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D134 JijM 30 P8 :41 
THIRTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session 
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SENATE 
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INTRODUCED BY HON. MANUEL B.. VILLAR, JR. 
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EXPLANATORY NOTE 
Emergency medicine 'is a recognized specialty medical field in the 
Philippines. This involves crucial decision-making and immediate action to save 
life and prevent any further disability to a patient in a life-threatening 
condition. This care is provided by emergency physicians who are specially 
trained to identify, stabilize, evaluate, treat or manage patients who are victims 
of accidents or acute illnesses or injury. 
At present, majority of hospital emergency units in the country are ill- 
equipped and lacking in medical personnel who have adequate knowledge and 
experience in emergency medicine. 
Hence, this bill seeks to professionalize emergency care in the country 
through the organization of emergency departments in tertiary medical 
situations. With its passage, it is hoped that competent emergency care shall be 
ensured and made available to the public. 
Considering the urgency and relevance of emergency medical care to out 
patient population who cannot afford expensive hospitalization, but whose 
conditions warrant prompt, timely and proper medical care, approval of this bill 
is earnestly sought. 


THIRTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session 
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m :  
SENATE 
S. No. ' 
615 
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INTRODUCED BY HON. MANUEL B. VILLAR, JR. 
TO PROFESSIONALIZE HOSPITAL EMERGENCY SERVICES 
AND FOR OTHER PURPOSES 
Be it enacted by the Senate and House of Representatives of the Philippine in Congress 
assembled: 
SECTION 1. Short Title. - This Act shall be known as the "Emergency Care Act 
of 2004." 
SECTION 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. 
SECTION 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; 
Basic Life Support pertains to the artificial support of breathing and 
circulation without the use of adjunctive equipment in victims of cardiac 
and respiratory arrest; 
b. 
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; 
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 
dysfunction of any body organ or part thereof. 
Emergency Facilities refer to provisions for the treatment of patients 
under life-threatening or limb-threatening conditions; 
d. 
e. 
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; 
In-Hospital Care is the practice of the medical profession in a hospital 
g. 


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Institution; 
Pre-Hospital Care is the practice of medicine outside the jurisdiction of 
the hospital institutions or tertiary medical institutions; 
Triage is a process by which patients are classified depending upon the 
severity of illness or injury in order to prioritize treatment and care. 
h. 
i. 
SECTION 4. Coverage. - This Act shall be applicable to all tertiary medical 
institutions in the country as defined by law or government regulation. 
SECTION 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. 
SECTION 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 emetgency 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. 
SECTION 7. Emergency Care Guiding Principles. - In the application of 
emergency care, the following shall be observed: 
a. 
The Emergency Department shall have the physical design and resources 
to evaluate and stabilize the condition of all who seek emergency care; 
Emergency care shall be continuously available twenty-four (24) hours a 
b. 
day; 
c. 
Timely emergency care shall be provided by qualified emergency-trained 
physicians and emergency-trained nursing staff who are physically 
present in the Emergency Department during all hours of operation; 
Appropriate emergency care shall be provided, regardless of the patient's 
ability to pay, to all individuals who require emergency care; 
d. 
e. 
The Emergency Departments shall have active public information, 
education and related programs for emergency care information. 
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. 
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SECTION 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. 
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. 
b. 
c. 
Appropriate signs shall properly indicate directions to Emergency 
Departments in major thoroughfares. 
SECTION 9. Administration. 
a. 
The emergency facility shall be organized and directed to meet the 
emergency health care needs of the patients; 
There shall be a written organizational plan for Emergency Department 
consistent with the existing hospital by-laws, rules and regulations; 
Operation of Emergency Department shall be guided by mitten policies 
and procedures which include: 
1. 
b. 
c. 
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; 
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; 
The capability to evaluate and stabilize being immediately made 
available for all patients 
who presents any medical emergency 
condition; 
The emergency physician being responsible for the overall medical 
care of the patient and a registered nurse being responsible for 
5. 
6 .  
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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; 
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; 
A specific, printed or legibly 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; 
Written trqnsfer policies for transferring patients through a vehicle 
with 
appropriate life 
support 
capabilities, 
communication 
capabilities and staff. 
9. 
10. 
1 1. 
SECTION 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. 
The medical care provided in the ED shall be directed by an emergency 
physician who shall: 
1. 
b. 
Posses training or experience in emergency medicine sufficient to 
meet the qualifications for taking the Philippine Board of 
Emergency Medicine (PBEM) certification examination; 
Possess competence in the management and administration of the 
clinical services in an ED; 
2. 
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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; 
Familiar with pre-hospital emergency care delivery; and 
4. 
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; 


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2. 
Possess competence in management and administration of clinical 
services in an ED; 
Possess the knowledge and skills necessary to evaluate, manage 
and educate, patients in accordance with the standards or 
emergency nursing practice; and 
3. 
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. 
SECTION 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. 
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. . 
b. 
c. 
SECTION 12. 
Reports. - Hospitals shall make reports at such intervals 
and containing such information, as the lead agency may require. The report shall 
include in particular, recommendations for improving the delivery of in-hospital 
emergency care. 
SECTION 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. 
SECTION 14. Repealing Clause. - All laws, presidential decrees, executive 
orders, proclamations, rules ahd regulations which are inconsistent with the 
provisions of this Act are hereby repealed or modified accordingly. 
SECTION 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. 
SECTION 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,