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Öğe Perioperative management of Sneddon syndrome during thyroidectomy(2008) Ulukaya S.; Makay O.; Icoz G.; Demir F.; Sezer T.The perioperative management of an adult woman with Sneddon syndrome is presented. This syndrome is characterized by vasculopathy, hypercoagulable state, ischemic cerebral events, livedo reticularis, heart valve disease, and renal insufficiency. During surgery in these patients, the balance between bleeding and thrombosis requires rapid diagnostic information for therapeutic decisions. Thrombelastographic analysis may be a valuable tool to use in monitoring these patients. © 2008 Elsevier Inc. All rights reserved.Öğe Presence of patients' families during cardiopulmonary resuscitation: Physicians' and nurses' opinions(2008) Demir F.Aim. This paper is a report of a study to determine the opinions of physicians and nurses who work in a university hospital intensive care unit and emergency department about the presence of patients' families during cardiopulmonary resuscitation in these units. Background. Healthcare professionals have conflicting opinions about the presence of patients' families during cardiopulmonary resuscitation. Families who are allowed to be present have less fear and worry, feel they have supported their family member and are able to cope more easily. Method. The data for this descriptive questionnaire study were collected between November 2006 and January 2007. The respondents were 62 physicians and 82 nurses who worked in an emergency department or in cardiology or anaesthesia intensive care units in Turkey. The data were collected using a questionnaire and the responses summarized using frequencies and percentages. The chi-squared test was performed to test for differences in the opinion by profession, educational level, or number of years of working experience in the profession. Findings. The response rate was 79%. Of the respondents, 82.6% did not think it was appropriate for patients' families to be present during cardiopulmonary resuscitation. The most common concerns mentioned were that the family would interfere with the team's activities (56.3%) and that resuscitation is a very traumatic procedure (43.6%). Conclusion. Policies need to be developed regarding this topic because the absence of policy can cause misunderstanding and differences in practice. Further research is needed to determine what public education is needed to facilitate implementation of such policies. © 2008 The Author.Öğe Spinal hematoma after epidural catheter removal (case report) [Epidural kateter çekilmesi sonrasi spinal hematom](2010) Sertöz N.; Demir F.; Ayanoglu H.O.A 78-year old female patient with a diagnosis of gonarthrosis, was scheduled for total knee arthroplasty to the left knee under combined spinal and epidural anesthesia. In the lateral decubitus position an 18G Tuohy epidural needle was inserted through L4-5 interspace at the first attempt without any hemorrhagic complication and combined spinal and epidural anesthesia was applied. Since his routine laboratory test results were non-pathologic, his epidural catheter was withdrawn at the 48th postoperative hour. A second dose of low molecular weight heparin was given 1.5 hours after the removal of the catheter. Three hours after the removal of the catheter, severe lumbar and hip pain and paresthesia increasing with movements developed. Cardiovascular surgery was consulted because of development of edema in the operated leg. Doppler US, increase in the dosage of low molecular weight heparin, and 100 mg acety-lsalicylic acid for a putative acute deep venous thromboembolism were recommended. Magnetic resonance imaging obtained after intensification of postoperative lumbar and hip pains revealed an epidural hematoma at T 12-L2 level. The patient had to be taken to the operation room on the postoperative 90th hour when foot drop was developed, and drainage of the hematoma and laminectomy were performed. The patient was discharged from the hospital on the 15. postoperative day without any neurologic defect. In conclusion, subsequent to epidural catheter withdrawal noncompliant with ASRA (Association of Regional Anaesthesia) criteria and earlier anticoagulation, spinal hematoma developed Increase in the dosage of anticoagulation in consideration of deep vein thrombosis without proper consideration of differential diagnosis led to spinal hematoma with neurological findings.Öğe A survey on prevention of surgical infections in operating theaters(2009) Demir F.Background: It is well known that surgical site infections (SSIs) contribute significantly to the cost of nosocomial infections. Although many guidelines and recommendations exist, research has demonstrated that practices for preventing SSIs in operating theaters (OT) vary. Aim: The purpose of this study was to describe the current infection control practices for SSIs, formerly called surgical wound infections, in OTs, and compare these findings with evidence-based practice guidelines. Methods: In order to accomplish the purpose, a prospective, cross-sectional descriptive survey was conducted. Data were collected by interviewing the charge nurses in 24 OTs of 11 hospitals in the city of Izmir, Turkey. The results were tabulated and compared with an evidence-based guideline. Results: Data showed that there is a lack of adherence to the guideline. The most compliant areas to the guideline were hand/forearm antisepsis and the use of surgical gowns and drapes. Implications: It is suggested that increased compliance to infection control guidelines for surgical infections in OTs would facilitate providing best practice and evidence-based care. There is a need for further research to determine why there is a difference between what is practiced and what guidelines indicate should be practiced. © 2009 Sigma Theta Tau International.
