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

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: dokclar@yahoo.com
/ dokclar@gmail.com

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
2010
2011
2012
2013
NO. OF
REPORTING
HOSPITALS
115
ONEISS CY 2010-2013
NO. OF
REPORTED
CASES
35,068
TRANSPORT /
VEHICULAR
ACCIDENT
11,674
100
125
64
41,331
64,256
40,149
13,594
19,263
13,938
MAULING
2,525
7,944
12,948
7,075
FALL
5,111
6,771
11,733
6,721
NO. OF HOSPITALS IN THE PHILIPPINES: 1,821
DOH 70
GOVERNMENT 662
PRIVATE 1,089 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

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)

REVISED NATIONAL POLICY ON VIOLENCE
AND INJURY PREVENTION
ROAD TRAFFIC INJURIES

“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 1 ST TIER 2 ND TIER 3 RD TIER
EMERGENCY
DISPATCH
Communication
Facilities
Personnel Dispatched
Expected Response
Time
Awareness of the people on the available emergency numbers
Barangay Responders and Lay Persons
Presence of a Unified
Local Hotline Number
Presence of a Functional
National Hotline
Number
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
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

INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT 1 ST TIER 2 ND TIER 3 RD TIER
EMERGENCY
RESPONSE AND
CARE
Services provided onsite
Special equipment/resources utilized/required
First Aid and Basic Life
Support
Readily available basic first aid kit in the community
Basic Life Support and
Advanced Life Support
(depending on the training and capability of dispatched personnel
Complete equipment for
BLS. Need to have readily available ALS equipment (desirable but would depend on the training and capability of emergency personnel)
Advanced Life Support
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

INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT 1 ST TIER 2 ND TIER 3 RD TIER
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

INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT 1 ST TIER 2 ND TIER 3 RD TIER
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. 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 1 ST TIER 2 ND TIER 3 RD 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.
Already have a functioning and effective EMS network involving different sectors in its 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.
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
EMS COMPONENT 1 ST TIER 2 ND TIER 3 RD TIER
Governance
Lead Agency
Scope of
Implementation
Public Initiated
Public Initiated w/ beginning negotiations to forge a
Public-Private
Partnership
DRRMO is available but will opt to create a
Public Safety Office for the implementation of
EMS to address daily emergencies
Mapping / clustering of municipalities or barangays already started for province / city wide implementation
Public Safety Office already created
Province-wide / City-
Wide
Public – Private
Partnership
Public Safety Office
Province-wide / City-
Wide (sub-station link to the national EMS system)

INVENTORY OF LOCAL PREHOSPITAL EMS
SYSTEM
EMS COMPONENT 1 ST TIER 2 ND TIER 3 RD 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 EMS SYSTEM ORGANIZATIONAL /
STRUCTURAL FRAMEWORK
PEMSC
SECRETARIAT
(DOH-ENCDD)
POLICY -MAKING SERVICE DELIVERY
CAPACITY
DEVELOPMENT

LAUNDRY LIST OF PLANS PER SUBCOMMITTEE
POLICY-MAKING
• 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
SERVICE DELIVERY
• 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
CAPACITY DEVELOPMENT
• 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

PhilHealth Circular No. 012 – 2014
Z Benefit Rates for Selected Orthopedic
Implants
June 1, 2014

RESEARCH 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”

• 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

• 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