ROAD SAFETY FORUM 2014
Road Safety: Everybody’s Responsibility
PNP Multi-Purpose Center, Main Hall
National Headquarters Camp Crame
Quezon City, Metro Manila
May 16, 2014
8:00 AM – 5:00 PM
DOH RESPONSE TO POST-CRASH
CARE
CLARITO U. CAIRO, JR., MD, DPSVI, DPCOM
ACCREDITED SAFETY AND HEALTH PRACTITIONER
PROGRAM MANAGER, VIOLENCE AND INJURY PREVENTION
ESSENTIAL NON-COMMUNICABLE DISEASE DIVISION
DISEASE PREVENTION AND CONTROL BUREAU
Email: [email protected] / [email protected]
DEPARTMENT ORDER NO. 2008-0055
“Guidelines on the Disbursement / Utilization
of Road Safety Trust Funds for the
Operationalization of the National Electronic
Injury Surveillance System (NEISS) in Philippine
Orthopedic Center, Jose Reyes Memorial
Medical Center, East Avenue Medical Center,
Quirino Memorial Medical Center, Davao
Medical Center, and Vicente Sotto Medical
Center”
ONEISS CY 2010-2013
YEAR
NO. OF
REPORTING
HOSPITALS
NO. OF
REPORTED
CASES
TRANSPORT /
VEHICULAR
ACCIDENT
MAULING
FALL
2010
115
35,068
11,674
2,525
5,111
2011
100
41,331
13,594
7,944
6,771
2012
125
64,256
19,263
12,948
11,733
2013
64
40,149
13,938
7,075
6,721
NO. OF HOSPITALS IN THE PHILIPPINES: 1,821 http://uhmis1.doh.gov.ph/unifiedhmis
DOH
70
GOVERNMENT
662
PRIVATE
1,089
DEPARTMENT ORDER NO. 2011-0047
“Creation of the Philippine Network for Injury
Data Management System (PNIDMS)”
MEMBERS
DOH, DOTC, DPWH, UNICEF, WHO, PNPHPG, MMDA, SAFE KIDS PHILIPPINES, LTO,
DOLE, DSWD, UP-NCTS, NBI, BFP, CHED, NSO,
PHILHEALTH, PCW, PIRA, DEPED
http://uhmis2.doh.gov.ph/pnidms
ADMINISTRATIVE ORDER
NO. 2013-005
“National Policy on the Unified
Registry Systems of the Department
of Health (Chronic NonCommunicable Diseases, InjuryRelated Cases, Persons with
Disabilities, and Violence Against
Women and Children Registry
System)
ADMINISTRATIVE ORDER
No. 2014 - 0002
“Revised National Policy on
Violence and Injury
Prevention”
REVISED NATIONAL POLICY ON VIOLENCE
AND INJURY PREVENTION
ROAD TRAFFIC INJURIES
ADMINISTRATIVE ORDER
No. 2014 - 0007
“National Policy on the
Establishment of Prehospital
Emergency Medical Service
System”
RATIONALE
As an integral part of the Revised National
Policy on Violence and Injury Prevention
(AO 2014-0002), there is a need to
establish a prehospital EMS system at the
national and local level in order to prevent
deaths due to injuries and to minimize or
mitigate occurrence of disabilities.
GENERAL OBJECTIVE
Institutionalize a comprehensive,
accessible and integrated system of
prehospital emergency medical services
from the scene of incident to the
appropriate health care facility or hospital
at the national and local level.
SPECIFIC OBJECTIVES
• Develop, implement, monitor and evaluate evidencebased and customized standards and guidelines for
best practices in prehospital emergency medical
services;
• Enhance capacity of Regional Offices (ROs), Local
Government Units (LGUs), and other stakeholders as
well as strengthen collaboration with them towards
establishing an efficient and sustainable prehospital
EMS system; and
• Ensure full operationalization and implementation of
the prehospital EMS system from the national level
down to the grassroots level.
Action Framework for Prehospital Emergency Medical
Service System
Emergency Dispatch
• involves the immediate identification and
prioritizing of emergency situations, the timely
dispatch of the most appropriate resources and
full endorsement to the receiving hospital.
Dispatch encompasses all aspects of
communication including request processing,
coordination and support, and documentation
and monitoring
INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT
1ST TIER
2ND TIER
3RD TIER
Awareness of the people
on the available
emergency numbers
Presence of a Unified
Local Hotline Number
Presence of a Functional
National Hotline
Number
EMERGENCY
DISPATCH
Communication
Facilities
Education among lay
persons already
strengthened
Personnel Dispatched
Expected Response
Time
Barangay Responders
and Lay Persons
20 minutes
Complete range of EMS
personnel including a
specialist (emergency
Wide array of responders
medicine or trauma
up to presence of a
surgeon) in the EMS
general physician in the
team
EMS team
10-15 minutes
< 10 minutes
Emergency Response and Care
• involves arrival of resources at the scene and
the timely initiation of appropriate interventions
INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT
1ST TIER
2ND TIER
3RD TIER
First Aid and Basic Life
Support
Basic Life Support and
Advanced Life Support
(depending on the
training and capability of
dispatched personnel
Advanced Life Support
Readily available basic
first aid kit in the
community
Complete equipment for
BLS. Need to have
readily available ALS
equipment (desirable but
would depend on the
training and capability of
emergency personnel)
Wide-range of available
equipment in the
provision of BLS and
ALS interventions
EMERGENCY
RESPONSE AND
CARE
Services provided onsite
Special
equipment/resources
utilized/required
Emergency Transport
• involves transporting the patient to the most
appropriate facility and continued provision of
care en route
INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT
1ST TIER
2ND TIER
3RD TIER
Ambulance Type B
Wide range of vehicles
Complete Range of
Vehicles (ideal number of
responders vis-a-vis
number of ambulance
used
Patient Transport w/
capacity to provide BLS
BLS w/ capacity to
provide ALS (depending
on the training and
capability of responders
and ambulance type and
equipment
Advanced Life Support
EMERGENCY
TRANSPORT
Transportation
Options
Services Provided en
route to Hospital
Inter-Facility Referral and Transport
• involves the transport of patient with medical
escorts, if necessary, from one facility to
another, as the patient requires services that are
not available in the referring facility
INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT
1ST TIER
2ND TIER
3RD TIER
Strengthening of
existing health
facilities
Availability and
strengthening of
trauma-receiving
facilities
Availability of
Trauma-capable
Facility
INTER-FACILITY
REFERRAL AND
TRANSPORT
Referral Network
Existing Healthcare Delivery Systems
• involves the various levels of health units, e.g.
barangay health stations, rural health units, free
standing clinics, etc., and referral units, i.e. interlocal health zones
Available Groups of Service Providers and
Stakeholders
• begins with the organizational structure and
dynamics of the Program Management
Committee which coordinates the strategies and
implementation of the National Policy on
Violence and Injury Prevention, and shall later
include healthcare professionals, accredited
EMT / paramedics, barangay health workers,
and volunteer organizations
INVENTORY OF LOCAL PREHOSPITAL EMS SYSTEM
EMS COMPONENT
1ST TIER
2ND TIER
3RD TIER
Identified stakeholders that
could be involved in the
implementation.
Already have a functioning
and effective EMS network
involving different sectors in
its implementation.
SERVICE PROVIDERS
AND OTHER
STAKEHOLDERS
Shall identify possible
stakeholders, including
potential roles and
responsibilities that could
assist in the effective and
efficient implementation of
the EMS system.
Stakeholders with existing
roles on pre-hospital EMS
will be initially tapped to
assist / provide resources in
the provision of emergency
medical services
Framework of the network
including possible roles and
responsibilities of the
stakeholders are already
recognized and beginning
coordination and sharing of
resources among them are
done.
Each of the stakeholders is
functioning well according to
their designated roles.
Sharing of resources,
technical expertise, and
capacity building are also
being done among
stakeholders
Support Facilities and Systems
• refer to accessible communication and
transport facilities
Legal Framework
• defines the contractual liabilities of all
stakeholders (individuals, agencies, and
hospitals) as defined in appropriate policy
mechanisms and instruments. It also
involves developing and operationalizing
procedures and guidelines for policy
implementation
Governance
• system management and supervision at the national (or local)
level by a council/network/coalition, which may include
representation from the government and other stakeholders
under the chairmanship of an appropriate authority. It will
coordinate the implementation of the EMS system within the
country (or province or city) through standardization, regulation,
accreditation, policy making, monitoring and evaluation,
technical and capability building, resource sharing and
management, and steering inter-sectoral coordination. Also, it
will manage and supervise at the local level by the local chief
executive through a fitting office that will overlook functioning of
the EMS system at the grassroots level.
INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
1ST TIER
2ND TIER
3RD TIER
Governance
Public Initiated
Public Initiated
w/ beginning
negotiations to forge a
Public-Private
Partnership
Public – Private
Partnership
Lead Agency
DRRMO is available but
will opt to create a
Public Safety Office for
the implementation of
EMS to address daily
emergencies
Public Safety Office
already created
Public Safety Office
Scope of
Implementation
Mapping / clustering of
municipalities or
barangays already started
for province / city wide
implementation
Province-wide / CityWide
Province-wide / CityWide (sub-station link to
the national EMS
system)
EMS COMPONENT
INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT
1ST TIER
2ND TIER
3RD TIER
Presence of Supporting
Policy
Already crafted and
proposed – for
consultation and
approval
YES
YES
Protocols used for
system implementation
Protocols used are local
protocols from LGUs
having the same
characteristics with
already existing EMS
system
Local Protocol used
National Protocol used
ROLES AND RESPONSIBILITIES
Regional Offices (ROs)
shall provide technical assistance to the LGUs and
oversee the local institutionalization of
prehospital EMS system. They shall also establish
the standards for an efficient hospital referral
system within the locality.
ROLES AND RESPONSIBILITIES
DOH Hospitals
shall ensure provision of quality promotive,
preventive, curative, rehabilitative, and palliative
care for patients involved in violence and injury.
ROLES AND RESPONSIBILITIES
Local Government Units (LGUs)
shall adopt and implement the prehospital EMS
system and provide services and necessities in
primary health care facilities and hospitals in their
localities.
ROLES AND RESPONSIBILITIES
Non-government organizations, professional
groups, other national government agencies /
organizations, private sector, and the academe
shall assist in the implementation of this Order.
Prehospital Emergency Medical
Service Committee (PEMSC)
DOJ, DILG, DOTC, DEPED,
PCEM, PRC, DOH
PREHOSPITAL EMS SYSTEM ORGANIZATIONAL /
STRUCTURAL FRAMEWORK
PEMSC
SECRETARIAT
(DOH-ENCDD)
POLICY -MAKING
SERVICE DELIVERY
CAPACITY
DEVELOPMENT
LAUNDRY LIST OF PLANS PER SUBCOMMITTEE
POLICY-MAKING
SERVICE DELIVERY
CAPACITY DEVELOPMENT
• DEVELOPMENT OF POLICY OR
ORDINANCE FOR THE
ESTABLISHMENT OF SAFETY
EMERGENCY MEDICAL SERVICE
SYSTEM AT THE LOCAL LEVEL
• DEVELOPMENT OF GUIDELINES
FOR THE ESTABLISHMENT AND
OPERATIONALIZATION OF LOCAL
PREHOSPITAL EMS SYSTEM
• DEVELOPMENT OF GUIDELINES
FOR MEDICOLEGAL CARE OF THE
VICTIMS OF VIOLENCE AND
INJURIES
• DEVELOPMENT OF GUIDELINES
FOR MENTAL HEALTH CARE
AFTER TRAUMA-RELATED
EMERGENCIES
• DEVELOPMENT OF TRIAGE
GUIDELINES AND PROTOCOLS
FOR INTERFACILITY TRANSFER
• FORMATION OF FUNCTIONAL
MULTISECTORAL PREHOSPITAL EMS
TEAM
• INCLUSION OF PREHOSPITAL
TRAUMA CARE IN PHILHEALTH
BENEFIT PACKAGES
• DEVELOPMENT OF TOOL OR
METRIC FOR SAFETY RISK
ASSESSMENT AND MANAGEMENT
IN THE COMMUNITY
• AVAILABILITY OF MENTAL HEALTH
AND PSYCHOSOCIAL SUPPORT FOR
VICTIMS OF VIOLENCE AND
INJURIES AND THEIR FAMILIES
• AVAILABILITY OF IEC MATERIALS
ON SAFETY PROMOTION AND
VIOLENCE AND INJURY PREVENTION
• AVAILABILITY OF EMERGENCY
TRANSPORT SERVICES IN EVERY
COMMUNITY
• STANDARDIZATION OF EMS
TRAININGS
• ACCREDITATION AND
REGULATION OF EMS TRAINING
AND EMERGENCY TRANSPORT
PROVIDERS
• ACCREDITATION, CERTIFICATION,
AND REGISTRATION OF EMS
PRACTITIONERS
• AVAILABILITY OF TRAINED AND
CERTIFIED FIRST RESPONDERS IN
EVERY BARANGAY / COMMUNITY
• AVAILABILITY OF TRAINED AND
CERTIFIED FIRST RESPONDERS IN
SCHOOLS, WORKPLACES, MALLS
AND OTHER INSTITUTIONS
• ORIENTATION AND TRAINING OF
ONEISS AND PNIDMS USERS
SAFETY AND EMERGENCY MEDICAL
SERVICE SYSTEM AT THE LOCAL LEVEL
UPDATES
PhilHealth Circular No. 012 – 2014
Z Benefit Rates for Selected Orthopedic
Implants
June 1, 2014
UPDATES
RESEARCH TOPICS 2014-2015
• “Determination of Incidence of Injuries from
Vehicular Crashes in the Philippines (20112013)”
• “Study on the Socio-Economic Burden of
Violence in the Philippines”
• “Study on the Socio-Economic Burden of Road
Traffic Injuries in the Philippines”
NEXT STEPS
• Issuance of the Department Order on the
Guidelines for the Establishment and
Operationalization of Prehospital EMS System
at the Local Level
• Piloting of Prehospital EMS System: at least
one province per region
• Development of Training Modules on Basic
and Advanced Prehospital Trauma Care
NEXT STEPS
• Drafting of the “National Policy on the
Prevention and Control of Harmful Alcohol
Use”
• Organizing the National Summit on Safety
Promotion and Violence and Injury Prevention
• Development of Action Framework for Each
Subprogram of VIPP