Full bed capacity: PGH addresses ER ‘congestion’


Philippine General Hospital Director Gerardo Legaspi confirmed that the emergency room has reached its full bed capacity, addressing concerns about overcrowding and long waiting times.

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Philippine General Hospital (Photo from University of the Philippines)

In an interview with ABS-CBN's TeleRadyo Serbisyo on Friday, Oct. 6, Legaspi admitted that PGH’s emergency room capacity has been experiencing issues for some time.

"Matagal na pong nangyayari 'yan at ginagawan lang namin ng paraan na maasikaso lahat ng pasyente. Ang aming emergency room was designed for only 70 patients at sa huli kong census na nakuha, 202 ang pasyenteng nasa loob, ito ay yung nasa kama na (This has been happening for a long time, and we are just finding ways to attend to all the patients. Our emergency room was originally designed for only 70 patients, but in my latest census, there were 202 patients inside, those who are on beds),” he said.

Legaspi highlighted the critical situation, with 40 patients requiring respirators, turning the ER into a large ICU.

“Para tayong nagpapatakbo ng isang hospital na kasing laki na siguro ng mga private hospitals na nakapaligid sa PGH (It's like we're running a hospital probably as big as the private hospitals surrounding PGH)," he said.

Legaspi explained that PGH uses the "emergency severity score" or ES1-5 for patient accommodation to the emergency room.

"Pagka ikaw ay mamamatay within the hour or two hours, nandun ka sa ES1 and two, so kahit ano pang puno ng ospital, ipapasok ka doon kasi kailangan kang malapatan ng resuscitation o agad na paggagamot (If you are at risk of dying within the hour or two hours, you are categorized as ES1 and 2, so no matter how crowded the hospital is, you will be admitted because you need immediate resuscitation or treatment)," he said.

Patients categorized as ES3, with conditions such as bone fractures and non-life-threatening injuries, and those who have been waiting for approximately six hours, are attended to next, he added.

Meanwhile, ES4 and ES5 are reserved for patients with minor illnesses like coughs, colds, or stomachaches, and they are required to wait, prioritizing ES1 and ES2 cases, he also said.

Legaspi explained that doctors use a system called "triaging" in emergency medicine to assess patients and determine the most critical cases.

“If we have limited resources and limited space, kailangan mamili kung sino ang pwedeng pumasok (Choices need to be made about who will enter),” he said.

Legaspi acknowledged that some patients, despite waiting in ambulances or outdoor seats for two days, are not emergencies but rather seeking medical evaluation.

The PGH director suggested filling wards with stretcher beds to address growing congestion, but this approach could be “riskier” as patients on stretchers may not receive the same level of attention as those in the emergency room.
"We will determine where to place each patient, often opting for the emergency room since all doctors can easily access them,” he pointed out.

“Ang problema nga lang ay ang nurses na na-assign sa ER ay 70 lang, so kailangan naming dagdagan, but even with that, the hospital's current ratio is one is to 20 to 22, isang nurse para sa 20 na pasyente, which is low (The problem, however, is that the nurses assigned to the ER are only 70, so we need to increase their numbers. But even with that, the hospital's current ratio is one nurse for every 20 to 22 patients, which is low)," Legaspi said.

He emphasized that PGH is a popular choice for patients due to its proximity to residences, with 30 percent of its patients coming from Region 4A, and its provision of free services as a key factor. (Zekinah Elize Espina)