Emergencias
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To determine whether the Emergency Severity Index (ESI) is valid for triage according to evidence based on classifying real patients in a general referral hospital's emergency department. ⋯ This pilot of the ESI triage algorithm in the emergency department of a referral hospital found evidence supporting the system's validity.
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To determine prognostic factors in out-of-hospital cardiac arrests managed with semiautomatic external defibrillators (SAEDs) by emergency health service responders in Galicia, Spain. ⋯ Prognostic factors related to survival of SAED-managed out-of-hospital cardiac arrest in Galicia were the presence of a shockable rhythm, shorter response time, continuation of basic life support measures including advanced airway management, bystander life-support maneuvers, an urban location, and night timing of the arrest.
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To assess the in-hospital and long-term prognostic importance of cardiomegaly demonstrated by a simple admission radiograph in patients hospitalized for acute myocardial infarction. ⋯ Cardiomegaly was an independent predictor of both hospital mortality and long-term mortality after discharge in this series.
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To determine perception of quality of care for acute heart failure (AHF) of patients discharged from the emergency department in comparison with the perception of admitted patients; to explore the variables associated with perception of quality. ⋯ Patients with AHF have high opinions of the different components of care received in the emergency department, and their evaluations are unrelated to whether they were admitted or discharged home. Those discharged home agree with the decision and their opinion remains firm regardless of whether adverse events occur later.
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The purpose of this paper is to describe the main proposals for ensuring national health service sustainability, in the light of a review of the most relevant diagnostic reports and guidelines published since the onset of the economic crisis. The following proposals are among the most frequently mentioned in the literature: selective financing of technology, reorganization to provide more care for chronic conditions and better coordination between levels of care and the network of social and health care services, and the reinforcement of primary care. Also commonly suggested is the reform of health care governance. Likewise, the authors briefly examine the measures adopted to date to promote the system's sustainability and discuss how the emergency department can further this aim.