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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Having read the interesting article by Garc&#237;a Caballero et al&#46; entitled &#8220;Limitation of therapeutic effort in patients hospitalized in departments of internal medicine&#8221;&#44; which&#44; among other data&#44; reveals the delay in starting palliative measures&#44; I wish to comment on the option&#44; in selected cases&#44; of starting these measures in the emergency department&#46; Considering that most patients who are admitted to internal medicine departments are hospitalized in urgent situations&#44; this could improve the care for the patients described in the article&#46; The special care conditions of emergency departments and their organization do not facilitate this approach&#46; Observational units<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> would therefore be the most appropriate setting for the joint assessment of this type of patient by the emergency department staff and internal medicine specialists responsible for the hospital units&#46; In recent years&#44; Spanish emergency departments have made a special effort to generate and assess evidence on the predictors of mortality for various diseases and in introducing geriatric assessment scales into clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#8211;5</span></a> These efforts show the interest of practitioners in predicting mortality and in properly addressing geriatric patients&#46; There has been progress in collaborative work among various specialties&#44; in addition to internal medicine &#40;which treats patients who are potential candidates for limitation of therapeutic effort&#41;&#44; such as oncology&#44; hematology&#44; and intensive medicine and practitioners assigned to emergency departments&#46; These collaborations could help prevent the start of measures shown to be ineffective&#44; which extend unnecessary suffering and that result in a delay in implementing palliative measures&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>"
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June - July 2018 Limitation of therapeutic effort in emergency departments: A shared decision
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Vol. 218. Issue 5.
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Vol. 218. Issue 5.
Pages 266 (June - July 2018)
Correspondence
DOI: 10.1016/j.rceng.2018.02.011
Limitation of therapeutic effort in emergency departments: A shared decision
Limitación del esfuerzo terapéutico desde los servicios de urgencias: una decisión compartida
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A. Juan Pastor
Institut Català de la Salut, Barcelona, Spain
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