Acil servisten yoğun bakıma geçiş: detaylı anamnez ve erken görüntülemenin tanı ve tedavi süreçlerine katkısı

Abstract

Amaç: Acil servislerin (AS) aşırı kalabalık olması, sağlık hizmetlerinin kalitesini düşüren ve hem ulusal hem de uluslararası düzeyde mortalite ve morbidite oranlarını artıran önemli bir halk sağlığı sorunudur. Bu çalışmanın amacı, acil servisten yoğun bakım ünitesine (YBÜ) nakledilen hastalarda ayrıntılı anamnez ve erken yatak başı non-invaziv görüntülemenin (ultrasonografi) önemini vurgulamanın yanı sıra acil servislerdeki aşırı hasta yoğunluğunun sağlık hizmetleri üzerindeki etkisini ele almak ve sağlık hizmetlerinin kalitesini artıracak çözümler sunmaktır. Gereç ve Yöntemler: 20.06.2024 ile 25.11.2024 tarihleri arasında Mardin Eğitim ve Araştırma Hastanesi erişkin acil servisinden çeşitli nedenlerle anestezi YBÜ'ye kabul edilen 18 yaş üstü hastalar çalışmaya dahil edildi. YBÜ'ye kabul edilen hastalara ayrıntılı anamnez ve non-invaziv ultrasonografik görüntüleme yapıldı. Bulgular: Anestezi YBÜ'ye kabul edilen 242 hastadan 21'inde ayrıntılı anamnez ve görüntüleme ile hastaların tedavisine katkıda bulunan ek bulgular tespit edildi. Bu hastaların 11'i erkek, 10'u kadındı. En sık başvuru tanıları trafik kazası [8/21, (%38,1)] ve solunum sıkıntısı [6/21, (%28,6)] idi. Sonuçlar: Çalışmamızda, acil servisten YBÜ'ye transfer edilen hastalarda ayrıntılı anamnez ve non-invaziv görüntüleme tekniklerinin uygulanması tanı ve tedaviye ek katkılar sağlamıştır. Acil servise başvuru oranını azaltmak ve acil servisin uygun kullanımını sağlamak için stratejiler geliştirmenin gerekli olduğuna inanıyoruz.

Keywords

• acil servis
• yoğun bakım ünitesi
• ultrasonografi
• detaylı anamnez
• ekokardiyografi

Transition from emergency department to intensive care: the contribution of detailed anamnesis and early imaging to diagnosis and treatment processes

Abstract

Aims: The overcrowding of emergency departments (EDs) is a significant public health issue that diminishes the quality of healthcare services and increases mortality and morbidity rates both nationally and internationally. This study aims to emphasize the importance of detailed anamnesis and early bedside non-invasive imaging (ultrasonography) in patients transferred from the ED to the intensive care unit (ICU). It also addresses the impact of ED overcrowding on healthcare services and proposes solutions to enhance healthcare quality. Methods: Between June 20, 2024, and November 25, 2024, patients over 18 years admitted to the ICU via the adult ED at Mardin Training and Research Hospital for various reasons were included in the study. A detailed anamnesis and non-invasive ultrasonographic imaging were performed for all ICU-admitted patients. Results: Among the 242 patients admitted to the ICU, additional findings that influenced treatment decisions were identified in 21 patients through detailed anamnesis and imaging. Of these patients, 11 were male and 10 were female. The most frequent admission diagnoses were traffic accidents [8/21, (38.1%)] and respiratory distress [6/21, (28.6%)]. Conclusion: Our study demonstrates that performing detailed anamnesis and utilizing non-invasive imaging techniques in patients transferred from the ED to the ICU provides critical contributions to diagnosis and treatment. Strategies should be developed to reduce unnecessary ED visits and promote the appropriate use of emergency services.

Keywords

• Emergency department
• intensive care unit
• ultrasonography
• detailed anamnesis
• echocardiography

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