: Aim: Acute carbon monoxide (CO) poisoning is a potentially mortal, though preventable, condition. Mild poisoning presents with non-specific symptoms, such as fatigue, headache, nausea and vomiting, whereas severe exposure to CO can result in loss of ... ...

Abstract	Aim: Acute carbon monoxide (CO) poisoning is a potentially mortal, though preventable, condition. Mild poisoning presents with non-specific symptoms, such as fatigue, headache, nausea and vomiting, whereas severe exposure to CO can result in loss of consciousness, coma, and death. The aim of this study was to investigate the utility of lactate and carboxyhemoglobin (COHb) levels in the clinical presentation and treatment of patients with acute CO poisoning. Material and Methods: Data were obtained from the hospital information system and patient files with ICD-10 code “T58: Toxic effects of CO”. The blood parameters and vital signs of patients at admission, causes of poisoning, time to hospital, and Glasgow coma scores during admission were recorded. Within related and relevant complications of CO intoxication and data concerning treatment plans and hospitalization status were recorded. Results: A statistically significant difference was found between COHb and lactate levels of patients who did and did not develop neurological and cardiac complications (p<0.001). Moreover, a statistically significant difference was found in COHb and lactate levels among patients who did or did not receive hyperbaric oxygen therapy, and who were hospitalized or not (p<0.001). As looking for biochemical profile, significant correlations was found between COHb and pH, base excess, and bicarbonate and lactate levels. Conclusion: This study shows that COHb and lactate levels at admission to the emergency department are significant for prognosis, follow-up, and treatment of patients with CO poisoning. Elevated lactate and COHb levels may also found to be associated with neurological and cardiac complications.
Keywords	zehirlenmeler ; karbon monoksit ; laktat ; hiperbarik oksijen ; karboksihemoglobin ; poisoning ; carbon monoxide ; lactate ; hyperbaric oxygenation ; carboxyhemoglobin ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Duzce University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The Effect of the COVID-19 Pandemic on the Anxiety Level of Emergency Medical Services Professionals.

Usul, Eren / Şan, Ishak / Bekgöz, Burak

Psychiatria Danubina

2020 Volume 32, Issue 3-4, Page(s) 563–569

Abstract: Introduction: Healthcare professionals are one of the groups most affected by a pandemic that affects the whole world. This study aimed to determine the anxiety level of emergency medical services professionals in Ankara, Turkey after the emergence of ... ...

Abstract	Introduction: Healthcare professionals are one of the groups most affected by a pandemic that affects the whole world. This study aimed to determine the anxiety level of emergency medical services professionals in Ankara, Turkey after the emergence of the COVID-19 pandemic. Subjects and methods: In the first part of the survey, the participants of the study were asked about their socio-demographic characteristics and their contact with the COVID-19 patients. In the second part, a survey with 20 questions that determined the state anxiety level derived from the State Anxiety Inventory was performed after obtaining verbal consent. Results: The mean age of the participants was 33.1±6.9, while 52.7% of all participants were males. In this study, the mean STAI Anxiety Score was 50.7±11.6. Anxiety scores were higher in females and those who had family members at risk of COVID-19 infection (p<0.05). The majority of those who had family members at risk of the infection started to stay in guesthouses instead of going home. Participants were worried about transmitting the infection to their family members (p<0.05). They felt more anxious when treating COVID-19 diagnosed or other patients (p<0.05). In addition, they thought that their anxiety level increased in general (p<0.05). Conclusion: The COVID-19 pandemic caused an anxiety increase in EMS workers in Turkey. Protecting the physical and mental health of the EMS employees who work at the front line against the COVID-19 pandemic and who have a high risk of infection, and ensuring their efficient work should be the main priority.
MeSH term(s)	Anxiety/epidemiology ; COVID-19 ; Emergency Medical Services ; Female ; Humans ; Male ; Pandemics ; SARS-CoV-2 ; Turkey/epidemiology
Language	English
Publishing date	2020-12-28
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1067580-2
ISSN	0353-5053
ISSN	0353-5053
DOI	10.24869/psyd.2020.563
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Article ; Online: The effect of meteorological variables on suicide.

Kayipmaz, Selvi / San, Ishak / Usul, Eren / Korkut, Semih

International journal of biometeorology

2020 Volume 64, Issue 9, Page(s) 1593–1598

Abstract: We aimed to reveal the relationship between the meteorological variables and suicide rates (completed suicides and suicide attempts) independently of the seasonal cycle and holiday effects. This is an observational retrospective study. We collected the ... ...

Abstract	We aimed to reveal the relationship between the meteorological variables and suicide rates (completed suicides and suicide attempts) independently of the seasonal cycle and holiday effects. This is an observational retrospective study. We collected the data on age, gender, and suicide method of all suicide cases transferred to hospitals from the scene by emergency medical services as well as those cases in which the victim died on the scene between January 1, 2017 and June 30, 2019. We also collected data on maximum, minimum, and average temperatures (°C), average humidity (%), and average actual pressure (hPa) measured daily in Ankara. The total number of cases due to suicide between the given dates was 6777. The suicide method in 60.1% of the cases was drug poisoning, which was the most common suicide method. Investigating the effect of meteorological variables on suicide cases (suicide attempts and completed suicides), the present study found that after smoothing the effect of the day of the week and seasonality, an increase in the minimum temperature on the day of the application by 1 unit (1°C degree) leads to an increase in the number of suicides by 0.01 point (0.01 ± 0.005, p = 0.046). There was no significant change in the variables other than the minimum temperature. We believe that the results of the present study will contribute to growing body literature about the epidemiology of suicide. We also believe that there is a need for large-scale studies that include individual data to reveal causality.
MeSH term(s)	Data Collection ; Humidity ; Meteorology ; Retrospective Studies ; Temperature
Language	English
Publishing date	2020-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	280324-0
ISSN	1432-1254 ; 0020-7128
ISSN (online)	1432-1254
ISSN	0020-7128
DOI	10.1007/s00484-020-01940-x
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Article ; Online: Effects of COVID-19 Pandemic on Emergency Medical Services.

Şan, İshak / Usul, Eren / Bekgöz, Burak / Korkut, Semih

International journal of clinical practice

2020 Volume 75, Issue 5, Page(s) e13885

Abstract: Introduction: In this study, we aimed to analyse the changes that occurred after the COVID-19 pandemic using the data of EMS of Ankara province.: Materials and methods: EMS data for the same time interval (March 11-April 24) in the last 3 years (2018, ...

Abstract	Introduction: In this study, we aimed to analyse the changes that occurred after the COVID-19 pandemic using the data of EMS of Ankara province. Materials and methods: EMS data for the same time interval (March 11-April 24) in the last 3 years (2018, 2019 and 2020) were compared. Results: While the number of calls increased by 90.9% during the pandemic period (from 2019 to 2020), the number of cases increased by 9.8%. Of all cases transported to hospital, 15.2% were suspected of and 2.9% were diagnosed with COVID-19. In the pandemic period, case frequency decreased in the 0-6 age group (-4.1%) and 7-18 age group (-39.9%) while the number of patients in the 19-65 age group (12.9%) and 65+ age group (21.5%) increased. There was a statistically significant difference between pre-pandemic and pandemic period in terms of rural area case frequency. During the pandemic period, case frequency of angina pectoris (-35.2%), myocardial infarction (-45%), acute abdomen (-23.8%) and cerebrovascular diseases (-2.9%) decreased contrary to pre-pandemic period (2019). During the same period, symptoms of fever (+14.1%) and cough (+956.3%) increased. There was a statistically significant difference between pre-pandemic and pandemic period in terms of forensic case frequency (P < .05). In addition, there was a statistically significant difference between these periods in terms of the frequency of patients who died at the scene. Conclusion: Although the use of ambulances has increased in the pandemic process, the use of EMS for time-sensitive diseases has decreased.
MeSH term(s)	Ambulances ; COVID-19 ; Emergency Medical Services ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2020-12-25
Publishing country	India
Document type	Journal Article
ZDB-ID	1386246-7
ISSN	1742-1241 ; 1368-5031
ISSN (online)	1742-1241
ISSN	1368-5031
DOI	10.1111/ijcp.13885
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