Emergency Department In Turkey Research Articles

Clinical and Laboratory Effects of Foodborne Illness in Children.

The World Health Organization estimates that 31 foodborne pathogen account for 600 million cases of illness annually. This study, conducted in a pediatric emergency department in Turkey, addresses the limited research on pediatric foodborne diseases (FD) in the country, exposing a significant knowledge gap. Analyzing 17,091 pediatric cases, 106 FD cases were identified, predominantly affecting boys (94.3%) with an average age of 7.65 ± 6.51 years. Remarkably, no patients required pediatric intensive care admission, and no mortalities were recorded. Hyponatremia emerged as a prevalent electrolyte disorder in pediatric FD, while hyperkalemia was notably observed in children under 5. The study emphasizes the severity of FD in children under 5, reflected in longer hospital stays, underscoring the urgent need for targeted interventions and improved detection methods in pediatric FD.

Patients' opinion on violence against healthcare workers and their level of satisfaction in emergency department in Turkey: A cross-sectional study

BackgroundViolence, with an increasing rate of cases in the health care system which adversely affects the quality of provision of services, has become a social health issue that also has negative impacts both on healthcare workers and patients. This study was conducted to determine the opinion of patients, who had been admitted to the emergency department, towards violence against healthcare workers, and their level of satisfaction with health services. MethodsThe study employed a cross-sectional design and was conducted with 348 patients who had received healthcare services in the adult emergency department in Turkey. The Emergency Department Patient Satisfaction Survey and An eight-item questionnaire prepared by the researchers consisting of the patient's characteristics and their statements on violence were used to collect the data. ResultsAmong the patients, 26.7% stated that they had been violent toward healthcare workers. It was determined that 91.4% of the cases were verbal and 8.6% were physical. Among the patients, 82.2% had not known about the legal sanctions for violence against healthcare workers. The low level of propensity for violence in patients who were satisfied with the emergency department service was statistically significant (p < 0.05). ConclusionsAs a result of the study, it was found that one in four patients had been violent to healthcare workers, and the vast majority had a lack of information about legal sanctions. Policymakers should take deterrent measures to prevent the occurrence of violence and develop more critical sanctions.

Missed nursing care in pediatric emergency departments in Turkey: A cross-sectional study

ObjectiveA pediatric emergency department deals with a vast number of patients and a high load of emergent/high-priority healthcare practices. Therefore, at times, it is possible to experience missed nursing care in this department. This study aims to ascertain the types of and reasons for missed nursing care cases in pediatric emergency departments in Turkey. MethodThis is a cross-sectional survey study. Survey data were collected from 155 nurses using the “Introductory Information Form” and the “MISSCARE-Pediatric Emergency Department Survey.” ResultsGastrostomy care, colostomy care, tracheotomy care, and teaching about hospital discharge were the care practices most often missed. The volume of patients, urgent patient situations, an inadequate number of nurses in charge, too many inexperienced nurses in the department, and assignment of work outside the scope of the job are the main reasons for missed care. ConclusionPediatric emergency department patients experience missed nursing care and nurses should be supported more in order for them to provide efficient care to children.

Mental health emergency admissions in the paediatric emergency department.

To evaluate the demographic characteristics, diagnoses and length of stay of mental health emergency attendance to the paediatric emergency department (ED), to determine the burdens these patients brought to the paediatric ED and to the national economy by examining hospital costs. This retrospective observational study was conducted in a tertiary hospital's paediatric ED in Turkey. Data were obtained from the electronic medical record system from January 2018 to January 2020. A total of 142 admissions were included of whom 60% were female. The mean age was 15.2 ± 1.8 years, 50% of cases were suicide attempts and 19% were alcohol intoxications. The majority (85.9%) of patients were discharged from the emergency observation unit. Among the diagnostic groups, the mean age was higher in patients with a history of substance abuse. There was a female predominance among patients who were admitted due to suicide attempts. Among the diagnostic groups, the duration of hospital stay and cost of hospitalization were higher in patients who were followed up with a diagnosis of suicide attempt. Mental health problems are frequent in the paediatric ED. We determined that the most common cause of attendance in paediatric emergencies was suicide attempts, and the length of hospital stay and hospital cost were higher in this diagnostic group. Although further research is necessary to determine national trends in paediatric mental health problems in the paediatric ED, screening strategies and early detection and interventions in primary healthcare may allow more effective care for childhood mental health problems.

Farklı Hekim Gruplarının Pediatrik Akut Bakteriyel Rinosinüzite Yaklaşımları

Objective: Our aim in this study is to analyze the compliance rates with current guidelines by raising awareness among pediatricians, otolaryngologists, general practitioners and family physicians about the diagnosis and treatment of acute bacterial rhinosinusitis. Methods: A survey containing 18 questions was sent to physicians working in the Marmara Region of Turkey. The responses and variables, including age, gender, duration of professional experience, specialty area, and the number of cases diagnosed in one month, were evaluated concerning the current guidelines from the American Society of Infectious Diseases Results: Totally 500 physicians were enrolled into this study. The majority of the physicians participating in the study [91,4% (n=458)] did not know how to differentiate acute rhinosinusitis from viral upper respiratory tract infection clinically. The number of physicians prescribing the correct antibiotic but at the wrong dosage was 186 (37.2%). It was observed that general physicians made more mistakes in determining the diagnosis with the correct criteria than the other specialties (p=0.03). Conclusion: There appears to be a problem of clinical inertia in the diagnosis and treatment of pediatric acute bacterial rhinosinusitis at the emergency department in Turkey, possibly due to unfamiliarity with the condition, patient overload, worries about performance fees, and failure to update medical knowledge concerning current guidelines. Increased emphasis on continuing professional education and various supportive measures for primary care physicians may help to resolve this.

Evaluation of Patients Presenting to the Emergency Department with Suicidal Drug Poisoning

Introduction: Drug intoxications may be associated with accidental or suicidal ingestion of toxic agents. In both cases, emergency treatment includes administration of the relevant antidote and gastric decontamination. If necessary, patients are followed up in wards and intensive care units, whereas a group of patients are discharged directly from the emergency department. Materials and Methods: The aim of this study was to conduct a retrospective evaluation of examination findings, laboratory investigations, duration of treatments, psychiatric follow-up studies, hospitalization rates and mortality rates in patients admitted to our emergency department due to drug intoxication between 2017 and 2018. Results: Of the 126 patients included in our study, 83 were female, with a mean age of 33.58 ± 13.58 years and a range of 18 to 92 years. Of all patients, 76 were hospitalized in the ward and 1 in the intensive care unit, while 49 were treated in the emergency department. One patient had mortality on the eighth day of hospitalization. Eighty-six patients had been on psychiatric treatment prior to admission, whereas 82 patients were referred to the psychiatry department after admission. The rate of psychiatric consultation was significantly higher in patients who were hospitalized in any department due to drug intoxication than in patients who were discharged directly from the emergency department (p &amp;lt;0.001). Conclusion: Drug intoxications continue to be a growing problem for physicians working in emergency departments in Turkey as well as in the world. The incidence of drug intoxications was higher in patients who had previously applied to psychiatry outpatient clinics than those who had not. Our study highlighted the shortcomings of physicians in emergency departments in referring this patient group to the psychiatry department. There is a duty for health professionals in emergency departments to direct patients to receive adequate psychosocial support.

Evaluation of Cardiology Consultation Quality and Quantity Requested from Emergency Departments in Turkey

Introduction: Emergency cardiac consultation is a very big part of cardiology practice and there is not any trial evaluating this subject qualitatively and quantitatively with different perspectives yet. We wanted to investigate this process in terms of correlation between emergency physicians and cardiologists. Methods: Patients who are consulted in a cross-sectional and prospectively 5 different public hospitals were included in the study. In order to examine the nature and intensity of the cardiology consultations and also the diagnostic compatibility, electrocardiography (ECG) and to investigate the adequacy of the first medical treatment were chi-square and correlation analyzes. A P value &lt;0.05 was accepted as a statistical significance limit. Results: Totally 627 patients (502 patients by practitioners and 125 patients by emergency medicine specialists) were consulted to cardiology. The most common admission cause was chest pain (%47.8), and the most common cause of consultation was having no/weak idea about patient’s clinical diagnosis (%39.9). The diagnosis consistency of 48% of consulted patients by EMS was excellent while it was 32.1% in practitioners (p=0.001). Good and excellent ECG interpretation of EMS was 72.8% and it was 50.7% in practitioners (p&lt;0.001). Good and excellent first medical treatment were 46.4% in EMS while it was 38,4 in practitioners (p=0.05). Nearly half of consultations (48.8%) were considered as definitely unnecessary or unnecessary by cardiologists. There was statistically significant correlation between the necessity of consultation and last decision (r=0.811, p&lt;0.001). Conclusion: There is a big variability in emergency cardiac consultations from the standpoint of consultation necessity, ECG interpretation, first medical management quality and accurate diagnosis.

The effect of perceived stress on organizational silence in emergency service doctors in Turkey: The mediating role of emotional intelligence.

The purpose of this study is to determine the role of emotional intelligence in the relationship between the stress perceptions of emergency medicine doctors and their organizational silence behaviors. Data were collected digitally from 434 doctors working in emergency departments in Turkey. On the assumption that perceived stress was effective on organizational silence behavior and that emotional intelligence mediates this relationship, hypotheses were developed and a mediating effect model was established. The research model and hypotheses were shaped through Structural Equation Modeling (SEM). Hayes 4th model was used to test the research hypotheses. The research model was tested via SPSS Process v4.1 by Andrew F. Hayes. According to the correlation analysis to determine the relationship between the variables, it was determined that perceived stress was positively correlated with organizational silence behavior, emotional intelligence was negatively correlated with perceived stress, and emotional intelligence was negatively correlated with organizational silence. As a result of the mediating effect model test, it was determined that emotional intelligence had a statistically significant mediating effect in the effect of perceived stress on organizational silence. Within the framework of the findings, it is thought that emotional intelligence is a key variable in turning the negative energy between stress and silence into positive.

The effect of buzzy and cold spray on pain, anxiety, and fear of children during venipuncture in pediatric emergency department in Turkey; A randomized controlled study

PurposeIt was aimed to evaluate the efficacy of Buzzy and cold spray in reducing pain, anxiety, and fear of children during venipuncture in the emergency department (ED). MethodsThis study is an experimental, parallel-group (intervention-control), randomized controlled, single-blind design. The study was conducted with 161 children aged 5–12 years in pediatric ED. Data were collected by the ‘Personal Information Form’, ‘Wong Baker-Facial Expression Rating Scale’, ‘Child Anxiety Statement Scale’, and ‘Child Fear Inventory’. Data were analyzed with descriptive statistics, Mann Whitney U test, Kruskal Wallis H test, and Intraclass Correlation. ResultsDescriptive features of the children were homogeneous. ‘Wong Baker-Facial Expression Rating Scale’, ‘Child Anxiety Statement Scale’, and ‘Child Fear Scale’ score averages of the children in the control group were higher than the children in the Buzzy group and the cold spray group (p < 0.001). The pain scores of the Buzzy group were higher than those in the cold spray group (p < 0.001). The anxiety and fear mean scores of the children in the Buzzy and cold spray groups were similar (p > 0.05). ConclusionIt was determined that Buzzy and cold spray were more effective than standard care in reducing the level of pain, anxiety, and fear in children ages 5–12 years during venipuncture in the pediatric emergency. The cold spray was more effective in reducing pain than Buzzy. Practice implicationsNurses can use Buzzy and cold sprays to manage the fear, anxiety, and pain associated with venipuncture.

Trends in Geriatric Trauma Emergency Department Admissions During COVID-19.

The impact of coronavirus disease-2019 (COVID-19) on geriatric trauma presenting to the emergency department is unknown. To examine geriatric trauma emergency department admission trends during the COVID-19 pandemic. This retrospective, observational, comparison study was conducted in an academic emergency department in Turkey. Trauma patients 65 years and older who presented to the emergency department within 1 year of March 12, 2020, were included. Patients admitted in the same date range in the previous year were included as the control group. The characteristics of the patients, injured area, and injury mechanisms were compared. Geriatric trauma admissions decreased (relative risk = 0.71, odds ratio [OR] = 0.69 [95% confidence interval, CI: 0.62, 0.77], p < .001). According to the type of injury, there was no significant difference in admissions to the emergency department (p = .318). During the pandemic, there was an increase in falls and a decrease in stab wounds and gunshot wounds (p = .001). Multiple trauma (OR = 5.56 [95% CI: 3.75, 8.23], p < .001), fall (OR = 2.41 [95% CI: 1.6, 3.73], p < .001), and-assault related injuries (OR = 4.43 [95% CI: 2.06, 9.56], p < .001) were determined as factors that increased the admissions to the emergency department compared with the prepandemic. Although geriatric trauma emergency department admissions decreased during the pandemic, those due to falls and assaults increased. Although curfews and social isolation resulted in a decrease in penetrating injuries, assault-related trauma has increased.

Investigating the compassion fatigue in emergency department physicians and nurses

Purpose: This study aimed to determine compassion fatigue in the physicians and nurses working in the emergency department. In this context, this study is the first and original study on compassion fatigue of emergency nurses and physicians in Turkey. Materials and Methods: This research was conducted as a descriptive study to determine compassion fatigue in the physicians and nurses working in emergency departments in Turkey. Results: This study concluded that 73.5% of the nurses and 67% of the physicians had above average compassion fatigue. A significant difference was found between the emergency service nurses and physicians’ total compassion fatigue scores. Conclusions: According to the results of this study, it was determined that the physicians and nurses working in the emergency department had above average compassion fatigue. Timely, appropriate and effective interventions should be undertaken by emergency department managers to reduce physicians’ and nurses’ compassion fatigue levels. It may be recommended to organize training programs for effective stress management and coping strategies for physicians and nurses working in the emergency department. Keywords: Compassion fatigue, emergency department, physician, nurse.

The Effectiveness of National Early Warning Score, Quick Sequential Organ Failure Assessment, Charlson Comorbidity Index, and Elixhauser Comorbidity Index Scores in Predicting Mortality Due to COVID-19 in Elderly Patients.

Introduction: As the mortality rate in coronavirus disease 2019 (COVID-19) patients older than 65 years is considerable, evaluation of in-hospital mortality is crucial. This study aimed to evaluate in-hospital mortality in COVID-19 patients older than 65 years using the National Early Warning Score (NEWS), Quick Sequential Organ Failure Assessment (q-SOFA), Charlson Comorbidity Index (CCI), and Elixhauser Comorbidity Index (ECI).Methods: This retrospective study included data from 480 patients with confirmed COVID-19 and age over 65 years who were evaluated in a university emergency department in Turkey. Data from eligible but deceased COVID-19 patients was also included. NEWS, q-SOFA, CCI, and ECI scores were retrospectively calculated. All clinical data was accessed from the information management system of the hospital, retrieved, and analyzed.Results: In-hospital mortality was seen in 169 patients (169/480). Low oxygen saturation, high C-reactive protein (CRP) and urea levels, and high q-SOFA and ECI scores helped us identify mortality in high-risk patients. A statistically significant difference was found in mortality estimation between q-SOFA and ECI (p <0.001), respectively.Conclusion: Q-SOFA and ECI can be used both easily and practically in the early diagnosis of in-hospital mortality in COVID-19 positive patients over 65 years of age admitted to the emergency department. Low oxygen saturation, high CRP and urea levels, and high q-SOFA and ECI scores are helpful in identifying high-risk patients.

Targeted Temperature Management Experience of an Academic Emergency Department: A 5-Year Retrospective Study.

Targeted temperature management (TTM) for postcardiac arrest syndrome patients is a cornerstone therapy to reduce mortality and neurological morbidity. The care of critical patients is provided in the emergency department (ED) when intensive care units (ICUs) are unavailable. This study aimed to determine the characteristics and mortality outcomes of postcardiac arrest patients who underwent TTM in an academic ED. Postcardiac arrest patients who underwent TTM between January 1, 2014, to November 1, 2018, at a tertiary care academic ED in Turkey were examined retrospectively. The mean age of 24 patients in whom TTM was initiated in the ED was 60.7 ± 19.2 years. Five (20.8%) of the patients who underwent TTM were discharged. Four (80%) of the discharged patients were in out-of-hospital cardiac arrest (OHCA). All patients with a total cardiopulmonary resuscitation duration of >25 minutes died. Mortality was significantly higher in patients without light reflexes (p = 0.006). Two patients who underwent TTM in the ED became organ donors after neurological determination of death. If the ICU cannot meet the needs, early initiation of TTM in the ED may contribute to good neurological outcomes. In this study, 80% of the patients who have positive neurological outcomes are OHCA. Lack of light reflex may be an evidence of poor neurological outcomes in postcardiac arrest patients. Emergency physicians should be encouraged to apply TTM.

The epidemiology of poisoning in emergency department in Turkey

The epidemiology of poisoning in emergency department in Turkey

Clinical Characteristics of Children Diagnosed with COVID-19 in a Pediatric Emergency Department in Turkey

Giriş: Dünyada pandemiye yol açan COVID-19 hastalığının klinik özelliklerinin anlaşılması, hastalığın kontrol altına alınması açısından önemlidir.Amaç: Çalışma çocuk acil servisine başvuran COVID-19 tanılı hastaların klinik özelliklerinin belirlenmesi amacıyla yapıldı.Yöntem: Retrospektif tipteki araştırmanın evrenini 11 Mart 2020 - 1 Temmuz 2020 tarihleri arasında, İstanbul’daki bir hastanenin çocuk acil servisine COVID-19 şüphesi ile başvuran hastalar (N = 183), örneklemini ise Polymerase Chain Reaction test sonucu pozitif çıkan 1 ay-18 yaş arasındaki tüm çocuklar (n = 30) oluşturdu. Verilerin analizinde, tanımlayıcı istatistiksel yöntemler kullanıldı.Bulgular: Araştırmanın yapıldığı çocuk acil servisine COVID-19 şüphesi ile 183 hastanın başvurduğu, bu hastaların %16,39'unun (n = 30) Polymerase Chain Reaction testi sonucunun pozitif olduğu belirlendi. Polymerase Chain Reaction test sonucu pozitif olan çocukların %50'sinin erkek, %50’sinin kız, yaş ortalamalarının 7,2 ± 5,41 yıl (Minimum-Maksimum: 53 gün-17 yaş) olduğu, %96,7’sinin ailesinde de pozitif vaka bulunduğu belirlendi. Çocukların klinik belirtileri ateş (%53,3), öksürük (%36,7), halsizlik (%30), baş ağrısı (%13,3), tat duyusu kaybı (%10) idi. Klinik belirtiler asemptomatik (%16,7), hafif (%70) ve orta (%13,3) şiddette idi.Sonuç: Çocuklarda COVID-19 tanısı alma sıklığının düşük olduğu, hastalığın hafif bulgular ile seyrettiği, en sık görülen bulguların ateş ve öksürük olduğu belirlendi.

Perfusion index: Could this be a new triage tool for upper gastrointestinal system bleeding in the emergency department? A prospective cohort study.

Many scoring systems for predicting mortality, rebleeding and transfusion needs among patients with upper gastrointestinal bleeding (UGIB) have been developed. However, no scoring system can predict all these outcomes. To show whether the perfusion index (PI), compared with the Rockall score (RS), helps predict transfusion needs and prognoses among patients presenting with UGIB in emergency departments. In this way, critical patients with transfusion needs can be identified at an early stage. Prospective cohort study in an emergency department in Turkey, conducted between June 2018 and June 2019. Patients' demographic parameters, PI, RS, transfusion needs and prognosis were recorded. A total of 219 patients were included. Blood transfusion was performed in 174 patients (79.4%). The PI cutoff value for prediction of the need for blood transfusion was 1.17, and the RS cutoff value was 5. The area under the curve (AUC) value for PI (AUC: 0.772; 95% confidence interval, CI: 0.705-0.838; P < 0.001) was higher than for RS (AUC: 0.648; 95% CI: 0.554-0.741; P = 0.002). 185 patients (84.5%) were discharged, and 34 patients (15.5%) died. The PI cutoff value for predicting mortality was 1.1, and the RS cutoff value was 7. The AUC value for PI (AUC: 0.743; 95% CI: 0.649-0.837; P < 0.001) was higher than for RS (AUC: 0.725; 95% CI: 0.639-0.811; P < 0.001). PI values for patients admitted to emergency departments with UGIB on admission can help predict their need for transfusion and mortality risk.

Patients with autism in the emergency department: cause of admissions and challenges

Objective: This study aims to understand the presentations of autism spectrum disorder (ASD) patients in a tertiary hospital’s emergency department (ED) in Turkey, and the difficulties of families face in the ED. Method: Clinical characteristics of ASD patients who presented to the ED between 1 January 2015 and 15 November 2020 were obtained by retrospective file review. The caregivers of the patients who had presented to the ED in 2020 were interviewed by a phone call. Results: There were 740 applications of 224 patients (192 boys, 32 girls). Almost half of the patients were between 0 and 5 years old. Respiratory problems were the most common cause of admissions in all age groups. The second common reasons for ED visits were gastrointestinal problems in 0–5 years old, traumatic injuries/poisoning in 6–12 years old, and epilepsy/syncope in 13–17 years old. Psychiatric problems were less common (2.7%) than other reasons for admission. The most challenging issue for children was “the crowded waiting area, and the long waiting period” and followed by “physical restraint imposed on the child,” “noise,” and “bright light.” Conclusion: As the clinicians’ awareness and use of more accurate diagnostic tools have increased, the ASD prevalence has gradually increased. To increase the quality of healthcare services for these patients, awareness studies and new interventions are needed.

Evaluation of the factors predicting the need for intensive care of patients with COVID-19 aged above 65 years: data from an emergency department in Turkey.

Individuals aged ≥65 years are more susceptible to COVID-19 disease and admission to intensive care is most notable. The scoring systems (national early warning score, quick sequential organ failure assessment, shock index) are recommended for rapid assessment of patients in emergency room conditions. The goal of our study is to evaluate scoring systems in conjunction with predictive factors of need for admission to intensive care of patients ≥65 years old with a diagnosis of COVID-19 who applied to the emergency room. Patients were divided into two groups according to evolution in the emergency room, being those who needed or not intensive care. National Early Warning Score, quick sequential organ failure assessment, shock index scores and serum biochemistry, blood count and blood gas values were evaluated from hospital information management system records. Of the patients included in the study, 80.8% were admitted to the ward and 14.5% to the unit of intensive care. Lymphocyte count, base deficit and bicarbonate levels were lower, and the levels of C-reactive protein, lactate, D-dimer, urea and lactate dehydrogenase were higher in patients who needed intensive care. Quick sequential organ failure assessment and shock index were considered significant in the group admitted to the intensive care unit. We recommend that quick sequential organ failure assessment and shock index be used quickly, practically and easily in predicting the need for intensive care unit in patients aged ≥65 years in emergency department diagnosed with COVID-19.

Allergic reactions due to concomitant administration of multiple drugs in intravenous fluid in emergency departments in Turkey

The present study aimed to evaluate patients who were referred to adult allergy clinic due to allergic reactions after concomitant multiple intravenous-drug administrations in Emergency Department (ED). Between January 2017 and January 2019, patients admitted to our allergy clinic with hypersensitivity reactions to intravenous drugs administered in ED were included retrospectively. Fifty-seven patients who developed allergic reactions after intravenous drug administration in EDs were evaluated. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) were the most common cause of allergic reactions (n = 40, 70.2%). Skin Prick Tests (SPT) were positive in 6 (10.5%) patients. Drug Provocation Tests (DPT) were positive in 10 (17.5%) patients. No significant correlation was found between the total number of drugs in the intravenous fluid and the degree of allergic reaction (r = -0.145, p = 0.282). There was no statistically significant difference between the degree of allergic reaction and history of atopic disease (p = 0.579). In conclusion, concomitant administration of multiple drugs in intravenous fluids may increase the risk of allergic reactions.

Workplace Violence in Emergency Departments in Turkey.

Background Studies on workplace violence against physicians in emergency departments (EDs) in Turkey are lacking. Methods To describe the frequency and types of workplace violence, a 34-question online survey of the past 12 months was sent to physicians working in EDs in Turkey. Types of violence were categorized as verbal threats, physical assaults, confrontation, stalking, and sexual harassment. Results A total of 366 physicians completed the survey; 4 were excluded (minimum 20 hours/week). Sixty-two percent of respondents were men. Ninety-nine percent reported verbal abuse and 54% reported physical violence. Family members, not patients, were the most common perpetrators of every form of workplace violence. Hospitals limiting the number of visitors and loitering had 14% reduction in physical threats. Only 23% of respondents indicated that their hospital offered information about preventing and managing workplace violence even though 86% noted interest. Only 1% never had fear, even though 89% indicated they had security staff. Over 89% felt that hospital security was lacking in number and ability to protect. For 82%, workplace violence affected their ability to provide patient care. Ninety percent indicated that current laws do not adequately protect them. There was also no statistically significant difference in any type of workplace violence based on the timing or length of shifts, type of hospital, or number of hours worked. Of all types of violence reported, only stalking demonstrated a statistically significant difference between men and women. Conclusion Workplace violence is a real danger for physicians working in EDs in Turkey, similar to other countries, demonstrating that this problem transcends borders. Further studies should assess root causes of violent behaviors of patients and their visitors, as well as possible (administrative, social, and legal) mechanisms to minimize such violence. Hospitals that limited the number of visitors and empowered security officers were associated with decreased violence.