• Òscar Miró, Carolina Sánchez, Víctor Gil, Daniel Repullo, Eric Jorge García-Lamberechts, Juan González Del Castillo, and Pere Llorens.
• Área de Urgencias, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España. Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, España.
• Emergencias. 2022 Apr 1; 34 (2): 85-94.

ObjectivesTo describe routine diagnostic and therapeutic care processes and assignment of resources available for treating patients with acute heart failure (AHF) in Spanish hospital emergency departments (EDs).Material And MethodsWe surveyed the heads of all hospital EDs in the Spanish national health service concerning their routine diagnostic, therapeutic, and decision-making processes for treating patients with AHF. Questions also covered processes related to continuity of care for patients after discharge. Responses were grouped by hospital size and location (Spanish autonomous community) for comparison.ResultsHeads of 250 of the 282 EDs (89%) responded. Thirty-two percent had a cardiologist on call, and a specialized AHF unit was present in 35%. Such untis were present in more than half the EDs in the Community of Madrid and in Catalonia. Eighty-four percent of EDs measured natriuretic peptide (NP) levels, 80% carried out echocardiographic assessments (although only 24% reported that more than half their staff were trained to undertake echocardiography), and 64% had high-flow nasal cannula (HFNC) systems. Only the Community of Valencia, Navarre, and La Rioja had the capacity for NP analysis, echocardiography, and HFNC therapy in 80% or more of their hospital EDs. Forty-six percent had admission protocols for patients with AHF, and 60% scheduled outpatient clinic appointments on discharge. Fifty-seven percent of the hospitals with AHF units had consensus-based protocols with their EDs, and 40% of them could schedule clinic appointments from the ED. Large hospitals had significantly better conditions with respect to some of these aspects of organization and care.ConclusionThere is room for improvement in the diagnosis and treatment of patients with AHF. We detected opportunities to ensure more effective continuity of care for these patients.

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