Sir wazza wrote:In Khon Kaen and Udon, which im both familar with the following applies.
The Amphur Muang is divided into 4 sections and depending which area ur accident / medical emergency occurs will depend on what clincal response applies.
The repsonse is controlled by a call centre / disptach centre.
Private hospitals are exempt from this intial repsonse.
1 /- Chinese rescue pickups, I cant remember the actual name, mutinie ??? sic , these are based from the temples and can be volunteers or even crims doing parole or community hours etc. Little training or no training this and have inside a spinal board and a basic first aid kit and some carrry a well used Extrication collar ( Was it cleaned from the last blood contamination ?? ) . No Oxygen ., No Suction.
Watch ur valuables. Some people work there on weekends and do get 200 baht per shift, Seen as making merit etc.
2/- The local goverment hospital responds its ambulance. Has a crew of 2 or 3 . Driver, Hosp orderley and a Nurse. Depending on how much funding they have, the nurse might have gone to KK / Sirindorn College for a crash course in Pre Hospital Care. The equipment varies and no uniform standards. some dont have O2, in the small outlying areas and no portable suction.
3/- City Ambulances ie Udon Provincial Hospital, KK trauma centre. These have basic equipment, training as above , Portable O2 on most and suction. Crew of 3, Nurses are ER based and still dont have the Emergency Skills of a Paramedic. They provide basic life support only. Nurses do not admin drugs for resuscitation and can consult for some stuff. They can do IV's but they dont save lives.
No Defibs on ambulances except on the Kiprajak Military Hospital in Udon. BUT Nurses are not allowed under law to admin a defib.
4/- Private Hospital Ambulances, look nice , but have the same standard as above.
Scoop and run is the best policy.
There are NO Paramedics in Thailand, the law does not recognise them.
Thailand needs to focus on the basics of Resuscitation.
Airway, Breathing with O2 and Circulation with control of blood loss.
Untill they can competently keep some ones airway open and and not obstructed by the tongue / blood / debris etc, people will continue to die.
The head injury stats are shocking, if ur lucky to survive your primary head injury, then with a partially obstructed airway and no O2, u will develop a secondry brain injury as a result of the raised intercranial pressures.
These people are taken home to die 10 days after the accident or die from aspiration pneumonia coz they inhaled their own vomit whilst lying on their back with no body looking after their ABC's.
Now then who doesnt wear their helmets and who doesnt wear seat belts.
Excellent post/info from our very own medical man Wazza, this is just a sample of what makes this forum great...Cheers mate.
