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    Pre-hospital airway management preferences of paramedics
    (Bayrakol Medical Publisher, 2020) Beydilli, Inan; Korkmaz, Ilhan; Yilmaz, Fevzi; Gungor, Faruk; Kirpat, Vedat; Kozaci, Nalan; Avci, Mustafa
    Aim: The success of paramedics in the pre-hospital airway management in traumatic and non-traumatic critically ill patients, especially in cardiac arrest, is very important in terms of mortality and morbidity. Materials and Methods: Patients who were admitted to the Emergency Department by pre-hospital emergency ambulance service were included in the study. The standard data registration form was created for the study. Demographic data, pre-hospital and in-hospital vital signs, GCS scores, cardiac rhythms, applied airway method, transport time and 48-hour mortality rates were recorded in the study form. Results: While the initial approach to airway management was a bag-valve mask in 80 patients (82%), advanced airway management was performed in 18 (18%) patients. The mean time period for the ambulance arriving at the patient was 6.52 +/- 3.06 min and the mean time period of transport to the hospital was 11.42 +/- 9.53 min in all patients. Although there was no difference between patients managed with BVM and patients managed with advanced airway interventions in terms of a time period needed to access patient (p=0.957), there were significant differences in terms of a time period needed to access emergency service (p=0.001) and total time period (p=0.001) Among patients with CPA, there was a significant difference between patients managed with and without advanced airway interventions in terms of 48-hour mortality (p=0.035). Discussion: Although the pre-hospital airway management still remains its mystery, we think that providing ventilation with BVM without losing time and transportation to the hospital would be more appropriate for patients in short distances and for patients with less risk of aspiration in terms of mortality and transportation time.
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    Retrospective analysis of the microbiological spectrum of pneumonia in Turkish patients with lung cancer
    (TERMEDIA PUBLISHING HOUSE LTD, 2016) Avci, Nilufer; Hartavi, Mustafa; Kacan, Turgut; Bayindir, Murat; Avci, Mustafa; Ozakin, Cuneyt; Engin, Aynur; Deliqonull, Adem; Evrensel, Turkkan; Akalin, Halis
    Aim of the study: The spectrum of pulmonary infections in patients with lung cancer is wide, and tools for target-oriented infection control measures are necessary. In this retrospective study we report the microbiological spectrum of pneumonia (based on the results of sputum culture) in a case series of Turkish patients with lung malignancies. Material and methods: Between 2010 and 2011 a total of 119 patients (111 males and 8 females, mean age: 59.8 +/- 9.6 years) with lung cancer and pneumonia were identified at the Department of Medical Oncology of two Turkish Universities (Uludag University, Bursa and Cumhuriyet University, Sivas). Expectorated sputum samples were collected in sterile specimen containers and processed immediately in the hospital bacteriology laboratory. Results: Of the 119 study patients, 92 (77.3%) had positive isolates from sputum cultures. The most frequent isolate from the sputum of lung cancer patients with pneumonia was Aspergillus fumigatus (n = 22), followed by Haemophilus influenzae (n = 13) and Pseudomonas aeruginosa (n = 12). The likelihood of having a positive Aspergillus fumigatus sputum culture was significantly and independently associated with febrile neutropaenia (OR = 1.32, 95% CI: 1.17-3.68, p < 0.05) and the development of pneumonia within the first 10 days of chemotherapy initiation (OR = 1.78, 95% CI: 1.37-4.12, p < 0.01). Conclusions: We conclude that Aspergillus fumigatus was the most frequent isolate, but the high diversity of pathogens clearly challenges the empirical use of antimicrobial drugs.