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    Factors influencing recurrent emergency department visits for mild acute respiratory tract infections caused by the influenza virus
    (Peerj Inc, 2023) Tatliparmak, Ali Cankut; Alpar, Suleyman; Yilmaz, Sarper
    Background. Seasonal viral outbreaks, exemplified by influenza A and B viruses, lead to spikes in emergency department (ED) visits, straining healthcare facilities. Addressing ED overcrowding has become paramount due to its implications for patient care and healthcare operations. Recurrent visits among influenza patients remain an underexplored aspect, necessitating investigation into factors influencing such revisits.Methods. Conducted within a tertiary care university hospital, this study adopts an observational retrospective cohort design. The study included adult patients with acute respiratory symptoms diagnosed with influenza using rapid antigen testing. The cohort was divided into single and recurrent ED visitors based on revisits within 10 days of initial discharge. A comparative analysis was performed, evaluating demographics, laboratory parameters, and clinical process data between recurrent visitors and single visitors.Results. Among 218 patients, 36.2% (n = 139) experienced recurrent ED visits. Age and gender disparities were not significant. Antibiotics were prescribed for 55.5% (n = 121) and antivirals for 92.7% (n = 202) of patients, with no notable influence on recurrence. Recurrent visitors exhibited lower monocyte counts, hemoglobin levels, higher PDW and P-LCR percentages, and increased anemia prevalence (p = 0.036, p = 0.01, p = 0.004, p = 0.029, p = 0.017, respectively). C-reactive protein (CRP) levels did not significantly affect recurrence.Conclusion. This study highlights the pressing concern of recurrent ED visits among mild influenza patients, magnifying the challenges of ED overcrowding. The observed notable prescription rates of antibiotics and antivirals underscore the intricate land-scape of influenza management. Diminished monocyte counts, hemoglobin levels, and altered platelet parameters signify potential markers for identifying patients at risk of recurrent visits.
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    A shortcut for preparing doses of positive inotropic drug infusions in emergency patient management-fast inotrope bag (FiB) coefficient''
    (Mre Press, 2023) Alpar, Suleyman; Yilmaz, Sarper; Ak, Rohat
    The most basic rule for the management of patients in the emergency departments (EDs) and critical & intensive units (ICUs) are quick decision and quick order medication. For this reason, calculator applications are a necessary part of EDs in order to calculate some drug doses quickly. With the simple formula we discovered, it will be much easier to place an order for the 4 most frequently used drugs of the EDs (dopamine, dobutamine, norepinephrine, epinephrine). We recommend this simple and fast calculation method to all EDs and ICUs with fast inotrope bag (FiB) coefficient. This coefficient has been developed especially for simple pump devices or dosing devices that do not use ready-made inotropic drug bags and that, if needed, first control the preparation of the solution and then the hourly infusion of the prepared solution. These devices are used only because the amount of solution to be given to the patient per hour can be monitored. Taking advantage of this coefficient, the inotrope needed by the patient can be administered easily and quickly with only the patient's weight information, and the initial dose corresponds to the dose range recommended by the guidelines for inotropes.