Emergencias
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To analyze whether current medical residency training programs in Spain foster the acquisition of knowledge and skills that enable specialists to provide emergency and urgent medical care. ⋯ Currently available residency training in Spain does not provide appropriate preparation for practicing emergency medicine. Emergency medicine has its own body of theory and settings for practice that differ from those of other specialties. Therefore, at present there is a training gap in Spain that should be filled by creating a specialization in emergency medicine.
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To evaluate the potential epidemiologic and economic impact of applying an HIV screening protocol in hospital emergency departments (ED) and compare it to current clinical practice in Spain. ⋯ A protocol for targeted screening of persons in circumstances suggestive of risk for HIV infection in Spain would increase diagnoses, avert new infections, and generate savings in comparison with screening practices currently in effect.
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To analyze the characteristics of superior court decisions in litigation or administrative procedures for medical malpractice claims involving urgent care settings in the Spanish national health service. ⋯ In medical and other health-care malpractice cases, the majority of claims (about 64%) are dismissed. This finding, unreported until now, may help to contain the overestimation of risk of liability in urgent medical care. It also reinforces the need to provide medical practitioners with more training regarding the legal aspects of health care.
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Emergency services' main purpose is to save lives, but that worthy mission cannot always be accomplished. When caring for patients toward the end of life, we have an ethical obligation to talk with them and their relatives to obtain consensus on treatment and possibly limit it or adjust management in accordance with the patient's condition. Emergency department protocols are necessary for optimizing care to provide the greatest possible comfort and control of symptoms in patients at the end of life to prevent unnecessary suffering and preserve dignity. This article sets out recommendations - including the principles and ethical standards that underlie them - so that emergency services can develop end-of-life care protocols for use in their own settings.