THE EFFECT OF THE COVID-19 PANDEMIC PROCESS ON TRAUMA CASES IN PRE-HOSPITAL EMERGENCY HEALTH SERVICES

Öz

Purpose: This thesis was conducted as a retrospective cross-sectional study to evaluate the impact of the COVID-19 pandemic process on trauma cases receiving Pre-Hospital Emergency Medical Service. Material and Methods: The population of the study consisted of all patients in Türkiye who received Pre-Hospital Emergency Medical Service from the Ministry of Health 112 Emergency Health Services. The research data was analyzed in two stages. The first phase is the 24-month period before 11.03.2020, when the first COVID-19 case was seen in Turkey, and the second phase is the 24-month period after 11.03.2020. In evaluating descriptive data number (n) and percentage (%) were examined. Non-parametric data was analyzed with Mann-Whitney U and Kruskal-Wallis H tests. Results: 234,000 cases were included in the study, 50.2% (n = 117,408) belong to the pre-COVID-19 pandemic period, and 49.8% (n = 116,592) belong to the pandemic. When the distribution of cases according to the trauma area is examined; head and neck (59.47% vs. 56.82%), upper extremity (14.47% vs. 13.25%) and thorax (1.94% vs. 1.54%) traumas during the pandemic period increased compared to pre-pandemic period. Lower extremity (9.03% vs. 11.78%) and multiple trauma cases (7.18% vs. 9.01%) decreased during the pandemic period. When the distribution of cases according to trauma mechanism is examined; during the pandemic period, the cases of blunt trauma (57.58% vs. 54.71%) and penetrating trauma (13.14% vs. 11.91%) increased compared to the pre-pandemic period. Falls (1.02% vs. 1.29%), gunshot (6.22% vs.6.62%) and blast trauma cases (0.04% vs. 0.17%) decreased. Conclusion: During the pandemic period in Türkiye, although there was an increase in home accidents, there was a decrease in traffic accidents. In general, contrary to the literature, there was a decrease in firearm injuries during the pandemic in Türkiye. During the pandemic, various factors, especially the concern about contamination, increased the refusal to be transferred to the hospital in patients receiving Pre-Hospital Emergency Medical Service

Anahtar Kelimeler

• Pre-Hospital Emergency Medical Services
• COVID-19
• Trauma

COVİD-19 PANDEMİ SÜRECİNİN HASTANE ÖNCESİ ACİL SAĞLIK HİZMETLERİNDE TRAVMA OLGULARI ÜZERİNE ETKİSİ

Öz

Amaç: Çalışma, COVİD-19 Pandemi sürecinin Hastane Öncesi Acil Sağlık Hizmeti alan travma olguları üzerine etkisini değerlendirilmek amacıyla, retrospektif kesitsel bir çalışma şeklinde yapılmıştır. Gereç ve Yöntem: Araştırmanın evrenini TC Sağlık Bakanlığı 112 Acil Sağlık Hizmetleri’nden Hastane Öncesi Acil Sağlık Hizmeti alan Türkiye’deki tüm hastalar oluşturmuştur. Araştırma verilerinin iki aşamalı olarak değerlendirilmesi yapılmıştır. Birinci aşama Türkiye’de ilk COVİD-19 vakasının görüldüğü 11.03.2020 öncesi 24 aylık dönem, ikinci aşama ise 11.03.2020 sonrası 24 aylık dönemdir. Tanımlayıcı verilerin değerlendirilmesinde sayı (n) ve yüzde (%) dağılımları incelenmiştir. Parametrik olmayan verilerin analizi ise Mann-Whitney U ve Kruskal-Wallis H testleri ile analiz edilmiştir. Bulgular: Çalışmaya 234.000 olgu dahil edilmiş olup %50,2’si (n=117.408) COVİD-19 Pandemisi öncesi döneme, %49,8’i ise (n=116.592) pandemi dönemine aittir. Olguların travma bölgesine göre dağılımı incelendiğinde; pandemi döneminde baş-boyun (%59,47’ye karşın %56,82), üst ekstremite (%14,47’ye karşın %13,22) ve toraks (%1,94’e karşın %1,54) travmaları pandemi öncesi döneme göre artmıştır. Alt ekstremite (%9,03’e karşın %11,78) ve çoklu travma olguları (%7,18’e karşın %9,01) ise pandemi döneminde azalmıştır. Olguların travma mekanizmasına göre dağılımı incelendiğinde; pandemi döneminde künt travma (%57,58’e karşın %54,71) ve delici-kesici travma (%13,14’e karşın %11,91) olguları pandemi öncesine göre artmıştır. Düşme (%1,02’ye karşın %1,29), ateşli silah (%6,22’ye karşın %6,62) ve blast travma olguları (%0,04’e karşın %0,17) ise azalmıştır. Sonuç: Türkiye’de Pandemi sürecinde, ev kazalarında artış olmakla birlikte, trafik kazalarında azalma meydana gelmiştir. Genel olarak literatürün aksine Türkiye’de Pandemi sürecinde ateşli silah yaralanmalarında azalma meydana gelmiştir. Pandemi sürecinde bulaşma kaygısı başta olmak üzere çeşitli faktörler, Hastane Öncesi Acil Sağlık Hizmeti alan hastalarda hastaneye nakil reddini arttırmıştır.

Anahtar Kelimeler

• Hastane Öncesi Acil Sağlık Hizmetleri
• COVİD-19
• Travma.

Kaynakça

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