Emergency care then and now

MANILA, Philippines - In today’s generation, where proper medical practices and technologies are made available to everyone, emergency situations can be properly handled and well taken care of in various hospitals that adhere to the protocols and guidelines of Emergency Medicine (EM).

Thirty years ago, however, hospitals responded differently to cases requiring immediate care.

Before the practice of EM materialized in the Philippines, the emergency room was nothing more than a “room.” According to Dr. Esteban Almeda, Asian Hospital and Medical Center’s (AHMC) Emergency Department (ED) chairman, hospitals did not have specialized systems to provide optimal emergency medical care.

“There was medical staff in attendance such as nurses, medical students and resident doctors, though none specifically trained to tend to emergencies,” said Almeda. “A patient would have to wait for an hour or more before definitive care was given.”

Medical institutions abroad began studying how to effectively and swiftly respond to emergencies. “The United States started it in the 70s, understanding the perception that emergency medical care starts at the door, eventually developing efficient pre-hospital emergency medical systems,” said Almeda, adding that developing standards for medical care is a continuous and dynamic process.

EM in the Philippines began in 1988 and since then it has grown to be a recognized specialty by the Philippine Medical Association. From day one, AHMC imbibed the standards of EM with its patient-centered philosophy.

“There’s nobody in training. You are attended by a specialist who will care for you from the start of your visit up until you are discharged to go home or admitted to the hospital,” said Almeda, adding that AHMC was the first in the country to have an emergency medicine specialist, nurses and clinical aids than solely from the emergency medical staff.

Throughout its development, AHMC has sought to adopt the most current EM practices such as point-of-care testing, with a laboratory incorporated in the Emergency Department, efficiently reducing the turnaround time for most tests.

AHMC also practices evidence-based triage protocols, where patients are attended to based on the severity of their condition and not on a first-come, first-served way.

Currently staffed by 27 experienced emergency physicians, more than 70 staff nurses and clinical aids with a strong camaraderie — a trait unique to an ED — the department’s design was closely patterned after modern hospitals in the US.

It incorporates features that are unique here in the Philippines such as separate entrances for walk-in patients and those borne by ambulances and treatment rooms providing patient privacy. The treatment areas are composed of primary care, pediatric and urgent care rooms, eight critical and trauma care bays, and three rooms for patients with communicable illnesses.

Because the Emergency Department is one of the doors to the hospital, AHMC pays constant attention to improving its efficiency. “We design our facilities and processes with a ‘Patient First’ state of mind,” Almeda said.