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Vol. 57. Issue 2.
Pages 184 (February 2004)
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Vol. 57. Issue 2.
Pages 184 (February 2004)
DOI: 10.1016/S1885-5857(06)60111-4
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The Entrance of the Emergency Department
La puerta de urgencias
Guillermo Burillo-Putzea, María J Hernández Sáncheza, Marcos Expósito Rodrígueza
a Servicio de Urgencias. Hospital Universitario de Canarias. Santa Cruz de Tenerife. Spain.
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To the Editor:

The article recently published by Sanchis et al1 has, we believe, a rather unfortunate title in Spanish. The Dictionary of the Spanish Language edited by the Royal Spanish Academy2 has, as the first meaning of the word puerta: "vano de forma regular abierto en pared..., para poder entrar o salir" (door: "regular shaped opening in a wall..., for entering or leaving") and as its third meaning: "cualquier agujero o abertura que sirve para entrar y salir por él..." ("any hole or opening used for entering or leaving through..."). The emergency room door does not, therefore, appear to be the ideal place to undertake risk stratification studies in patients with chest pain, to make clinical decisions, or even to give immediate medical care. This mistake is repeated later on in the text.

The emergency room door of almost all hospitals in Spain has a hospital porter or a member of the security staff, but we have yet to see a doctor at one, least of all a cardiologist.3 The American College of Emergency Physicians, in its manual Emergency Department Design: A Practical Guide to Planning for the Future,4 situates the area for triage or patient classification, not care, beside the main door, which is usually staffed by trained nurses using specific protocols.

In 2001 the category of hospital emergency physician was created in the area covered by the now defunct National Institute of Health-INSALUD.5 This was later extended to most of the other areas of Spain, which had their own autonomous regions and their own health care organization and responsabilities.6,7 The text of the decree, besides defining the functions of an emergency physician, implicitly recognizes the existence of emergency services with a hierarchical design. We believe the use of terms which, if not biased, are at least outdated in articles in prestigious journals, which we emergency physicians usually read, is the equivalent of talking about bone doctors, shrinks or tooth-pullers.8

Until such time as the specialty of emergency care physician is created,9 this medical work is just as interesting, worthy and gratifying as any other, more so when it is carried out with the optimal infrastructure and staff.

We have previously expressed our opinion in this Journal concerning the relationship between the emergency and cardiology services regarding chest pain units.10 It just remains to congratulate the authors on their work in this respect, although we trust they will in future use more appropriate terms when referring to emergency areas, units or services.

Sanchis J, Bodi V, Llàcer A, Facila L, Pellicer M, Bertomeu V, et al..
Estratificación del riesgo de pacientes con dolor torácico sin elevación del segmento ST en la puerta de urgencias..
Rev Esp Cardiol, 56 (2003), pp. 955-62
21.?? ed. Madrid: Real Academia Espa??ola, 1992; p. 1689.
Montero Pérez FJ, Calderón de la Barca Gázquez JM, Jiménez Murillo L, Berlango Jiménez A, Pérula de Torres L..
Situación actual de los servicios de urgencias hospitalarios en España (I): descripción general y análisis de la estructura física y funcional..
Emergencias, 12 (2000), pp. 226-36
Huddy J..
Emergency department design: a practical guide to planning for the future. Dallas: American College of Emergency Physicians.
Emergency department design: a practical guide to planning for the future. Dallas: American College of Emergency Physicians, (2002), pp. 31-7
BOE de 10 de diciembre de 2001.
Diario Oficial de la Generalitat Valenciana de 16 de septiembre de 2002.
Bolet??n Oficial de Canarias de 22 de febrero de 2002.
Caldeiro MA, Feliu E, Foz M, Gracia D, Herranz G, Lience E, et al..
Medicina clínica. Manual de estilo. Publicaciones biomédicas. Barcelona: Ediciones Doyma.
Medicina clínica. Manual de estilo. Publicaciones biomédicas. Barcelona: Ediciones Doyma, (1993), pp. 47-8
Sra. D.a Ana Mar??a Pastor Juli??n, para informar sobre las l??neas generales que va a desarrollar su Departamento. Diario de Sesiones del Senado de 21 de Octubre de 2002.
Jiménez Murillo L, García..
Castrillo Riesgo L, Burillo. Putge G, Montero Pérez J, Casado Martínez J.L. Unidades de dolor torácico y Urgencias..
Rev Esp Cardiol, 56 (2003), pp. 217-18
Revista Española de Cardiología (English Edition)

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