FOURTEENTH CONGRESS OF THE REPUBLIC) 
OF THE PHILIPPINES 
) 
First Regular Session 
) 
S E N A T E  
S. B. No. 
594 
Introduced by Sen. Jinggoy Ejercito Estrada 
EXPLANATORY NOTE 
Emergency medicine is a recognized specialty medical field in the Philippines. 
This involves immediate decision-making and action to prevent the occurrence of death 
or any further disability for a patient in a life-threatening condition or health crisis usually 
under high-stress conditions. This care is provided by emergency physicians who are 
specially trained to identify, stabilize, evaluate, treat or manage patients who are victims 
of sudden injuries or acute illnesses or injury. 
The patient population caught in emergency situations is unrestricted, presenting a 
wide spectrum of episodic and undifferentiated physical and behavioral conditions 
needing immediate attention to prevent death or disability. However, although the 
specialty is practiced primarily in emergency facilities, it includes broad responsibilities 
relating to community disaster preparedness and emergency medical services (EMS) 
systems which are intricately intertwined. 
At present, majority of hospital emergency units in the country are 
compartmentalized, ill-equipped and staffed with unsupervised physicians, nurses or 
paramedical personnel who have no experience in making critical decisions in life and 
death situations. 
Quality emergency facilities with carefully designed physical 
accommodations hacked by full technological and technical support, and properly trained 
personnel necessary to bridge the gap between pre-hospital and in-hospital care are sadly 
wanting. These result in the absence of, or inadequate delivery of emergency medical 
service. 
This bill, therefore, seeks to professionalize emergency care in the country 
through the organization of emergency departments in tertiary medical situations. 
Hopefully, this will ensure competent emergency care at all times by a team of qualified 
and experienced emergency personnel, learned in the highest standards of emergency- 
care delivery through a program of continuing education and training in the area of life- 
support services. Considering the urgency and relevance of emergency medical care to 
out patient population who cannot afford expensive hospitalization, hut whose conditions 
warrant prompt, timely and proper medical care, the approval of this hill is urgently 
recommended. 


Introduced by Sen. Jinggoy Ejercito Estrada 
AN ACT 
TO PROFESSIONALIZE HOSPITAL EMERGENCY 
SERVICES AND FOR OTHER PURPOSES 
Be it enacted by the Senate and the House of Representatives of the Philippines in 
Congvess assembled: 
SECTION 1. Short Title. - This Act shall be known as the “Emergency Care 
Act of 2007’’. 
SEC. 2. 
Declaration ofPoZicy. - In line with the constitutional concern for 
the value of human life and the right of every person to quality and timely emergency 
care, it is hereby declared the policy of the State to professionalize hospital emergency 
services. 
SEC. 3. 
a) 
Definition of Term. - As used in this Act: 
Appropriate Emergency Care -refers to the care of patients in accordance 
with acceptable emergency medical practice standards; 
b) 
Basic Life Support - means the artificial support of breathing and 
circulation without the use of adjunctive equipment in victims of cardiac and respiratory 
arrest; 
c) 
Disaster - refers to an occurrence when the destructive effects of man- 
made or natural forces overwhelm the capabilities of the medical system to meet the 
demands for health care: 


d) 
Emergency - means the episodic and unanticipated occurrence of health 
crisis of sufficient severity that, in the absence of immediate medical attention, could 
reasonably be expected to place health in serious jeopardy, or result in serious 
impairment of bodily functions or serious dysfunctioning of any body organ or part 
thereof. 
e) 
Emergency Facilities - refer to provisions for the treatment of patients 
under life-threatening or limb-threatening conditions; 
f, 
Emergency Medical Services System (EMSS) - refers to a chain of 
coordinated services to provide quality emergency care to those who are ill or are injured 
at the scene and during transport to an emergency facility; 
g) 
In-Hospital Care - means the practice of the medical profession in a 
hospital institution; 
h) 
Pre-Hospital Care - means the practice of medicine outside the 
jurisdiction of the hospital institutions or tertiary medical institutions; 
i) 
Triage - is a process by which patients are classified depending upon the 
severity of illness or injury in order to prioritize treatment and care. 
SEC. 4. 
Coverage. - This Act shall be applicable to all tertiary medical 
institutions in the country as defined by law or government regulation. 
SEC. 5. 
LeadAgency. - The Department of Health (DOH) shall be the lead 
agency tasked to implement the provisions of this Act and in coordinating the services of 
hospital institutions which have emergency facilities. 
SEC. 6. 
Emergeitcy Care Committee. - There shall be created an 
Emergency Care Committee, hereinafter referred to as the Committee, organized under 
the office of the Department of Health (DOH) to prescribe the resources, manpower and 
intervention framework needed to meet the emergency needs of the populace. 


The Emergency Care Committee members shall be representatives of 
organizations with established or recognized dedication and expertise in Emergency 
Medicine. The Committee shall formulate and review emergency care guidelines and 
shall recommend the same to the Secretary of the DOH for approval and subsequent 
implementation. 
SEC. I. 
Emergency Care Guiding Principles. - In the application of 
emergency care, the following shall be observed: 
a) 
Emergency Department shall have the physical design and resources to 
evaluate and stabilize all who seek emergency care; 
b) 
Emergency care shall be continuously available twenty-four (24) hours a 
day; 
c) 
Timely emergency care shall be provided by qualified emergency 
physicians and emergency nursing staff who are physically present in the Emergency 
Department during all hours of operation; 
d) 
Appropriate emergency care shall be provided, regardless of the patient’s 
ability to pay, to all individuals who receive emergency care; 
e) 
Emergency Departments shall have active public information, education 
and related programs for emergency care information. 
Q 
Emergency care begins in the pre-hospital setting, continues to the 
Emergency Department (ED), and is concluded when responsibility for the patient is 
discharged. 
To promote optimal care, this transfer of responsibility shall be 
accomplished in an effective, orderly and predictable manner. 
SEC. 8. 
a) 
The Emergency Department shall be designed to provided a safe 
environment for the care of emergency patients and shall be accessible and open to all 
individuals, regardless of their economic status or financial capabilities. 
Facilities for Emergency Care. - 


b) 
The Emergency Department shall be designed to protect the right of the 
patient to visual and auditory privacy to the maximum extent reasonably possible, 
consistent with the medical necessity. 
c) 
Appropriate signs shall properly indicate directions to Emergency 
Departments in major thoroughfares. 
SEC. 9. 
Administration. - 
a) 
The emergency facility shall be organized and directed to meet the 
emergency health care needs of the patient populations; 
b) 
There shall be a written organizational plan for Emergency Department 
consistent with the existing hospital by-laws, rules and regulations; 
c) 
Operation of Emergency Department shall be guided by written policies 
and procedures which include: 
1) 
Integration of emergency medical nursing and ancillary services to 
insure that quality, safe and appropriate emergency care is continually monitored 
and evaluated; 
2) 
Formal orientation programs for new staff members in the 
Emergency Department to enable them to understand the mission of the 
institution and fulfill their responsibilities in providing emergency care; 
3) 
Enhance the professional knowledge and skills of emergency 
personnel to provide optimal care to patients; 
4) 
Written duties and responsibilities of physicians, nurses and 
support ancillary personnel in the ED and evaluation of the performance of all 
members of the emergency care team at regular intervals; 
5) 
A triage and screening process of those who enter the facility 
seeking emergency care shall be performed by special1 y-trained personnel under 
the supervision of the medical director of emergency services and the director of 
emergency nursing. Guidelines shall be developed for the screening and other 
process in the emergency care services; 


6) 
The capability to evaluate and stabilize being immediately made 
available for all patients who present any medical emergency condition; 
7) 
The emergency physician being responsible for the overall medical 
care of the patient and a registered nurse being responsible for the nursing 
evaluation, nursing assessment / diagnosis, nursing intervention and nursing care 
of the emergency patient; 
8) 
Maintenance in the ED of a control register identifying all 
individuals who seek emergency care in the facility; 
9) 
A legible and appropriate medical record established for every 
This record shall be retained and 
individual who avails of emergency care. 
promptly made available to emergency staff when needed; 
10) 
A specific, printed or legally written aftercare instructions given to 
all patients discharged or transferred from an ED. Moreover, patients with life- 
threatening or limb-threatening conditions or other emergency medical condition 
shall not be transferred from an emergency facility unless appropriate evaluation 
and stabilization procedures have been initiated; 
11) 
Written transfer policies for transferring patients through a vehicle 
with appropriate life support capabilities, communication capabilities and staff. 
SEC. 10. 
StafJizg. - 
a) 
The ED shall be staffed by appropriately-educated and qualified 
emergency care professional, including a physician and a registered nurse during all 
hours of operation. 
b) 
The medical 'care provided in the ED shall be directed by an emergency 
physician who shall: 
1) 
Posses training or experience in emergency medicine sufficient to 
meet the qualifications for taking the Philippine Board of Emergency Medicine 
(PBEM) certification examination; 


2) 
Possess competence in the management and administration of the 
clinical services in an ED; 
3) 
Be a member of the hospital medical staff. The ED medical 
director shall be a voting member of the executive committee of the hospital’s 
medical staff. In a university-affiliated hospital, emergency physicians shall be 
members of the faculty; 
4) 
5) 
Familiar with pre-hospital emergency care delivery; and 
Ensure that the emergency staff is at all times adequately qualified 
and appropriately educated. 
c) 
The nursing care provided in the ED shalI be directed by a registered nurse 
who shall: 
1) 
Possess education or experience in emergency or critical care 
nursing or who has completed an emergency care education program; 
2) 
services in an ED; 
3) 
Possess competence in management and administration of clinical 
Possess the knowledge and skills necessary to evaluate, manage 
and educate patients in accordance with the standards or emergency nursing 
practice; and 
4) 
Ensure that the nursing and support staff are appropriately 
educated and qualified. 
d) 
The medical director of the ED and the director of the emergency nursing 
shall assess their staffing needs on a regular basis. 
SEC. 11. 
Resources. - 
a) 
Equipment and supplies appropriate for the reasonable needs of all 
patients anticipated by the ED shall always be available in the facility at all times. 
b) 
c) 
Necessary medicines and agents shall always be available in the facility. 
Diagnostic services shall be made available within a reasonable period of 
time for individuals requiring such services. 


SEC. 12. 
Reports. - Hospitals shall make reports at such intervals and 
containing such information, as the lead agency may require. The reports shall include in 
particular, recommendations for improving the delivery of in-hospital emergency care. 
SEC. 13. 
Implementing Rules and Regulations (IRR). - Within one 
hundred twenty (120) days from the date of effectivity of this Act, the Department of 
Health (DOH), 
being the lead agency, shall promulgate the necessary rules and 
regulations for the effective implementation of this Act. 
SEC. 14. 
Repealing Clause. - All laws, presidential decrees, executive 
orders, proclamations, rules and regulations which are inconsistent with the provisions of 
this Act are hereby repealed or modified accordingly. 
SEC. 15. 
Separability Clause. - If, for any reason, any section or provision 
of this Act shall be held unconstitutional or invalid, the other section or provision not 
otherwise affected shall remain valid. 
SEC. 16. 
Effectivity Clause. - This Act shall take effect fifteen (15) days 
from its publication in the Official Gazette or in at least two (2) newspapers of general 
circulation. 
Approved,