Emergency Medical Services System in Thailand

[ChrisEMT]

Afternoon All

 

I am interested in people's views regarding the state of EMS in Thailand. I work in a pre-hospital care role in the UK and am also a co-director of a Foundation in Thailand (not Bangkok).

 

Training is an area that I see is in need of change.

 

Volunteers are un-coordinated and loosely organised with a variable range of skills and a lack of suitable equipment suitable for need...

 

Also, volunteers are limited in how far they can progress by the restrictions upon AEMT and Paramedic courses (entry requirements).

 

I am working on a collaborative project where we are bringing together a number of volunteer groups and Foundations to work together with shared resources, training and etc. We are also developing a new approach to training and development.

 

So here are my questions:

 

1. What is your view on the state of EMS in Thailand?

 

2. What ONE thing would you change for the better?

 

3. What is ONE thing that you find poor or bad about the EMS system in Thailand

 

4. Who should fund EMS in Thailand?

1. Government via MoPH / NIEMS
2. Private organisations
3. Other:

 

5. How CONFIDENT would you be in the treatment a volunteer / Foundation provided to you or your family?

 

6. Do you know the number for the Medical Emergency Line?

 

7. Have you ever need to call for an ambulance?

 

8. How was that experience?

 

9. Do you have any practical skills you can offer to volunteer EMS organisations?

 

10. How do you feel EMS in Thailand will look in 5 years time?

 

11. Is there the desire for change in your opinion?

 

12. Do you have any other comments or suggestions you would like to make?

 

 

If you would like to find out more about our work, I will be linking to our website in the New Year.

 

Wishing all the ex-pats (and the Thai readers as well) a really Happy Christmas and New Year - and PLEASE remember:

 

The SEVEN DEADLY DAYS - drive safe, driver sober, do not drink drive and if you're tired, don't drive!

 

Thanks and I really look forward to your comments and thoughts everyone!

 

Chris

[thaikahuna]

My OPINION is that there are some good EMS people out there. They care but level of training is sorely lacking. The biggest impediment is the matter of face. No MD in Thailand is going to lose face over an EMT / Paramedic saving a patient. This would be considered an intrusion into their inner sanctum and a faux pas here.

 

Another issue of contention is the abject refusal by Thai drivers to get out of the way and yield to an ambulance with lights and sirens blaring...or any other emergency vehicle. You have to change the thinking before you can make any changes worthwhile.

[Kwasaki]

1 hour ago, ChrisEMT said:

1. What is your view on the state of EMS in Thailand?

Great our local Thai gov hospital saved my life, the private I was taken to first was well useless.  

 

2. What ONE thing would you change for the better?

Nothing it's First class IMO already.

 

3. What is ONE thing that you find poor or bad about the EMS system in Thailand.

As 2.

 

4. Who should fund EMS in Thailand?

1. Government via MoPH / NIEMS
2. Private organisations
3. Other:

Government already funds it's Farangs should Insure themselves.

 

5. How CONFIDENT would you be in the treatment a volunteer / Foundation provided to you or your family?

Don't understand the question.!

 

6. Do you know the number for the Medical Emergency Line?

Yes.

 

7. Have you ever need to call for an ambulance?

No family and neighbours quicker in my case.

 

8. How was that experience?

Experience of what.?

 

9. Do you have any practical skills you can offer to volunteer EMS organisations?

Why would I do that.?

 

10. How do you feel EMS in Thailand will look in 5 years time?

They go with technology at their own pace I guess.

 

11. Is there the desire for change in your opinion?

Change to what.?

 

12. Do you have any other comments or suggestions you would like to

make?

Yeah why are you asking these stupid questions. ?

 

 

[swissie]

Mobile emergency services have contracts with hospitals. (they bring "patients" to the hospital that pays them the highest "commission".)
Hopefully, in case of a true medical emergency, the "contract-hospital" of the mobile emergency service is nearby and not somewhere accross town.
You may want to start there. Good luck. Welcome to Thailand.
Cheers. 

[realenglish1]

The main thing I would change is the publics view of emergency vehicles The do NOT move out of the way when an Ambulance

is blaring horns trying to get through

There needs to be a massive change in attitude with drivers on this rule

 

Hear a siren Get out of the way someones life may depend on it

Edited December 18, 2017 by realenglish1

[wildewillie89]

EMS in my local area are quite fast and caring, just have no real training. Would be similar to a basic first aid course many people have done at some point in their lives. They will call the hospital's ambulance in a situation they are unable to handle. 

Don't remember the actual EMS number (even though it is written on the car), but do have the driver's phone numbers and LINE ids saved in my favourites. A couple of them speak good enough English to know what is going on and know exactly where I live. 

Would change the fact many continually leave their lights on in non-working situations. Therefore cars fail to respect the vehicles in actual emergency situations. Also, I would change the paying of EMS by hospitals to bring patients in. Just creates further dangerous scenarios of EMS racing to get people. Not to mention wastes potentially valuable time of EMS taking patients that do not actually require an EMS so they get the money. 

Government should fund it, they waste a lot of money on some pretty useless projects that could go towards having two trained drivers in each local area. Rather than paying a couple of employees a bit extra to do a first aid course. Maybe the doctors at the local municipality hospitals could also be used by EMS in some areas. The municipality medical centre doctor where I live doesn't do a whole lot and works a minute down the road from where the EMS is, so maybe they could utilise him more (pick him up on the way).

 

Have used the local EMS. Went into a seizure, they strapped me to the bed and raced me to the hospital. They are not far from my house (on way to city hospital anyway) so even without training it is more valuable than going with the family, especially as have children to look after so would all just be too stressful/time consuming in an emergency event. Plus the Mrs wouldn't be able to lift me up. 

[Yme]

It's patchy, but considerably better than ust a couple of years ago. New government regulations due to come into force at the end of the year require those attending emergency events to have undergone 40 hours of training versus the current 24.

Remembering that most of them are volunteers they do a pretty good job... and they seem to have stopped having fights over who gets the body if two different foundations turn up at the same event

[mike324]

Are we talking about EMS that are from foundations such as por tech tung or EMS from hospitals?

 

I think Thai drivers do move out of the way, but they are too slow to react. And there are many times where traffic is so bad, the EMS vehicles are stuck. The most effective I've seen are where drivers/personnel on the car tell cars to move out of the way with a speakerphone, instead of waiting for cars to move.

 

Overall my impression are pretty good, just a few bad apples they drive like asses. Without the EMS, there would be a lot more deaths...

[Thaidream]

EMS services in Thailand should be attached to the local fire station if one exists within each local city and there should be a coverage area in which that EMS responds to all people within its jurisdiction. A patient should be transported to the nearest hospital if in serious condition to be stabilized and then moved accordingly. There should never be a situation when more than one EMS responds unless jurisdiction is unclear.

EMS should be a government service paid by tax revenue just as the fire service is paid. Reimbursement to the government is either by insurance or through a bill sent to the patient.Anything involving healthcare should be a human right and treatment given regardless of payment.

As far as training- all EMS responders need to be highly trained according to either European' Australian' or American standards and be tested before gaining an EMS certificate and then compensated at a proper level . The best EMS people are those who are highly trained; get a level of experience and make this a career.  In addition, these people need to be in direct contact with a doctor at the hospital they are bringing the patient  so proper equipment can be prepared.

[whiteflight]

There needs to be a motorbike rapid response team attached to every EMS team. They should be equipped with the most important equipment, an AED, atropine, tourniquet, etc.  It is the only effective and immediately feasible solution to the traffic problem, which itself kills many people by the tragic inability of EMS services to reach the patient in time. 

Edited December 18, 2017 by whiteflight
Typo

[MyFriend You]

14 hours ago, swissie said:

Mobile emergency services have contracts with hospitals. (they bring "patients" to the hospital that pays them the highest "commission".)
Hopefully, in case of a true medical emergency, the "contract-hospital" of the mobile emergency service is nearby and not somewhere accross town.
You may want to start there. Good luck. Welcome to Thailand.
Cheers. 

Exactly, my friend can speak & understand a lot of Thai, he overheard the EMS's calling different hospitals to see how much they would pay for the Farang (his father) patient, he demanded over and over to be taken to the Thai Military Hospital but would up in one outside of Bangkok.  -  had his father moved 2 days later........then refused to pay the Ambulance bill, let his lawyer take care of it.

I have ben told a few times, the Ambulance Drivers can't be trusted, patient care was not in their best interest, only what facility would pay them the most. 

[rwill]

my view on it is hope that you never need it.