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    Compliance with CATCH rules in administering computerized tomography scans to children admitted to the emergency department with minor head trauma
    (Carbone Editore, 2013) Katırcı, Yavuz; Ocak, Tarık; Karamercan, Mehmet Akif; Kocaşaban, Dilber; Yurdakul, Mehmet Serkan
    Background: Traumatic brain injury (TBI) is a major health problem frequently encountered in children. Although TBI-associated acute brain damage is frequently observed in children, the need for neurosurgical intervention is rare. In many centers, it has become standard practice to assess children with minor TBI (Glasgow Coma Scale [GCS], 13-15) using head computerized tomography (CT). Therefore. preventing unnecessary CT imaging in children with minor TBI is important. The Canadian Assessment of Tomography for Childhood Head injury (CATCH) guidelines comprise precise rules aimed at reducing CT imaging in pediatric patients with minor TBI. In this study, we retrospectively investigated pediatric patients with head trauma who presented to our emergency clinic and assessed CATCH compliance in cases where CT scans were administered. Methods: This study was performed by retrospectively investigating children 0-18 years of age who had a record of head trauma and underwent brain CT imaging at the emergency clinic of a tertiary city hospital with an annual patient population of approximately 245.000. Children with minor TBI who met the CATCH criteria for CT imaging, including a decrease in GCS to <15 within 2 h following trauma, evidence of an open or depression fracture, irritability during examination, basal skull fracture. large or boggy hematoma on the scalp, fall from a height of 3 feet or down five steps, motorized vehicle accidents, and fall from a motorcycle without a hehnet. were included in this study. The findings regarding compliance with CATCH rules were analyzed statistically. Results: A total of 2.253 children with head trauma presenting over 1 year were examined, and 731 children (32.4%) who undenvent CT scans were included because they conformed to the CATCH rules. Approximately 20% (n = 148) of these cases were asymptomatic. Indications for CT imaging included a dangerous trauma mechanism (77.2%, n = 564), a linear fracture without acute brain damage (5.6%, n = 127), and acute brain damage (1.6%. n = 36). Four patients (0.2%) with depression fractures underwent surgery. Interpretation: It was difficult to reach a consensus on the decision for brain CT imaging for minor head trauma in the pediatric age group. The CATCH criterion related to falling from a height of >3 feet was the most frequent indication for CT imaging in our study. However, the trauma mechanism of simply falling from a height 3 feet was insufficient to justify a decision to perform a CT scan.
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    Patients admitted to emergency units with injuries related to the four Hajj-associated annual animal sacrifice feasts from 2010 to 2013
    (K Faisal Spec Hosp Res Centre, 2016) Baştürk, Mustafa; Katırcı, Yavuz; Ocak, Tarık; Yurdakul, Mehmet Serkan; Duran, Arif
    BACKGROUND: During the Eid al-Adha ("Sacrifice Feast") religious holiday in Muslim communities animal sacrifices are made over a period of 3 days every year. OBJECTIVES: The aim of this study was to determine the type of sacrifice-related injuries, the characteristics of patients, treatments for injuries, and relationships between these factors to determine precautions that could be taken to avoid or mitigate sacrifice-related injuries. DESIGN: Retrospective study of medical records. SETTING: Emergency units at two hospitals from 2010 to 2013. PATIENTS AND METHODS: Patients admitted for treatment for injuries associated with sacrificial cutting during the four annual sacrifice feasts were classified as professional butchers, apprentice butchers, and third persons who were neither professional butchers nor apprentices. MAIN OUTOME MEASRE(S): Injuries associated with animal sacrifice. RESULTS: Of 592 patients, 22 (3.7%) were professional butchers, 149 (25.2%) apprentice butchers, and 421 (71.1%) third persons. Significant relationships were found between the profession of the injured person and the injury and subsequent treatment (P<. 05). CONCLUSION: To prevent and minimize the injuries associated with sacrificial cutting, there should be an area designated for sacrificing animals. Moreover, sacrifices should be performed by professionals in possession of a sacrificial cutting certificate. If owners of sacrificial animals insist on slaughtering animals, they should be trained by professional butchers who have a teaching certificate. To deal with an increasing number of such injuries during the sacrifice feast, hospital emergency units need to be adequately resourced with adequate equipment and staff. LIMITATIONS: Regional and local data could not be assessed completely. Patients who presented on the 4th day were not included in the study.