Asemptomatik Tansiyon Yüksekliğine Acil Tıp Asistanlarının Yaklaşımının Değerlendirilmesi

Öz

Amaç: İstanbul ilindeki Acil Tıp asistanlarının, acil servise başvuran asemptomatik tansiyon yüksekliği olan hastalara yaklaşımlarının
değerlendirilmesidir.
Gereç ve Yöntem: 15 Şubat-15 Temmuz 2015 tarihleri arasında İstanbul ilindeki eğitim ve araştırma hastaneleri ve üniversite
hastanelerindeki Acil Tıp kliniklerinde, Acil Tıp asistanı olarak çalışan 211 hekime anket çalışması yapılmıştır.
Bulgular: Asistanların % 31.3’ü (n=66) asemptomatik tansiyon yüksekliğinde tedaviye başlayacağını ifade ederken, % 68.7’si (n=145)
herhangi bir tedavi uygulamadıklarını ifade etmiştir. Tedaviye başlayacağını ifade edenlerin; tedaviye başlama sınırları sistolik kan
basıncı için 130 ile 200 mm-Hg arasında, diyastolik kan basıncı için 80 ile 120 mm-Hg arasında, ortalama arter basıncı için ise 70 ile
150 mm-Hg arasında değişmektedir. Asistanların % 56.4’ü (n=119) asemptomatik tansiyon yüksekliği ile gelen hastalarda tetkik isteme
eğilimindeyken, % 43.6’sı (n=92) tetkik istemeyeceğini ifade etmişlerdir. Tetkik isteyeceğini ifade edenlerin % 29.4’ü (n=35)
Hemogram, % 79.0’u (n=94) böbrek fonksiyon testleri, karaciğer fonksiyon testleri, % 90.8’i (n=108) elektrokardiyografi, % 31.1’i
(n=37) kardiyak markırlar, % 2.6’sı (n=15) ise beyin BT isteyeceğini ifade etmiştir.
Sonuç: Asemptomatik tansiyon yüksekliği gibi tedavi ve takibi arada konuların standart ve doğru bir yaklaşım ile yönetilebilmesi için,
bu konuyla ilgili eğitimlerin özellikle ilk yıllarda verilmesinin, asistanların yaklaşımlarını değiştirmekte önemli olacağını düşünmekteyiz.

Anahtar Kelimeler

• Acil servis
• Asemptomatik hipertansiyon
• Acil tıp asistanları

Evaluation of Emergency Medical Assistant's Approach to Asymptomatic High Blood Pressure

Öz

Purpose: It is the evaluation of the approach of the Emergency Medicine assistants in the city of Istanbul to patients with asymptomatic hypertension admitted to the emergency department. Material and Methods: A survey was conducted on 211 physicians working as emergency medical assistants in training and research hospitals and emergency medicine clinics in university hospitals in Istanbul between February 15 and July 15, 2015. Results: While 31.3% (n = 66) of the residents stated that they would start treatment in asymptomatic high blood pressure, 68.7% (n = 145) stated that they did not apply any treatment. For those who stated that they would start treatment; The limits of initiation of therapy ranged from 130 to 200 mm-Hg for systolic blood pressure, 80 to 120 mm-Hg for diastolic blood pressure, and 70 to 150 mm-Hg for mean arterial pressure. While 56.4% (n = 119) of the residents tended to request examination in patients presenting with asymptomatic high blood pressure, 43.6% (n = 92) stated that they would not want the test. 29.4% (n = 35) of those who stated that they would want to have a test, hemogram, 79.0% (n = 94) kidney function tests, liver function tests, 90.8% (n = 108) electrocardiography, 31.1% (n = 37) cardiac markers, 2.6% (n = 15) stated that they would require brain CT. Conclusion: We think that training on this subject, especially in the first years, will be important in changing the approaches of residents in order to manage issues such as asymptomatic high blood pressure with a standard and correct approach.

Anahtar Kelimeler

• Emergency clinic
• Asymptomatic hypertension
• Emergency medicine assistants

Kaynakça

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