Elektrik çarpması vakalarının demografik verileri ve yoğun bakım bulgularının incelenmesi
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Tarih
2015
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info:eu-repo/semantics/closedAccess
Özet
Amaç: Günlük yaşantımızda çok yaygın kullanım alanı olan elektrik enerjisinin, bu yaygın kullanımdaki artışla orantılı olmasa da, ölümcül kazalarının sayısı hala yüksektir. Bu kazaların büyük çoğunluğu evlerde ve işyerlerinde meydana gelmektedir Elektrik çarpması (EÇ) yaralanmaları genelde seyrek görülür. Fakat potansiyel olarak yüksek morbidite ve mortalite ile birlikte çoklu sistemi harap edici yaralanmadır Bölgemizde 3. basamak sağlık kuruluşu olarak çalışan hastanemizde, takibi ve yoğun bakımda tedavileri yapılan elektrik yaralanmalı hastaların demografik özellikleri, yoğun bakım skorları, gelişen komplikasyonlar ve organ yetmezlikleri vb durumları, yapılan işlemleri ( mekanik ventilatör, invaziv hemodinamik girişimler ) araştırılması planlandı. Materyal ve Metod: Bu çalışmamızda 2006 ile 2013 Dicle Üniversitesi Tıp Fakültesi yoğun bakımlarında takip ve tedavi edilen elektrik çarpmasına maruz kalmış yaklaşık 80 olgu dosyası taranarak retrospektif olarak incelendi.Çalışma formunda olgularının cinsiyet, yaş, kaza yeri, maruz kaldıkları elektrik akım türü, gelişen komplikasyonlar,eşlik eden yüksekten düşme ve düşmeye bağlı ek patolojiler, yatış süreleri, mekanik ventilatörde kalış süresi kaydedildi.Tam kan analizinde lökosit sayısı, biyokimyasal değerler, hastaların takipleri esnasında çekilen EKG ritm değişiklikleri kaydedildi. Olguların yoğun bakim takiplerinde entübasyon varlığı, hangi yoğun bakımda takip edildiği yatış süreleri, mekanik ventilatörde kalış süresi, enfeksiyon varlığı, mortalite/sağ kalım ve mortalite nedenleri incelendi. Çalışmanın istatistikleri ki-kare, mann-whitney U testi, pearson korelasyon testi ile değerlendirildi. Bulgular: Çalışmada akım türü ile cinsiyet karşılaştırılmasında düşük akımda erkek kadın oranı birbirine yakın bulunurken, yüksek akımda erkek oranı bariz yüksek olarak bulundu. Akım türü ile cinsiyet karşılaştırılması istatistiksel olarak anlamlı bulundu(p=0,01).Olay yeri kaza incelemesine baktığımızda 42(%52,5) ev tipi-düşük akım) 38’i (%47,5) sanayi tipi-yüksek akım olarak tespit edildi. Yüksek elektrik akım maruziyetine kalan hastalar en çok yanık yoğun bakım ve sonrasında cerrahi yoğun bakımlarda takip edilmiştir.Akım türü ile hastaların yattığı yoğun bakım arasında anlamlı bir ilişki bulunmuştur(p=0,05). Hastaların 29(%36,2)’u MV e bağlı bir şekilde yoğun bakım koşullarında takip edildi. Ölüm nedenleri ile EKG bulguları ile karşılaştırılmasında anlamlı bir ilişki bulundu(p=0,006) Sonuç: Günlük yaşam için elektrik vazgeçilmez bir enerji türüdür. Hemen hemen her türlü cihazın kullanımı için mutlaka elektrik enerjisi gereklidir. Dünyadaki kalkınmışlık düzeyi ve teknolojik gelişim, elektrikle çalışan aygıtlar ve tüketilen elektrik enerjisi ile doğru orantılı olarak kabul edilir. Elektrik enerjisi insanlık için ne kadar vazgeçilemez ise de gerekli emniyet tedbirleri alınmadığı sürece sonu ölümlere varan kazalara sebep olmaktadır. Elektrik yaralanmalarından korunabilmek icin meslek gruplarına, çocuk, genç ve erişkinlere, bu tip kazaların etyolojisine ışık tutacak eğitici programlar yapılmalı, yeni stratejiler belirlenmelidir.
Aim: Electricity, which is very widely used in our daily lives, it is widely, but not proportional to the increase in use, the number of fatal accidents is still high. The majority of these accidents occur in homes and workplaces . However, with high morbidity and mortality potentially devastating multi-system injury ,Electric shock (ES) injuries usually are rare. It is aimed to investigate health care provider, monitoring, and demographic characteristics of patients with electrical burn injuries treated in the intensive care unit, intensive care scores, complications, and organ failure, etc. situations, the operations (mechanical ventilation, invasive hemodynamic interventions) in 3.step working as a hospital in our region Materials and Methods: In this study, followed by 2006 and 2013 and treated in intensive care at Dicle University Faculty of Medicine, have been subjected to electric shock retrospectively analyzed 80 patients were scanned file. Working in the form of cases of gender, age, place of accident, exposure to electric current type, complications, concomitant falls and fall-related pathologies, duration of hospitalization, duration of mechanical ventilation were recorded .Analysis of whole blood leukocyte count and biochemical values taken during follow-up of patients with ECG rhythm changes have been saved. Follow-up of intensive care patients the presence of intubation, length of stay, which was followed by intensive care unit, duration of mechanical ventilation, presence of infection, mortality / survival rates and causes of mortality were examined .Statistics for the study were evaluated by Chi-square, Mann-Whitney U-test, Pearson correlation test. Results: With the type of the current study was to compare the sex ratio was similar in men and women at low current and high current male ratio was found to be dramatically higher. Comparison of the current type and gender were statistically significant (p = 0.01) Looking at the crime scene accident investigation at 42 patients (52.5%) of household-low current, 38 patients (47.5%) were identified as industrial high-current. The remaining patients with high electric current exposure were followed up the most burn intensive care and then the surgical intensive care units. The current type of patients in intensive care lies a significant correlation was found (p = 0,05). 29 patients (36.2%) of all patients were followed in intensive care unit by the MV(mechanical ventialtor)-linked form. Causes of death in comparison with ECG findings found no significant relationship (p = 0.006) Conclusion: Electricity;indispensable to our daily life is a kind of energy. The electrical energy for almost all types of use of the device is required. Development level and technological development in the world, is considered to be proportional to the energy consumed and the electric devices . Electrical energy is essential to mankind how long the necessary safety precautions are not taken up until death, cause accidents.To guard against electrical injuries occupational groups, children, young people and adults, educational programs should be made to shed light on the etiology of this type of accidents, new strategies must be determined.
Aim: Electricity, which is very widely used in our daily lives, it is widely, but not proportional to the increase in use, the number of fatal accidents is still high. The majority of these accidents occur in homes and workplaces . However, with high morbidity and mortality potentially devastating multi-system injury ,Electric shock (ES) injuries usually are rare. It is aimed to investigate health care provider, monitoring, and demographic characteristics of patients with electrical burn injuries treated in the intensive care unit, intensive care scores, complications, and organ failure, etc. situations, the operations (mechanical ventilation, invasive hemodynamic interventions) in 3.step working as a hospital in our region Materials and Methods: In this study, followed by 2006 and 2013 and treated in intensive care at Dicle University Faculty of Medicine, have been subjected to electric shock retrospectively analyzed 80 patients were scanned file. Working in the form of cases of gender, age, place of accident, exposure to electric current type, complications, concomitant falls and fall-related pathologies, duration of hospitalization, duration of mechanical ventilation were recorded .Analysis of whole blood leukocyte count and biochemical values taken during follow-up of patients with ECG rhythm changes have been saved. Follow-up of intensive care patients the presence of intubation, length of stay, which was followed by intensive care unit, duration of mechanical ventilation, presence of infection, mortality / survival rates and causes of mortality were examined .Statistics for the study were evaluated by Chi-square, Mann-Whitney U-test, Pearson correlation test. Results: With the type of the current study was to compare the sex ratio was similar in men and women at low current and high current male ratio was found to be dramatically higher. Comparison of the current type and gender were statistically significant (p = 0.01) Looking at the crime scene accident investigation at 42 patients (52.5%) of household-low current, 38 patients (47.5%) were identified as industrial high-current. The remaining patients with high electric current exposure were followed up the most burn intensive care and then the surgical intensive care units. The current type of patients in intensive care lies a significant correlation was found (p = 0,05). 29 patients (36.2%) of all patients were followed in intensive care unit by the MV(mechanical ventialtor)-linked form. Causes of death in comparison with ECG findings found no significant relationship (p = 0.006) Conclusion: Electricity;indispensable to our daily life is a kind of energy. The electrical energy for almost all types of use of the device is required. Development level and technological development in the world, is considered to be proportional to the energy consumed and the electric devices . Electrical energy is essential to mankind how long the necessary safety precautions are not taken up until death, cause accidents.To guard against electrical injuries occupational groups, children, young people and adults, educational programs should be made to shed light on the etiology of this type of accidents, new strategies must be determined.
Açıklama
Anahtar Kelimeler
Demografi, Demography, Elektrik çarpmaları, Electric injuries, Yaralar ve yaralanmalar, Wounds and injuries, Yoğun bakım üniteleri, Intensive care units
