Ambulance In Bangkok: Please Call 1646

[Golfja]

Just for your information:

Public Emergency Medical Services (EMS) can be activated by dialing 1669 throughout Thailand, but ONLY in Bangkok area, EMS Ambulance services can be reached by dialing 1646 which will directed you to "Erawan Center" - the centralized Bangkok CCC (Command and Communication Center) which formally handled by "Narenthorn Center". http://ems.narenthorn.or.th

Normal response time is 10-15 minutes, but the trained dispatchers at Erawan will triage your call and I advise you to have someone who speak Thai to talk over the phone for you, as I believe the dispatchers and on-duty commanding nurse there cannot speak fluent English.

After receiving your call, the commanding nurse will select what type of ambulances should be responsed. It can be either

1. BLS (Basic Life Support) ambulances from Por-Tek-Tung or Ruamkatanyu foundations within the system those already registerd with Erawan which require minimum 110 hours of training and and basic equipments: stretcher, spinal board with belts and head immobilizer, collar, splints and suction unit. Registered basic ambulances are ditinguished from regular volunteers that the vehicles are painted in white, and EMTs uniforms are also in white.

2. ALS (Advanced Life Support) ambulances from most government hospitals and some private hospitals (Hua Chiew, Bangkok, Vipawadee, etc) who registered with Erawan which require additional 1 registered nurse with pre-hospital care training on board, but some hospital have an extra doctor (resident emergency medicine) on board too. Equipments include everything the basic ones have plus emergency drugs, IV fluids, EKG and defibbrillators.

Normal response for most trauma victims, Erawan will send basic units first, if that basic unit cannot handle such as in case of multiple injury, trapped patient, they will request ALS unit from Erawan and wait while providing basic care until an ALS unit arrive. For medical emergencies, mostly Erawan will send advanced unit to the scene since it will obviously beyond capability of basic units such as unconcious patient. Right now, my EMS center at Rajavithi hospital has less area to response because of more hospitals have joined with Erawan, but we response to medical emergencies more than before... cases require CPR is increasing a lot, we have been to many places such as the top of Baiyok Tower (cardiac arrest), MRT, BTS, hotels, seminar room. My EMS center usually have 3-6 calls per day, so all registered ambulance who response each day in Bangkok should be around 30-40 calls... the number still very few when compared to real emergency patients who arrive to ER as people still rely on relatives or friends, hopefully this will change soon.

Anyway, believe it or not, my EMS center has been providing EMS ambulance to the public more than 13 years!!!! But most people still said we don't have truely public EMS ambulance by government. This maybe solved by proving education to schools and general publc through TV, radio, etc.

I posted this article just for your information since i've seen very little explanation in English of how to call an ambulance here in Thailand, and how EMS system works. Also, I've just read the old posts here something about ambulance service in Thailand, information from that post is partially wrong.

[yorkman]

i've seen very little explanation in English of how to call an ambulance here in Thailand, and how EMS system works. Also, I've just read the old posts here something about ambulance service in Thailand, information from that post is partially wrong.

And I see very little explanation in English here

Don't get angry, just explain shortly and clearly what you will do without a few baht being involved

[sriracha john]

I posted this article just for your information since i've seen very little explanation in English of how to call an ambulance here in Thailand, and how EMS system works. Also, I've just read the old posts here something about ambulance service in Thailand, information from that post is partially wrong.

These aren't old posts, but if there is wrong information in them, we'd appreciate your input.... which is most efficiently done by responding to the individual inaccuracy in the particular thread, rather than here.

http://www.thaivisa.com/forum/index.php?sh...=160471&st=

Ambulance Workers Shooting And Assaulting Each Other, turf war heats up

http://www.thaivisa.com/forum/index.php?sh...=142740&hl=

Rescuers Seek Rescue From Other Rescuers, the state of Thailand's ambulance services

http://www.thaivisa.com/forum/index.php?sh...c=80546&hl=

Video: Por Tek Tung - The Thai Body Snatchers, A Race to the Death in Thailand

[Golfja]

These aren't old posts, but if there is wrong information in them, we'd appreciate your input.... which is most efficiently done by responding to the individual inaccuracy in the particular thread, rather than here.

Thanks k.john, i will follow those thread and respond to them. Basically i'm just an EMT-basic which have minimum knowledge and capability of prehospital care but i am so interested and would be so annoying TAT or Tourist Police that they don't provide information on what to do in an accident or emergencies.

EMS system that running in Thailand right now do not receive money from end customer, but they have funds from the Universal Health Care which is 10 baht per head per population per year. For an example, if Thailand has 40 million people, there would be 400 million baht that goes to the Office of Emergency Medical Services taken care by Universal Health Care, this has been going on for 4 years. For operation cost in each EMS Ambulance centers, after taking care of each patient and complete the patient report form, they get reimbursement from provincial health office: for an ALS unit we get 1,000 baht through its oeperation center (that EMS unit does not receive the money directly), Intermediate unit (EMT basic + EMT - Intermedaite without Paramedic nurse) gets 750 baht, BLS unit gets 500 baht.

Thanks.

[A_MIKE_U_LIKE]

These aren't old posts, but if there is wrong information in them, we'd appreciate your input.... which is most efficiently done by responding to the individual inaccuracy in the particular thread, rather than here.

Thanks k.john, i will follow those thread and respond to them. Basically i'm just an EMT-basic which have minimum knowledge and capability of prehospital care but i am so interested and would be so annoying TAT or Tourist Police that they don't provide information on what to do in an accident or emergencies.

EMS system that running in Thailand right now do not receive money from end customer, but they have funds from the Universal Health Care which is 10 baht per head per population per year. For an example, if Thailand has 40 million people, there would be 400 million baht that goes to the Office of Emergency Medical Services taken care by Universal Health Care, this has been going on for 4 years. For operation cost in each EMS Ambulance centers, after taking care of each patient and complete the patient report form, they get reimbursement from provincial health office: for an ALS unit we get 1,000 baht through its oeperation center (that EMS unit does not receive the money directly), Intermediate unit (EMT basic + EMT - Intermedaite without Paramedic nurse) gets 750 baht, BLS unit gets 500 baht.

Thanks.

Thankyou Golfja Its nice to see people on here being helpful for a change Khob Khun Krup

[dekka007]

Normal response for most trauma victims, Erawan will send basic units first

Not knocking the service at all. But would it not be better to call either for example BNH, Samitivej, Bumrungrad emergency ambulance number which then sends a rapid response vehicle with 2 nurses, driver and doctor with EKG and defibbrillators straight away rather than wait for the normal response team to get there realise they cant do anything and call the emergency....

[Golfja]

Normal response for most trauma victims, Erawan will send basic units first

Not knocking the service at all. But would it not be better to call either for example BNH, Samitivej, Bumrungrad emergency ambulance number which then sends a rapid response vehicle with 2 nurses, driver and doctor with EKG and defibbrillators straight away rather than wait for the normal response team to get there realise they cant do anything and call the emergency....

Thanks, normally higher level of care, let's say ALS, should be better off for many patients. But the high cost of operation and lack of community involvement may not be good for Thailand. (trained volunteers who registered with ERAWAN and the public are considered part of community). For Samittivej and BNH ambulances, they may provide same level of cares and somtiems better equipments, but definitely have less experience and they are "for profit" services which is different from public EMS system being implemented in Thailand in general now. BNH will bill you later, but public EMS won't bill you and they can send to any hospital according to your social security card or hospital of your choice but must not too far from the scene.

I also remember one more thing. There are researches done in Thailand that analyze patients who visit to all ERs. Mostly they require only BLS care, only some require ALS intervention. The result is: for each of every 200,000 population, we should have 1 ALS ambulance plus 2 BLS ambulances. So, Bangkok has 10 Million people, in perfect situation we should have 100 ALS ambulances and 200 BLS ambulances, assuming everyone call 1646 in every emergencies, but this situation won't happen within the next 5 years. Another research done in Canada that BLS care is sufficient for most trauma petients. ALS care, surprisingly, has decrease survival rate because of delayed transportation. ALS cares are better than BLS in case of other emergencies. It's also widely debated on the Frech EMS system that usually take care of trauma victims for long period that has decrease chances of survival to trauma patients. Many think that if Princes Diana had the same injury outside France, she maybe survived.

At that time French's SAMU uni stayed to treat Princes Diana at scene for at least 1 hour, and drove 10-20 km/hr to nearby hospital to minimize bumps, also the ambulance stopped along the way many times to do sophisticated treatment to her. If this happens in U.S. she would be already in operation room.

[ignoramus]

Thanks golfja, very public-spirited post.

Your English is a million times better than my Thai.

[chiang mai]

This strikes me as advertising by one of the many groups that supply pickup truck to hospital services. Stil,l something is better than nothing but I would suggest that the Bumrungrad ambulance service might potentially achieve a higher survival rate in a life threatening situation, traffic permitting. As for those of us outside of Bangkok, well, you pays your money and you takes your chances.

[Golfja]

The result is: for each of every 200,000 population, we should have 1 ALS ambulance plus 2 BLS ambulances. So, Bangkok has 10 Million people, in perfect situation we should have 100 ALS ambulances and 200 BLS ambulances, assuming everyone call 1646 in every emergencies,

Sorry, i miscalculated. If Bangkok has 10 Million people, in perfect condition there should be 50 ALS ambulances and 100 BLS ambulances.

[A_MIKE_U_LIKE]

To be Fair (My Opinion only) France can not really be blamed for slow response or mishandling in this instance ..I think Diana would of gone via the Swiss Alps if thats how long it would of took her to die .A better example would be a average person in the street .But thank you for the information and for being helpful

At that time French's SAMU uni stayed to treat Princes Diana at scene for at least 1 hour, and drove 10-20 km/hr to nearby hospital to minimize bumps, also the ambulance stopped along the way many times to do sophisticated treatment to her. If this happens in U.S. she would be already in operation room.

[MrSquigle]

Good on you Golfja for putting in the effort to supply as much info as possible about this from someone on the inside.

Hope you are encouraged by everyone to add more.

I do also fear the 'pickup' ambulances....in Oz we call em 'utes'...bewt ones an all.

I sat in a coffee shop on Sukhumvit one day and watched the entire process of a lady who got hit by a car. The 'Ute' came, they fixed her up over a long period of time, then put her on a stretcher and loaded her in the back of the 'ute' alone, nobody to take care of her and off they went. Could just imagine her sliding around the back, stop...ooops sorry dear...go...ooops sorry dear etc etc.

Very scary.

[Golfja]

Good on you Golfja for putting in the effort to supply as much info as possible about this from someone on the inside.

Hope you are encouraged by everyone to add more.

I do also fear the 'pickup' ambulances....in Oz we call em 'utes'...bewt ones an all.

I sat in a coffee shop on Sukhumvit one day and watched the entire process of a lady who got hit by a car. The 'Ute' came, they fixed her up over a long period of time, then put her on a stretcher and loaded her in the back of the 'ute' alone, nobody to take care of her and off they went. Could just imagine her sliding around the back, stop...ooops sorry dear...go...ooops sorry dear etc etc.

Very scary.

well, many basic units now are "pick-up trucks", either they are dedicated unit by local municipal (Or Bor Tor) or upgraded from volunteer vehicle, they are still pick-ups. Those pick-ups who are registered BLS units are required to have roof, and same equipment and training, anyway enforcement and penalty for bad or below-standard units after firt-time registration maybe lacking, but enforcement and control has to go with the same pace with knowledge of each community. Right now the big picture of regulation is that the EMS Act is now being considered by authority, not sure this will help much. The act emphasis on protecting end customers such as when you call, the unit is mandatory to response to you, this is good but community knowledge and people in the system (in some communities) are not yet ready and may drive away good people in the system.

Pick-up trucks are not very suitable since it has high floor and limited space, but for limited resources it's not that bad. Some BLS ambulance centers have enough money to buy vans, Toyota Hi-ace, Kia Prestige, e.g. Ruamkatanyu has all basic cars in vans.. same as por tek tung, which are much better, so when they are ready (next 5-10 years?), they may phase out the pick-up BLS vehicles. For ALS ambulances, using van-type is mandatory.

[Golfja]

View one of Narenthorn EMS ambulance responding in lights and sirens (no patient visible in the video).

I am thinking to put some more in slide show krab. Thanks for all comments.

Cheers!~