Research

Area 1

Emergencies: Processes and pathologies

Team leader

Strategic objectives

The group has a general interest in the study of all processes and pathologies inherent to the emergency setting - in all cases adopting a patient – centered approach and focusing on the acute process leading to emergency consultation. This approach is absolutely unique in Catalonia and in Spain, in view of the topic involved and the perspective from which it is addressed. The processes seen in the Emergency Department are exclusive and unique, and improvement in their knowledge leads to healthcare and organizational implications with considerable scope and repercussion. While the transverse characteristics of emergency disease conditions cause them to be dealt with by other disciplines, in the first few hours of their presentation they are exclusively addressed by the Emergency Department, where clinical research has not classically been considered. As a result, the possibilities for gaining in-depth and new knowledge on the part of the group are immense.

Main lines of research

  1. Functional aspects of Hospital Emergency Departments. Since 1997, the group has dedicated an important part of its research effort to exploring the fundamental functional mechanisms of a Hospital Emergency Department. In a series of studies, the group has demonstrated that the most important limiting element regarding the efficacy, effectiveness and quality of the Emergency Department is fundamented upon extrinsic rather than upon intrinsic factors (service demand). Among the intrinsic factors, those dependent upon the Hospital rather than on the Emergency Department as such are the most decisive in determining the functionality of a given Emergency Department.
  2. Clinical aspects of intoxicated patients. This is a line of long tradition and history in our research group. The Clinic Hospital is a reference centre in Catalonia for healthcare and research in relation to intoxications of all kinds. It is a member of the SEMES-TOX group, which is the toxicology working group of the Spanish Society of Emergency Care Medicine and Urgencies, and of the STC-AETOX group of the Spanish Association of Toxicology.
  3. Treatment of arrhythmias in the emergency room. For over 10 years the group has participated in a coordinated manner with the cardiologists of the center, with primary care physicians working in clinics in their corresponding reference areas, and with other investigators in Spain who work in Emergency Departments (the group forms part of the arrhythmias chapter of the Spanish Society of Emergency Care Medicine and Urgencies), in the investigation of disorders of this kind. The most relevant contributions of the group in this setting have been in reference to ATRIAL FIBRILLATION.
  4. Evaluation of chest pain in the Emergency Department. The group coordinates and conducts important research work in the only structural chest pain unit currently operating in Spain, which began its activities in 2002. From the start, the group has centered its efforts on taking advantage of this fact to investigate the medical care of these patients, and to further knowledge of a subgroup of these subjects who had not been diagnosed at the time with acute coronary disease, and had therefore not been sufficiently investigated.
  5. Diffusion of the teaching of cardiopulmonary resuscitation maneuvers among the general population. This is an interdisciplinary line of work which, from its start in the year 2000, has involved different professionals (physicians and nurses in both out- and in-hospital emergency services, with pedagogical support). Its main objective is to explore all the possibilities and difficulties for diffusing knowledge of cardiopulmonary resuscitation maneuvers among the general population. The setting in which the research activity has been most intense is among students in secondary education (14-16 years of age), where the approach is made through a specific program, the PROCES (Programa de Reanimació cardiopulmonar Orientat a Centres d’Ensenyament Secundari, or cardiopulmonary resuscitation program oriented towards secondary education centres) designed exclusively for application in the current Catalan educational model, which has been fully developed by members of the group (Òscar Miró i Andreu, Miquel Sánchez-Sánchez, and Núria Díaz-Miranda).
  6. Emergency medical care for problems caused by drug abuse. Originally conceived as a toxicological variant, the importance and specificity of research in this field made it possible in 2001 to create this line of research. The advantages derived as a result of research from the emergency care perspective has made it possible to clearly improve our knowledge of this group of disorders. At present, the group works in collaboration with other groups in Spain and in other countries.
  7. Acute heart failure. This more recently created research line focuses on the differential aspects (both clinical and epidemiological) of acute decompensated heart failure. Investigation of this syndrome – highly prevalent in Emergency Departments – is carried out in combination with other Emergency Departments throughout Spain, within the context of the acute heart failure working group of the Spanish Society of Emergency Care Medicine and Urgencies.