Pediatrik adli olgular: Bir acil servis deneyimi

Abstract

AMAÇ: Çalışmamızın amacı, üçüncü basamak bir eğitim araştırma hastanesi acil servisine başvuru yapan adli nitelikli pediatrik yaş grubu hastaların demografik, epidemiyolojik özelliklerini ve tedavi sonuçlarını tespit ederek ulusal verilerimize katkı sağlamaktır. YÖNTEM: Bir eğitim araştırma hastanesi acil servisine üç yıl içerisinde başvuran 17 yaş ve altı pediatrik adli olgular geriye dönük olarak incelendi. Bu olgular travmatik olan trafik kazaları, darp, yüksekten düşme, kesici delici alet yaralanmaları, yanık, cinsel istismar, elektrik çarpması, ateşli silah yaralanması ve travmatik olmayan kazara ilaç içme, intihar girişimi, karbonmonoksit intoksikasyonu, besin zehirlenmesi, boğulma olarak iki grupta değerlendirildi. BULGULAR: Çalışmaya dâhil edilen 1737 pediatrik yaş grubu adli olgunun yaş ortalaması 11,09±5,15 yıl olup %60,7’sini n=1055 erkek olgular oluşturdu. En fazla başvuruyu 15-17 %38,7 yaş grubundaki olgular oluşturdu. En sık başvuru %43,1 n=748 ile trafik kazası nedeni ile olduğu görüldü. Bunu %26,3 n=457 ile darp olguları ve %7,5 n=130 ile kazara ilaç içme olguları takip etti. Pediatrik yaş grubu adli olguların en fazla akşam saatlerinde ve yaz aylarında başvurduğu tespit edildi. Sonlanım durumları açısından bakıldığında olguların %77’si n=1337 ayaktan tedavi edilirken %19,2’si n=334 ilgili servise yatırılarak takibe alındı. Ölüm oranının %0,7 n=12 olduğu tespit edildi. SONUÇ: Pediatrik yaş gurubunda meydana gelen adli olguların büyük bir kısmı önlenebilir sağlık sorunlarıdır. Yeni yöntemlerin uygulanması, koruyucu önlemlerin oluşturulması ve acil servislerde uygun medikal yaklaşımın sağlanabilmesi ve hazırlıklı olunması açısından her bölgenin adli olgu sıklığının ve kaynaklandığı nedenlerin belirlenmesi önemlidir.

Keywords

• Acil servis
• pediatrik yaş grubu
• adli olgu
• trafik kazaları

Pediatric forensic cases: An emergency department experience

Abstract

OBJECTIVE: The aim of this study is to analyze the pediatric forensic cases which are admitted to the emergency department of a third level training and research hospital retrospectively. In addition, we also aim to contribute to the national data bank by determining the treatment results and comparing this data with the other studies.METHODS: Pediatric forensic cases below the age of 17 years who were admitted to the emergency department of a training research hospital within a 1-year period were evaluated retrospectively. The cases were evaluated in two groups as traumatic traffic accidents, assault, falling from heights, sharp object injury, burn, electric shock, gunshot injuries and nontraumatic suicide attempt, carbon monoxide intoxication, etc. admissions.RESULTS: 1737 cases were included in the study. The mean age was 11.09±5.15 years and 60.7% n=1055 of the cases were male. The majority of the cases 38.7% were in the 15-17 year age group. The most common cause for admission was traffic accident 43.1% , followed by assault 26.3% and taking overdose drugs 7.5% . The patients were mostly admitted in the evenings and summer months. 77% of the patients were discharged from the emergency department and 19.2% patients were hospitalized; the mortality rate was 0.7%.CONCLUSION: A large proportion of forensic cases occurring in the pediatric age group are preventable medical problems. It is important to determine the frequency and causes of forensic cases in all regions of the country in order to plan implementation of new methods, establishment of protective measures and an appropriate medical approach in emergency services.

Keywords

• Emergency service
• pediatric age group
• forensic case
• traffic accidents

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