Our Mission is to:
- Provide efficient, effective, and timely emergency management to all individuals who seek care.
- Provide medical care with compassion and respect for each patient.
- Continue professional development of all staff at all levels and continue medical education.
- Institutionalize the standard system and procedure for emergency care.
- For JR Borja General Hospital Emergency Department to be the center of excellence in providing emergency care to patients not just from the city but also from the neighboring municipalities.
- To be known as the world-class Emergency Department with modern equipment and top-performing staff.
These are the core values that serve as guiding principles of the Emergency Department to work towards our goal:
- Accountability. Placing the patient’s best interests first and always being able to justify one’s actions.
- Balance. To be able to work hard and deliver quality care and service because the importance of good work/life balance is emphasized.
- Compassion. The recognition, understanding, and emotional resonance with the patient’s concerns, distress, pain, and suffering, coupled with relational action make them better.
- Competence. The willingness to improve oneself in terms of his/her knowledge and skills in order to provide quality care and service.
- Innovation. To nurture creativity to transform work processes suited to each case despite constraints.
- Integrity. The act of conducting oneself in an honest and ethical way with everyone. Encompass honesty, keeping one’s word, and consistently adhering to the principles of professionalism.
- Quality. Maintain rigorous standards for all the work and care deeply in providing excellent patient care and service.
- Teamwork. To work together and support each other combined with the experiences and expertise to strengthen the department and result in the best work.
Emergency and Acute Care
The Emergency Department is to receive, triage, assess, stabilize and provide acute health care to patients requiring resuscitation, to emergent, urgent, and less urgent conditions.
Medico-legal case, any case of injury or ailment where the physician, after history taking and clinical examination, considers that investigation by lawful authorities is warranted to ascertain justice and fix responsibility regarding the said injury or ailment according to the law.
Ambulatory Care Services
For non-critically ill patients who present themselves as non-urgent cases in the ED, and can be given appropriate care and discharge instructions for home care and follow-up.
Mass Casualty Incident Services
In circumstances or events resulting in a number of victims large enough to disrupt the normal course of emergency and healthcare services, resources are overextended but not overwhelmed.
Emerging and Re-Emerging Infectious Diseases (EREID)
Outbreaks of emerging infectious diseases, and continues to be susceptible to the threat of re-emerging infections such as Leptospirosis, Dengue, Tuberculosis, Meningococcemia, COVID-19, and others.
Ambulance Transport or Interfacility Transfer
Patients assessed as needing a higher level of care are referred to facilities capable of such. These patients are transported by ambulance after proper coordination with the receiving facility.
Infrastructure and Staffing
Serves as the first contact of all patients in the ED where registration and initial clinical assessment of patients occur.
Located in conjunction with the ambulance and walk-in entrance, waiting area, acute treatment and assessment areas and resuscitation bays.
One (1) physician – on 12- or 24-hours duty
Two (2) staff nurses – on 8 – or 12-hours shift
One (1) nursing attendant – on 8- or 12-hours shift
One (1) institutional worker – on 8- or 12-hour shift
This holds patients while waiting for their turn to be seen and examined by the triage physician, or while waiting to be transferred to their respective treatment areas. It also serves as a holding area for other relatives and/or caregivers that accompany the patient.
Located in conjunction with the triage area, ambulance and walk-in entrances, and clinical areas of the ED.
This is intended for patients for toxicological management before transfer to Acute Care Area.
Ambulatory Treatment Area
This is the consultation area for the assessment, treatment, management of patients without major illness, non-complex, injuries or conditions and expected to be sent home after.
Located in conjunction with the triage area and waiting area.
Acute Care Area
This area serves to assess, manage and initiate treatment on patients entering the ED.
Staff: Each department: One (1) physician (on 12- or 24-hour duty) and one (1) staff nurse (on 8- or 12-hour shift)
The area has 1 nursing attendant and 1 institutional worker for every 8- or 12-hour shift.
A special area within the acute care area that provides reception, assessment, and initiation of treatment to patients with life-threatening or time-critical illness or trauma.
The resuscitation team:
Physician of the department
Staff nurse of the department
Nurse team leader
A room intended to cater to patients suspected to have a highly communicable disease.
An area in the ED where nurses and other staff work behind includes chart processing and management, patient monitoring, and medication preparation.
Staff Call Room
An area for the staff to time out, eat, rest in between and to add morale and staff functions.
Equipment and Supply Storage Room
An area restricted to authorized staff for storage of devices and other consumables and place buffer stocks.
Minor Operating Theater
Dedicated to minor and urgent surgical procedures.
Organizational Structure of the Emergency Department
ER Department Cart Meds
Adenosine 6mg/2ml vial
Amiodarone 150mg/3ml ampule
Aspirin USP grade (325mg/tablet)
Aspirin 100 mg/tab
Atropine sulfate 1mg/ml ampule
B-adrenergic agonists (i.e. Salbutamol 2mg/ml)
Benzodiazepine (Diazepam 10mg/2ml ampule) – in high alert box
Calcium (usually Calcium gluconate 10% solution in 10ml ampule)
Clonidine 75 mcg/tablet or 150 mcg/tablet
Dexamethasone 4mg/ml ampule
Digoxin 0.5mg/2ml ampule
Diphenhydramine 50mg/ml ampule
Dobutamine 250mg/5ml ampule or pre-mixed solution 250mg/250ml
Dopamine 200mg/5ml ampule/vial or pre-mixed solution 250mg/250ml
Epinephrine 1mg/ml ampule
Enoxaparin 2000/4000/6000 IU prefilled syringe
Furosemide 20mg/2ml ampule
Haloperidol 50mg/ml ampule – in high alert box
Hyoscine N-Butylbromide 10mg ampule
Hydrocortisone 250mg/2ml vial
Ipratropium + Salbutamol nebule
Isosorbide dinitrate 5mg/tab
Lidocaine 10% in 50ml spray
Lidocaine 2% solution vial 1g/50ml
Magnesium sulfate 1g/2ml ampule
Mannitol 20% solution in 500ml/bottle
Metoclopramide 10mg/2ml ampule IV Midazolam
Morphine sulfate 10mg/ml ampule – in high alert box Nicardipine 10mg/10ml ampule
Nitroglycerin 10mg/10ml ampule or Isosorbide dinitrate 5mg SL tablet
Noradrenaline/Norepinephrine 2mg/2ml ampule
Phenobarbital 120mg/ml ampule IV or 30mg tablet – in high alert box
Potassium chloride 40mEq/20 vial – in high alert box
Sodium bicarbonate 50mEq/50ml ampule
Tranexamic acid 500mg/5ml ampule
Verapamil 5mg/2ml ampule
Vitamin B1/6/12 vial (1gB1, 1gB6, 0.01gB12 in 10ml vial) Vitamin K (Phytomenadione) 10mg ampule
Emergency Department Medications
Anti-Tetanus Serum (either equine based antiserum or human antiserum)
Heparin 5000 IU/vial
Hydralazine 20mg/1ml ampule
Oral Rehydration Solution
Plain LRS 1 liter/bottle
Plain NSS 1 liter/bottle – 0.9% Sodium Chloride
D5 LR 1 liter/bottle
D5 NSS 1 liter/bottle
D5 NM 1 liter/bottle
D5 0.3 NaCl 500ml/bottle and 1 liter/bottle
D5 IMB 1 liter/bottle
Dextran 500ml/bottle D10 Water
ER Department Equipment and Supplies
Equipment and Supplies
Aseptic bulb syringe
Clinical weighing scale Digital/electronic clocks
Defibrillator with paddles or AED
Dressing tray and table
ECG machine with leads
EENT Diagnostic Set with ophthalmoscope and otoscope
Eye protective goggles or face shield
Feeding Tubes (Fr. 8, 10, 12, 12, 16)
Indwelling Catheters (Fr. 8, 10, 12, 12, 16, 20, 22)
Gauze (sterile, pre-folded, individually packed)
Glucometer with strips and lancet Gooseneck lamp/examining light
Mask (respirator mask N95: small, medium, large) with fit testing as much as possible
Minor Instrument Set
Needles (disposable, different sizes)
Negatoscope (optional for institutions utilizing digital imaging)
OR light Oxygen Unit
Oxygen delivery devices (neonate, pedia, adult)
Sphygmomanometer (adult and pedia)
Suturing set with suture materials
Sutures: cutting/atraumatic sutures continued:
Slik, nylon, catgut
Wheeled stretcher with guard side rails
IV cannula (G26, 24, 22, 20, 18)
IV infusion sets (microset, macroseta, blood transfusion set)
Infusion set with volumetric chamber (soluset)
Spine board with Head Block and straps
Plaster of Paris Wadding Sheet
Splints for arm and leg
Orthopedic weights (sand bags)
Chest Tube Insertion equipment
Fluid warmer Intraosseous devices
Point of care testing: portable/mobile xray
Twelve Rights of Administering Medications
Right of the Patient to Refuse
Right of the Patient to Know the Reason for the Medication Right Evaluation
Right Medicine Preparation