Araştırma Makalesi
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Pediatrik adli olgular: Bir acil servis deneyimi

Yıl 2018, Cilt: 32 Sayı: 1, 1 - 9, 01.04.2018
https://izlik.org/JA76UY89EN

Öz

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.

Kaynakça

  • Turla A, Aydın B. Evaluation of the judicial cases that have been admitted to Ondokuz Mayıs University Medical Faculty. Adli Tıp Bülteni 2007;12 3 :106-11.
  • Durak D. Judicial problems in emergency room. 1st National Congress of Emergency Department, 02-04 April 2004, Bursa. Proceedings [in Turkish]: 35-8.
  • Baysal S, Birinci A. Childhood injuries and injury control. Turkiye Klinikleri J Pediatr Sci 2006;2:64-8.
  • Ozturk C, Sari HY, Bektas M, Elcigil A. Home accidents and mothers measurements in preschool children. Anatol J Clin Investig 2010;1:15-21.
  • Kenefake ME, Swarm M, Walthall J. Nuances in pediatric trauma. Emerg Med Clin North Am 2013;31:627-52.
  • Turkish Statistics Institute Newsletter. Child in Statistics, 2015: Number: 18622.
  • National Center for Injury Prevention and Control.CDC 24/7 Ten leading causes death and injury. Available from: http:// www.cdc.gov Accessed Online at 11 June 2018.
  • Murphy SL, Xu J, Kochanek KD. Deaths: Final Data for 2010. National Vital Statistics Reports 2013: 61 4 .
  • Turkish Statistics Institute Newsletter. Child in Statistics, 2017: Number: 2464.
  • Pediatric emergency medicine services in Turkey and World: Current status and Suggestions Study Reports. Çocuk Acil Tıp ve Yoğun Bakım Derneği 2008. Available from: http:// www.cayd.org.tr/ tr/raporlar/4 Accessed Online at 9 June 2018.
  • Büken E, Yaşar ZF. Assesment of forensic children cases applying to emergency service of Başkent University Ankara Hospital. Adli Tıp Bülteni. 2015;20 2 :93-8.
  • Türkmen N, Akgöz S, Çoltu A, Ergin N. Evaluation of legal cases admitted to Uludağ University Medical School Emer- gency Department. Uludağ Üniv Tıp Fak Derg. 2005;31 1 :25-9.
  • Korkmaz T, Erkol Z, Kahramansoy N. Evaluation of pediat- ric forensic cases in emergency department: A retrospective study. Med Bull Haseki 2014;52 4 :271-7.
  • Sever M, Saz EU, Koşargelir M. An evaluation of the pediat- ric medico-legal admissions to a tertiary hospital emergency department. Ulus Travma Acil Cerrahi Derg. 2010;16 3 :260-7.
  • Demir ÖF, Aydin K, Turan F, Yurtseven A, Erbil B, Gulalp B. Analysis of pediatric forensic cases presented to emergency department. Turk Arch Ped. 2013;48:235-40.
  • Amanullah S, Heneghan JA, Steele DW, Mello MJ, Linakis JG. Emergency Department Visits Resulting From Intentional Injury In and Out of School. Pediatrics. 2014;133 2 :254–61.
  • Borse NN, Gilchrist J, Dellinger AM, Rudd RA, Balleste- ros MF, Sleet DA. Childhood Injury Report: Patterns of Unin- tentional Injuries among 0-19 Year Olds in the United States, 2006.U. S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Injury Prevention and Control Division of Unintentional Injury Prevention. Atlanta, 2008. Accessed Online at 9 June 2018.
  • Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Eval- uation of the forensic patients presenting to the emergency department and legal reports. Med Bull Haseki 2012;50 1 :14-20.
  • Traffic safety facts 2003 data children. National Center for Statistics and Analysis. Available from: http://www-nrd.nhtsa. dot.gov Accessed Online at 21 June 2018.
  • Injuries in the European Union Summary of injury statistics for the years 2008-2010. European Association for Injury Pre- vention and Safety Promotion EuroSafe Amsterdam, Nether- lands. Available from: http://www.industrialsafety-tp.org Ac- cessed Online at 16 June 2018.
  • Peden M, Oyegbite K, Ozanne-Smith J, et al. World report on child injury prevention. World Health Organization 2008. Available from:http://www. who.int/violence_injury_preven- tion/en/. Accessed Online at 16 June 2018.
  • Children and road traffic injury. World report on child injury prevention. World Health Organization . Available from: http:// www. who.int/violence_injury_prevention/en/. Accessed On- line at 6 July 2018.
  • Aygin D, Açıl H. The study of the intoxication cases of the patients 0-18 years admitting to pediatric emergency unit. The Medical Bulletin of Şişli Etfal Hospital 2014;48 1 :27-33.
  • Bükülmez A, Tahta E, Şen TA, Alpay F. Evaluation of pa- tients with intoxication admitted to the pediatric emergency service. Kocatepe Tıp Dergisi 2013;14 1 :11-6.
  • Ünlü G, Aksoy Z, Ersan EE. Evaluation of children and youth attempting suicide. Pam Tıp Derg 2014;7 3 :176-83.
  • Toklucu MÖ, Akova S, Aydoğdu S, Yazar AS, Kul M. 2010 Demographic features of suicide attempt cases applied to Umraniye Education and Research Hospital Pediatric Emer- gency Department between 2010 and 2012. JOPP Derg ;4 3 :119-23.
  • 14. Santucci KA, Hsiao AL. Advances in clinical forensic medicine. Curr Opin Pediatr 2003; 15 3 : 304-8.
  • Jewkes R, Christofides N, Vetten L, Jina R, Sigsworth R, Loots L. Medico-legal findings, legal case progression, and outcomes in South African rape cases: retrospective review. PLoS Med 2009; 6 10 : 1000164.
  • Oliveira Aded NL, de Oliveira SF, da Silva Dalcin BL, de Moraes TM, Cavalcanti MT. Children and adolescents victim- ized by sexual abuse in the city of Rio de Janeiro: an appraisal of cases. J Forensic Leg Med 2007; 14 4 : 216-20.
  • Magalhaes T, Taveira F, Jardim P, Santos L, Matos E, Santos A. Sexual abuse of children. A comparative study of intra and extrafamilial cases. J Forensic Leg Med 2009; 16 8 : 455-9.

Pediatric forensic cases: An emergency department experience

Yıl 2018, Cilt: 32 Sayı: 1, 1 - 9, 01.04.2018
https://izlik.org/JA76UY89EN

Öz

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.

Kaynakça

  • Turla A, Aydın B. Evaluation of the judicial cases that have been admitted to Ondokuz Mayıs University Medical Faculty. Adli Tıp Bülteni 2007;12 3 :106-11.
  • Durak D. Judicial problems in emergency room. 1st National Congress of Emergency Department, 02-04 April 2004, Bursa. Proceedings [in Turkish]: 35-8.
  • Baysal S, Birinci A. Childhood injuries and injury control. Turkiye Klinikleri J Pediatr Sci 2006;2:64-8.
  • Ozturk C, Sari HY, Bektas M, Elcigil A. Home accidents and mothers measurements in preschool children. Anatol J Clin Investig 2010;1:15-21.
  • Kenefake ME, Swarm M, Walthall J. Nuances in pediatric trauma. Emerg Med Clin North Am 2013;31:627-52.
  • Turkish Statistics Institute Newsletter. Child in Statistics, 2015: Number: 18622.
  • National Center for Injury Prevention and Control.CDC 24/7 Ten leading causes death and injury. Available from: http:// www.cdc.gov Accessed Online at 11 June 2018.
  • Murphy SL, Xu J, Kochanek KD. Deaths: Final Data for 2010. National Vital Statistics Reports 2013: 61 4 .
  • Turkish Statistics Institute Newsletter. Child in Statistics, 2017: Number: 2464.
  • Pediatric emergency medicine services in Turkey and World: Current status and Suggestions Study Reports. Çocuk Acil Tıp ve Yoğun Bakım Derneği 2008. Available from: http:// www.cayd.org.tr/ tr/raporlar/4 Accessed Online at 9 June 2018.
  • Büken E, Yaşar ZF. Assesment of forensic children cases applying to emergency service of Başkent University Ankara Hospital. Adli Tıp Bülteni. 2015;20 2 :93-8.
  • Türkmen N, Akgöz S, Çoltu A, Ergin N. Evaluation of legal cases admitted to Uludağ University Medical School Emer- gency Department. Uludağ Üniv Tıp Fak Derg. 2005;31 1 :25-9.
  • Korkmaz T, Erkol Z, Kahramansoy N. Evaluation of pediat- ric forensic cases in emergency department: A retrospective study. Med Bull Haseki 2014;52 4 :271-7.
  • Sever M, Saz EU, Koşargelir M. An evaluation of the pediat- ric medico-legal admissions to a tertiary hospital emergency department. Ulus Travma Acil Cerrahi Derg. 2010;16 3 :260-7.
  • Demir ÖF, Aydin K, Turan F, Yurtseven A, Erbil B, Gulalp B. Analysis of pediatric forensic cases presented to emergency department. Turk Arch Ped. 2013;48:235-40.
  • Amanullah S, Heneghan JA, Steele DW, Mello MJ, Linakis JG. Emergency Department Visits Resulting From Intentional Injury In and Out of School. Pediatrics. 2014;133 2 :254–61.
  • Borse NN, Gilchrist J, Dellinger AM, Rudd RA, Balleste- ros MF, Sleet DA. Childhood Injury Report: Patterns of Unin- tentional Injuries among 0-19 Year Olds in the United States, 2006.U. S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Injury Prevention and Control Division of Unintentional Injury Prevention. Atlanta, 2008. Accessed Online at 9 June 2018.
  • Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Eval- uation of the forensic patients presenting to the emergency department and legal reports. Med Bull Haseki 2012;50 1 :14-20.
  • Traffic safety facts 2003 data children. National Center for Statistics and Analysis. Available from: http://www-nrd.nhtsa. dot.gov Accessed Online at 21 June 2018.
  • Injuries in the European Union Summary of injury statistics for the years 2008-2010. European Association for Injury Pre- vention and Safety Promotion EuroSafe Amsterdam, Nether- lands. Available from: http://www.industrialsafety-tp.org Ac- cessed Online at 16 June 2018.
  • Peden M, Oyegbite K, Ozanne-Smith J, et al. World report on child injury prevention. World Health Organization 2008. Available from:http://www. who.int/violence_injury_preven- tion/en/. Accessed Online at 16 June 2018.
  • Children and road traffic injury. World report on child injury prevention. World Health Organization . Available from: http:// www. who.int/violence_injury_prevention/en/. Accessed On- line at 6 July 2018.
  • Aygin D, Açıl H. The study of the intoxication cases of the patients 0-18 years admitting to pediatric emergency unit. The Medical Bulletin of Şişli Etfal Hospital 2014;48 1 :27-33.
  • Bükülmez A, Tahta E, Şen TA, Alpay F. Evaluation of pa- tients with intoxication admitted to the pediatric emergency service. Kocatepe Tıp Dergisi 2013;14 1 :11-6.
  • Ünlü G, Aksoy Z, Ersan EE. Evaluation of children and youth attempting suicide. Pam Tıp Derg 2014;7 3 :176-83.
  • Toklucu MÖ, Akova S, Aydoğdu S, Yazar AS, Kul M. 2010 Demographic features of suicide attempt cases applied to Umraniye Education and Research Hospital Pediatric Emer- gency Department between 2010 and 2012. JOPP Derg ;4 3 :119-23.
  • 14. Santucci KA, Hsiao AL. Advances in clinical forensic medicine. Curr Opin Pediatr 2003; 15 3 : 304-8.
  • Jewkes R, Christofides N, Vetten L, Jina R, Sigsworth R, Loots L. Medico-legal findings, legal case progression, and outcomes in South African rape cases: retrospective review. PLoS Med 2009; 6 10 : 1000164.
  • Oliveira Aded NL, de Oliveira SF, da Silva Dalcin BL, de Moraes TM, Cavalcanti MT. Children and adolescents victim- ized by sexual abuse in the city of Rio de Janeiro: an appraisal of cases. J Forensic Leg Med 2007; 14 4 : 216-20.
  • Magalhaes T, Taveira F, Jardim P, Santos L, Matos E, Santos A. Sexual abuse of children. A comparative study of intra and extrafamilial cases. J Forensic Leg Med 2009; 16 8 : 455-9.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Adli Biyoloji
Bölüm Araştırma Makalesi
Yazarlar

Emine Kadıoğlu Bu kişi benim

Gönderilme Tarihi 1 Ocak 2018
Yayımlanma Tarihi 1 Nisan 2018
IZ https://izlik.org/JA76UY89EN
Yayımlandığı Sayı Yıl 2018 Cilt: 32 Sayı: 1

Kaynak Göster

Vancouver 1.Emine Kadıoğlu. Pediatrik adli olgular: Bir acil servis deneyimi. ATD [Internet]. 01 Nisan 2018;32(1):1-9. Erişim adresi: https://izlik.org/JA76UY89EN

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