EMS’DE HEMORAJİK TRAVMA OLGULARINDA ŞOK İNDEXİNİN SIVI TEDAVİSİNDE BELİRLEYİCİ ROLÜ: RETROSPEKTİF BİR ÇALIŞMA

Bu makalenin ilk hali 19 Mayıs 2026 tarihinde yayımlandı. https://dergipark.org.tr/tr/pub/hod/article/1404819

Düzeltme Notu

Düzeltme

Öz

Amaç: Çalışmanın amacı, hastane öncesi acil bakımda aktif kanaması olan travma hastalarına sıvı tedavisi başlamada, şok indeksinin (SI) belirleyici rolünün değerlendirilmesidir. Yöntem: Bir üniversite hastanesi acil servisine 01.07.2010-01.07.2020 tarihleri arasında, acil yardım ambulansları ile getirilen 18 yaş ve üzeri, aktif kanaması olan travma hastaları taranmıştır. Toplam 3367 hasta dosyası taranmış, araştırmaya alınma kriterlerine uyan 587 hasta çalışmaya dahil edilmiştir. Hastaların şok indeksleri (SI) EMS ambulansında ilk ölçülen vital bulguları esas alınarak hesaplanmıştır. Bağımsız ve bağımlı değişkenler arasındaki ilişkinin belirlenmesinde ki-kare testi kullanılmıştır. Sonuçlar %95 güven aralığında değerlendirilmiştir ve p<0,05 istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Hastaların, %76.7’sine hastane öncesinde >500 mL IV kristaloid sıvı uygulandığı, %66.4’ünde hastane öncesi SI’a göre hemorajik şok olduğu, %60.3’ünün ilk ölçülen sistolik kan basıncının>90 mmHg olduğu bulunmuştur. Hastanede ex olanların hastane öncesi SI ortalamaları taburcu olanlarınkinden daha yüksektir. SI’a göre şok olmayan hastalardan hastane öncesi IV sıvı uygulananlarda, hastanede ex olma durumunun daha yüksek olduğu bulunmuştur. Sonuç: SI hastane öncesi travmalı hastanın tanımlanmasında ve mortalite değerlendirmesinde bir araç olarak kullanılabilir. Hastane öncesi sıvı tedavisi ihtiyacının belirlenmesinde SI belirleyici bir araç olarak kullanılabilir.

Anahtar Kelimeler

• hatane öncesi acil sağlık hizmetleri
• travma
• şok indeksi
• IV sıvı tedavisi

THE DECISIVE ROLE OF SHOCK INDEX IN FLUID THERAPY IN HEMORRHAGIC TRAUMA CASES IN EMS: A RETROSPECTIVE STUDY

Bu makalenin ilk hali 19 Mayıs 2026 tarihinde yayımlandı. https://dergipark.org.tr/tr/pub/hod/article/1404819

Öz

Aim: The study aimed to evaluate the determining role of the shock index (SI) in initiating fluid therapy in trauma patients with active bleeding in out-of-hospital emergency care. Method: Trauma patients aged 18 years and older with active bleeding who were brought to the emergency department of a university hospital between 01.07.2010 and 01.07.2020 were scanned. A total of 3367 patients’ files were scanned, and 587 of them who met the inclusion criteria were included in the study. The patients' shock indexes (SI) were calculated based on the first measured vital signs in the EMS ambulance. The SPSS was used for statistical analysis. The chi-square test was used to determine the relationship between the independent and dependent variables. The results were evaluated at a confidence interval of 95%, and p <0.05 was accepted as statistically significant Results: It was found that >500 mL IV crystalloid fluid was administered to 76.7% of the patients at out-of-hospital, 66.4% (n=390) had hemorrhagic shock according to the out-of-hospital SI, 60.3% had a systolic blood pressure of >90 mmHg at the first measurement. Out-of-hospital SI averages of those who died in the hospital were higher than those who were discharged. It was found that among the patients who did not have shock according to the SI, those who received out-of-hospital IV fluids had a higher hospital death rate. Conclusion: SI can be used as a tool for out-of-hospital trauma patient identification and mortality assessment. SI can be used as a predictive tool in determining the need for out-of-hospital fluid therapy.

Anahtar Kelimeler

• prehospital emergency health services
• trauma
• shock index
• IV fluid therapy

Kaynakça

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