FIFTEENTH CONGRESS OF THE REPUBLIC 
) 
OF THE PHILIPPINES 
) 
First Regular Session 
) 
SENATE 
Senate Bill No. 638 
7 
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 lifesupport 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 bill is urgently recommended. 


FIFTEENTH CONGRESS OF THE REPUBLIC 
OF THE PHILIPPINES 
First Regular Session 
SENATE 
Senate Bill No. 
638 
) 
) 
) 
- " 
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 Congress assembled: 
SECTION 1. Short Title. - This Act shall be known as the "Emergency 
Care Act of 2010". 
SEC. 2. Declaration of Policy. - 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. Definition of Terms. - As used in this Act: 
a) 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 
manmade 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. Lead Agency. - 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. Emergency 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 
Emergericy 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. 7. 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. 
f) 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. - Facilities for Emergency Care. 
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. 
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 
Oulfil 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 ali 
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 specially-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 
individual who avails of emergency care. This record shall be retained and 
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. Staffing.-
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) Familiar with pre-hospital emergency care delivery; and 
5) Ensure that the emergency staff is at all times adequately qualified 
and appropriately educated. 
c) The nursing care provided in the ED shall 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) Possess competence in management and administration of 
clinical services in an ED; 
3) 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) Necessary medicines and agents shall always be available in the facility. 


• 
• 
c) 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,