Browsing by Author "Guven, Ramazan"

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Breaking Bad News in the Emergency Department: How Do the Patients Want It
(Aves, 2018) Guven, Ramazan; Kaykisiz, Eylem Kuday; Onturk, Hatice; Sasmaz, Muhammed Ikbal; Ari, Asim; Eyupoglu, Gokhan; Parlak, Ayse Gurol
Aim: When breaking bad news (BBN) is not managed correctly, the negative impact on patients and patient's relatives is much greater. The aim of the present study was to investigate the thoughts of the patient/patient's relatives about how BBN should be given in four hospitals located in the eastern region of Turkey. Materials and Methods: In this cross-sectional, multicenter study, a total of 760 patients were included using a six-item questionnaire. Participants were divided into two groups according to educational status as high school and below (Group 1) and university and above (Group 2). The difference between the groups was determined according to p<0.05 level of significance. Results: There was a statistically significant difference between the two groups in terms of the answers to items about how, where, and to whom should a doctor tell the death and also possible negative situation of a patient to his/her relatives. All participants were asked where they preferred to stay in the emergency department when cardiopulmonary resuscitation (CPR) was needed in one of the family members. Of the participants, 47.4% (n=360) reported that they preferred waiting in a seat close to the room where CPR was performed. Conclusion: The emergency physician should break the bad news considering the educational status of the patient/patient's relatives. BBN should be carried out by sitting down face-to-face with the patients or family members in a room where no other patients are present. In contrast to some literature data, patient's relatives are more likely to wait near the CPR room instead of watching CPR.
Comparing the Interpretation of Diffusion-Weighted Magnetic Resonance Images Made by Emergency Physicians and On-Call Radiologists
(Emergency Medicine Physicians Assoc Turkey, 2018) Sasmaz, Muhammed Ikbal; Akca, Ali Haydar; Guven, Ramazan; Altan, Burak; Baraz, Nuri; Kirpat, Vedat; Gunduz, Ali Mahir
Aim: Stroke is a leading cause of adult disability and death worldwide. It is very important to determine the ischemic tissue at risk in stroke patients. Although brain computed tomography (CT) is the first and standard imaging technique, diffusion-weighted magnetic resonance imaging (DW-MRI) is superior to CT and is the optimal imaging technique for the diagnosis of acute ischemic stroke. In our study, we aimed to compare the interpretation of DW-MRI between emergency physicians (EP) and on-call radiologists (OCRs). Materials and Methods: This multi-centered, prospective study was conducted at three central hospitals from June 1, 2016 to May 31, 2017. DW-MRI images of the patients were first interpreted by the EP and then by the OCR. Finally, DW-MRI images were interpreted by a definitive result team comprised of two radiologists who were blinded to the study. Sensitivity, specificity, positive predictive value, negative predictive value, and. coefficient were calculated. Results: In total, 315 patients' DW-MRI images were examined. The interpretation sensitivity and specificity rates of the DW-MRI images for EPs were 95.1% and 98.7%, respectively, whereas those for OCRs were 98.8% and 98%, respectively. There was almost perfect agreement (kappa value > -0.80) regarding DW-MRI interpretations of both OCRs and EPs. Conclusion: Our study showed that EPs were very successful in interpreting DW-MRI after a short-term training.