ROAD SAFETY FORUM 2014 Road Safety: Everybody’s Responsibility PNP Multi-Purpose Center, Main Hall...

ROAD SAFETY FORUM 2014

Road Safety: Everybody’s ResponsibilityPNP Multi-Purpose Center, Main HallNational Headquarters Camp Crame

Quezon City, Metro ManilaMay 16, 2014

8:00 AM – 5:00 PM

DOH RESPONSE TO POST-CRASH CARE

CLARITO U. CAIRO, JR., MD, DPSVI, DPCOMACCREDITED SAFETY AND HEALTH PRACTITIONER

PROGRAM MANAGER, VIOLENCE AND INJURY PREVENTION ESSENTIAL NON-COMMUNICABLE DISEASE DIVISION

DISEASE PREVENTION AND CONTROL BUREAUEmail: [email protected] / [email protected]

mailto:[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”

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

ONEISS CY 2010-2013

NO. OF HOSPITALS IN THE PHILIPPINES: 1,821DOH 70GOVERNMENT 662PRIVATE 1,089

http://uhmis1.doh.gov.ph/unifiedhmis

http://uhmis1.doh.gov.ph/unifiedhmis

DEPARTMENT ORDER NO. 2011-0047

“Creation of the Philippine Network for Injury Data Management System (PNIDMS)”

MEMBERS

DOH, DOTC, DPWH, UNICEF, WHO, PNP-HPG, MMDA, SAFE KIDS PHILIPPINES, LTO,

DOLE, DSWD, UP-NCTS, NBI, BFP, CHED, NSO, PHILHEALTH, PCW, PIRA, DEPED

http://uhmis2.doh.gov.ph/pnidms

http://uhmis2.doh.gov.ph/pnidms

ADMINISTRATIVE ORDER NO. 2013-005

“National Policy on the Unified Registry Systems of the Department

of Health (Chronic Non-Communicable Diseases, Injury-

Related 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 evidence-based 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

EMERGENCY DISPATCH

Communication Facilities

Awareness of the people on the available

emergency numbers

Presence of a Unified Local Hotline Number

Presence of a Functional National Hotline

Number

Personnel DispatchedBarangay Responders

and Lay Persons

Education among lay persons already

strengthened

Wide array of responders up to presence of a

general physician in the EMS team

Complete range of EMS personnel including a specialist (emergency medicine or trauma

surgeon) in the EMS team

Expected Response Time

20 minutes 10-15 minutes < 10 minutes

Emergency Response and Care

• involves arrival of resources at the scene and the timely initiation of appropriate interventions



EMERGENCY RESPONSE AND

CARE

Services provided on-site

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

Special equipment/resources

utilized/required

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 Transport

• involves transporting the patient to the most appropriate facility and continued provision of

care en route



EMERGENCY TRANSPORT

Transportation Options

Ambulance Type B Wide range of vehicles

Complete Range of Vehicles (ideal number of

responders vis-a-vis number of ambulance

used

Services Provided en route to Hospital

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

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



INTER-FACILITY REFERRAL AND

TRANSPORT

Referral Network

Strengthening of existing health

facilities

Availability and strengthening of trauma-receiving

facilities

Availability of Trauma-capable

Facility

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. inter-

local 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 SYSTEMEMS COMPONENT 1ST TIER 2ND TIER 3RD TIER

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

Identified stakeholders that could be involved in the

implementation.

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.

Already have a functioning and effective EMS network

involving different sectors in its implementation.

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.



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 / City-Wide

Province-wide / City-Wide (sub-station link to

the national EMS system)



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.


DOH Hospitals

shall ensure provision of quality promotive, preventive, curative, rehabilitative, and palliative care for patients involved in violence and injury.


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.


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

POLICY -MAKING SERVICE DELIVERY CAPACITY DEVELOPMENT

SECRETARIAT(DOH-ENCDD)

• 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

POLICY-MAKING SERVICE DELIVERY CAPACITY DEVELOPMENT

LAUNDRY LIST OF PLANS PER SUBCOMMITTEE

SAFETY AND EMERGENCY MEDICAL SERVICE SYSTEM AT THE LOCAL LEVEL

UPDATES

PhilHealth Circular No. 012 – 2014Z Benefit Rates for Selected Orthopedic

ImplantsJune 1, 2014

UPDATESRESEARCH TOPICS 2014-2015

• “Determination of Incidence of Injuries from Vehicular Crashes in the Philippines (2011-2013)”

• “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

ROAD SAFETY FORUM 2014 Road Safety: Everybody’s Responsibility PNP Multi-Purpose Center, Main Hall...

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