Integrated Clinical Clerkship in Emergency Medicine AY 2021- 2022

Pre-hospital care is the provision of emergency medical services in the field and in transit before arrival at a health care facility. In "Ambulansyang de Paa", pre-hospital care is rooted in the Filipino "bayanihan" concept, with communities banding together to create systems and makeshift resources to respond to emergencies. However, humans get tired, supplies get used up, money runs out, and resourcefulness can only get you so far. The point of emergency medical services is rendered obsolete when you have to travel 4 hours to get down a mountain. Moreover, the patients are accompanied by good samaritans who have limited or no knowledge at all of acute life-saving interventions. Should the patient's status deteriorate, how are they expected to help this patient? This problem is further aggravated by the lack of health care facilities with capabilities to actually respond to emergencies. Pre-hospital care is an important pillar of the health care delivery system. It bridges the gap between the acutely ill patient and the emergency care provider. Even just the human resource aspect can potentially improve survival outcomes in patients with acute life-threatening conditions. The provision of medical resources (i.e., stretchers, splints, IV fluids, etc.) that may be present in the ambulance depending on their capabilities can be the deciding factor that will determine whether or not that patient will be dead on arrival. Modes of transport as a factor is also contributory not just in improving outcomes but also in improving patient's access to health care that they would normally not be able to get due to distance alone. In this way, pre-hospital care is an important component of health care delivery and must be improved in our country.