Acil servis hekimlerinin vertigoya yaklaşımlarının ve standing algoritmasını kullanımlarının değerlendirilmesi

Abstract

AMAÇLAR: Acil servise başvuru oranı yüksek olan vertigo konusunda hekimlerin hastalara ilk yaklaşımlarını ve bilgilerini araştırmak; yeni kılavuzlarda önerilen algoritmaların kullanımı konusunda farkındalık yaratmak; doğru ve hızlı tanı koymak; tanı aşamasında hastaların gereksiz yere muayene edilmesini önlemek; tedavi kalitesini ve hızını artırmak en önemli hedeflerimizdi. YÖNTEMLER: Türkiye'deki tüm illerde yetişkin acil servislerinde çalışan hekimlere çevrimiçi anket gönderildi. Anket beş bölümden ve 34 sorudan oluşuyordu. Demografik bilgileri içeren 4 soru, hastaya genel yaklaşımı sorgulayan 8 soru, vertigo ile ilgili kavramları sorgulayan 4 soru, genel bilgileri sorgulayan 9 soru ve son bölümde algoritmalar ve diğer bilgileri sorgulayan 9 soru vardı. BULGULAR: Türkiye'deki çeşitli hastanelerin acil servislerinde çalışan 171 hekim kendi rızalarıyla ankete katıldı. Katılımcıların medyan yaşı 34 olarak hesaplandı. Vertigolu hastaların yaş aralığı sorulduğunda %43,3'ü 40-50 yaş aralığında olduğunu, %93,6'sı ise kadın hastaların daha fazla başvurduğunu belirtti. En çok istenen test %79 ile EKG oldu. Hastaların %32,3'ünün STANDING algoritmasını bildiğini, %19,2'sinin ise kullandığını belirttiği görüldü. Vertigolu hastalarda HIT testinin kullanılma oranı %38,4 olarak belirlendi. Hekimin vertigolu hastalara ilişkin deneyiminin mevcut yanıt oranı artarken, akademik düzey ile doğru yanıt oranı arasında anlamlı bir fark bulunmadı. SONUÇ: Acil hekimleri, vertigolu hastalar için yatak başı fizik muayene teknikleri konusunda daha fazla eğitim almalı ve STANDING algoritması konusunda daha fazla pratik yapmalıdır.

Keywords

• vertigo
• acil servis
• HİT
• STANDİNG

Evaluation of emergency service physicians' approaches to vertigo and their use of the standing algorithm

Abstract

Aims: The most important goal of the study was to investigate the initial approaches of physicians to patients and their level of knowledge about vertigo, which has a very high rate of emergency department visits; and to make accurate and rapid diagnosis by creating awareness about the use of the STANDING algorithm recommended in the new guidelines. Methods: An online survey was sent to physicians working in adult emergency departments in all provinces in Turkiye. The survey consisted of five sections and 34 questions. There were 4 questions containing demographic data, 8 questions asking about the general approach to the patient, 4 questions about concepts related to vertigo, 9 questions about general knowledge, and the last section included 9 questions asking about algorithms and other knowledge. Results: 171 physicians working in emergency departments of various hospitals in Turkiye participated in the survey with their own consent. The median age of the participants was calculated as 34. When asked about the age range of patients with vertigo, 43.3% stated that they were between 40-50, and 93.6% stated that female patients applied more. The most requested test was ECG with 79%. It was observed that 32.3% of physicians stated that they knew the STANDING algorithm and 19.2% stated that they used it. The rate of using the head impulse test (HIT) test in patients with vertigo was determined as 38.4%. While the current response rate of the physician’s experience with vertigo increased, no significant difference was found between the academic level and the correct response rate. Conclusion: Emergency physicians should receive more training in bedside physical examination techniques for patients with vertigo and should have more practice with STANDING algorithm.

Keywords

• Vertigo
• emergency department
• HIT
• STANDING

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