Browsing by Author "Avci, Akkan"

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Etomidate Versus Ketamine Effective Use in Emergency Procedural Sedation for Pediatric Orthopedic Injuries
(2016) Disel, Nezihat Rana; Yilmaz, Hayri Levent; Sertdemir, Yasar; Yesilagac, Hasan; Avci, Akkan; 25834964; AAY-2668-2021
Objectives: The aim of this study was to compare the induction and recovery times, postsedation observation durations, and adverse effects of etomidate and ketamine in pediatric patients with fractures and/or dislocations requiring closed reduction in the emergency department. Methods: Forty-four healthy children aged 7 to 18 years were included. The patients were randomly divided into 2 groups. Group 1 (24 patients) received etomidate and fentanyl, and group 2 (20 patients) received ketamine intravenously. The Ramsay Sedation Scale and American Pediatric Association discharge criteria were used to evaluate the patients. Results: There were 70 fractured bones and 3 joint dislocations. Except in 1 case (2.3%), all of the injuries were reducted successfully. The mean amount of drugs used to provide adequate sedation and analgesia were 0.25 mg/kg of etomidate and 1.30 mu g/kg of fentanyl in group 1 and 1.25 mg/kg of ketamine in group 2. Fourteen patients (31.8%) reported adverse effects, and none required hospitalization. There was no difference between the groups in the recovery times, occurrence of adverse effects, and postsedation observation durations (P > 0.05). The mean (SD) induction time for the patients in group 1 was 4.3 (1.0) minutes, whereas it was 2.2 (1.6) minutes in group 2 (P < 0.001). Conclusions: Etomidate induces effective and adequate sedation in the pediatric emergency department for painful orthopedic procedures. Ketamine, which has longer action times, might be preferred for reductions because orthopedic procedures could be lengthy.
First description of elevated high-sensitivity troponin I for pufferfish poisoning: a case report
(2021) Avci, Akkan; Cinar, Hayri; Yesiloglu, Onder; Avci, Begum Seyda; Yesilagac, Hasan; Sumbul, Hilmi Erdem; 0000-0002-1365-9256; AAJ-6068-2021
The Role of Procalcitonin in Predicting Necessity of Antivenom Administration and Clinical Severity in Snake Bites
(2022) Icme, Ferhat; Avci, Akkan; Yilmaz, Nurettin; Urfalioglu, Ahmet Burak; Avci, Begum Seyda; Yesiloglu, Onder; Tugcan, Mustafa Oguz; Sumbul, Hilmi Erdem; Yesilagac, Hasan; Sapmaz, Ekrem; 35491125
One of the most important steps for preventing deaths due to snake bites is to administer snake antivenom to the eligible patients in a swift manner. In our study, we aimed to investigate whether procalcitonin is useful for predicting the clinical severity and the necessity of antivenom therapy at the early stages in patients presenting with snake bite. A total of 78 patients over the age of 18 who applied to the emergency department within the first 24 hours were included in this retrospective cross-sectional study. Age and sex of patients, severity of snake bites, total antivenom vials administered, observation periods and outcomes were recorded. Patients were graded according to their clinical severity after the snake bite. Procalcitonin, complete blood count and biochemical parameters of the patients were recorded. According to their clinical severity, the patients' grades were as follows: 21 (26.9%) patients were grade 0; 21 patients (26.9%) were grade 1; 16 patients (20.5%) were grade 2; and 20 patients (25.6%) were grade 3. Snake antivenom was administered to 57 (73.1%) patients. There was a statistically significant difference between procalcitonin levels of patients in respect to their grade (P < 0.001). Sensitivity and specificity of procalcitonin levels of 13.45 and above were 100% and 100% respectively, both for the need of antivenom administration and for the blister formation in the patients. According to our study, we believe that elevated procalcitonin levels should alert the clinicians for possible blister formation, higher clinical severity, and increased requirement for antivenom administration.