Ulus Travma Acil Cerrahi Derg. 2012; 18(1): 23-30 | DOI: 10.5505/tjtes.2012.84748

Acil servise baþvuran travma hastalarýnda rutin testlerin gerekliliðinin analizi

Özlem Köksal, Þebnem Eren Çevik, Þule Akköse Aydýn, Fatma Özdemir
Uludað Üniversitesi Týp Fakültesi, Acil Týp Ana Bilim Dalý, Bursa

AMAÇ
Son yýllarda ileri travma yaþam desteði protokollerine göre rutin testlerin gerekliliði tartýþýlmaktadýr. Bu çalýþmanýn amacý, majör travma hastalarýnda rutin testlerin gerekliliði ve tanýsal deðerini analiz etmektir.
GEREÇ VE YÖNTEM
Bu prospektif çalýþmada, Glasgow Koma Skoru 15, Revize Travma Skoru 12 olan ve 15-65 yaþ arasý majör travma ile acil servise baþvuran toplam 103 künt travma hastasý deðerlendirildi.
BULGULAR
Hastalarýn (%30,1 kadýn,%69,9 erkek) yaþ ortalamasý 35±12.97 idi. Tüm hastalarýn %72,8’i araç içi trafik kazasý, %12,6’sý araç dýþý trafik kazasý ve %14,6’sý yüksekten düþme ile baþvurdu. Rutin testlerin hepsi ayrý ayrý deðerlendirildi. Servikal inceleme ile lateral servikal röntgen istemi, pelvik muayene ile tam kan sayýmý ve idrar testi istemi hariç, tam kan sayýmý, yan servikal röntgen ve karýn ultrasonografisi istem nedenleri ile diðer test sonuçlarý ve istem nedenleri karþýlaþtýrýldýðýnda önemli farklýlýklar saptandý.
SONUÇ
Çalýþmamýza göre biyokimyasal testler, ön-arka göðüs grafisi ve ön-arka pelvis grafisi hedefe yönelik testler olarak istenebilir. Hedefe yönelik testlerin istemi ile maliyet ve iþ yükü azalacaktýr.

Anahtar Kelimeler: Majör travma, rutin testler, istem nedeni, hedefe yönelik test.

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Analysis of the necessity of routine tests in trauma patients in the emergency department

Özlem Köksal, Þebnem Eren Çevik, Þule Akköse Aydýn, Fatma Özdemir
Department Of Emergency Medicine, Uludag University, Bursa, Turkey

BACKGROUND
The necessity of routine tests as regarded in the Advanced Trauma Life Support protocols has become controversial in recent years. The aim of this study was to analyze the necessity of routine tests in trauma patients.
METHODS
This was a prospective study. A total of 103 blunt trauma patients aged between 15 and 65 years who presented to the emergency department with major trauma, Glasgow Coma Scale of 15 and Revised Trauma Score of 12 were admitted to the study.
RESULTS
The average age of the patients (30.1% female, 69.9% male) was 35±12.97 years. A total of 72.8% of the patients presented for motor vehicle crashes, 12.6% for pedestrian injury and 14.6% for fall from a height. All of the routine tests were evaluated separately. With the exception of cervical examination-lateral cervical X-ray results and pelvic examination-complete blood count and urinalysis test results, significant relations were determined between the reason for requiring a test and the results of the other tests (complete blood count, lateral cervical X-ray and abdominal ultrasonography).
CONCLUSION
According to our study, biochemical tests, anterior-posterior chest X-ray and anterior-posterior pelvic X-ray can be ordered as targeted tests. Conducting targeted tests will reduce costs and workload.

Keywords: Major trauma, routine tests; reason for requirement; targeted test.

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ATIF KOPYALA