Çocuk sağlığı ve hastalıkları uzmanları ile pratisyen hekimlerin ateşli havale hakkındaki görüş ve uygulamaları

Amaç: Ateşli havale (AH), çocukluk çağının sık görülen, iyi huylu ve ateşle ortaya çıkan bir havale türüdür. AH’si olan bir çocuk değişik hekimlik dallarına mensup hekimler tarafından görülebilir. Çalışmada AH ile sık karşılaşan çocuk sağlığı ve hastalıkları uzmanları ile pratisyenlerin hastalık hakkındaki görüş ve uygulamalarının değerlendirilmesi amaçlandı. Yöntem: Çoğunluğu Konya’dan olmakla birlikte muhtelif illerden 100 çocuk sağlığı ve hastalıkları uzmanı ile 100 pratisyen çalışmaya dahil edildi. Uzman ve pratisyenler için ayrı anket hazırlandı. Anketler yüz yüze görüşülerek hekimlerce dolduruldu. Bulgular: Uzmanların % 62.1’i ve pratisyenlerin % 51.6’sı AH denilebilmesi için ateşin en az 38.0 C olması gerektiğini belirtti. Uzmanların çoğu ateşli havalede üst yaş sınırını 6, pratisyenlerin çoğunluğu ise 5 yaş olarak kabul etmekteydi. Uzmanların % 60.0’ının biyokimya, EEG, görüntüleme çalışması gibi tetkikler istediği ve sadece % 13.0’ünün LP gerekçelerini tam olarak bildiği tespit edildi. Pratisyenlerin çoğunluğu AH’yi sevk ettiğini ve % 41.1’i AH’de BOS incelemesinin gerekli olduğunu belirtti. Sonuç: Hem çocuk sağlığı ve hastalıkları uzmanları hem de pratisyenlerin AH ile ilgili bilgilerinde güncellenmesi gereken hususlar vardır. Hizmet içi ve sürekli eğitim bu konuda yararlı olabilir.

Anahtar Kelimeler:

Hekimler, Çocuk, Anketler, Ateş, Nöbetler, febril

The management and the knowledge of pediatrists and general practitioners concerning febrile seizures

Objective: Febrile seizures (FS) are a kind of seizures, benign, age related, commonly appearing during childhood, along with fever. A child with FS can be followed-up by physicians from different medical branches. In our study, we targeted to evaluate the thoughts of pediatrists and general practitioners (GPs) frequently encountering these children with FS. Methods: In the study, two different questionnaires were prepared for pediatrists and GPs, respectively. One hundred pediatrists and 100 GPs were included into the study. Results: As upper age limit in FS, pediatrists accepted six, but GPs accepted five. Of all the participants, 62.1% of the pediatrists and 51.6% of the GPs expressed that minimum body temperature should be at least 38.0 °C to be called febrile seizure. According to most of pediatrists, the upper age limit in FS was six; however, GPs’ opinion, the same level in FS was five years. It was determined that 60.0% of the pediatrists ordered such tests as biochemistry, electroencephalography (EEG) and neuroimaging study, while most of the GPs referred patient to higher health centers. Only 13.0% participant pediatrists expressed the whole lumbar puncture (LP) criteria accepted today in the children with fever and seizures. However, 41.1% of the GPs announced cerebrospinal fluid investigation to be necessary in FS. Conclusion: It was suggested that postgraduational education towards these physicians having the probability of frequently encountering FS patients and giving priorities to this issue more in medical schools will be useful.

Keywords:

Physicians, Child, Questionnaires, Fever, Seizures, Febrile,

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