Emergency Response

[fresnoboy]

Deadline for emergency response under new lawDeadline for emergency response under new law

source: The Nation Published on December 27, 2007

The Emergency Medical Service Act, which requires rescue workers to reach accident victims within 10 minutes, will be implemented next April, Public Health Minister Mongkol Na Songkhla said yesterday.

The National Legislative Assembly (NLA) endorsed the new bill last week.

Mongkol said it was the first Thai law that tried to ensure accident victims would be resฌcued as soon as possible.

According to ministry records, 60,000 people die in emergencies and road accidents each year. Mongkol said if resฌcue teams reach victims within an hour 6,000 to 18,000 lives could be saved.

The act is expected to see improvements made to the entire emergency medical sysฌtem.

Rescue workers will have to be registered and permitted to undertake their profession by the National Emergency Medical Service Centre.

The act will also prevent patients being sent to certain private hospitals where rescue vans take them in order to receive commissions.

This system is regarded as particularly unfair for patients who do not have the funds to be admitted to private hospitals.

Moreover, all hospitals across the country will be punฌished if they refuse any patient who does not have funds availฌable for treatment.

Mongkol has proposed a national emergency response centre with an easily memoฌrised hotline number to make it easier for the public to report accidents.

Trained staff would ask callers about the condition of victims before dispatching a rescue team to reach the acciฌdent site within 10 minutes.

The ministry also plans to install a rapid communication network at 9,000 primary healthcare units nationwide. The National Health Security Office has allocated Bt558 milฌlion for the project.

_________________

Nobody gets out of the way for ambulances ! I can't wait to see this in action

[Mosha]

No body gets out of the way of Ambulances! Down here they use fire engines to water the plants.

It's not that long back when I was following a local Piu Yai, when I noticed an ambulance behind me. I pulled over while she continued hogging the middle of the road for 5K doing 50kph

Edited January 2, 2008 by Mosha

[Tony Clifton]

requires rescue workers to reach accident victims within 10 minutes

They drive like maniacs as it is, they're probably now convinced they've been issued a licence to kill on the way to any accident.

[Andiamo]

No body gets out of the way of Ambulances! Down here they use fire engines to water the plants.

It's not that long back when I was following a local Piu Yai, when I noticed an ambulance behind me. I pulled over while she continued hogging the middle of the road for 5K doing 50kph

Exactly! How on earth is this going to be implemented. A totally radical change of mindset of Thai Drivers is going to be needed!!! Will it happen....... Mmm, sorry to be pessimistic but I think I'll Wait and See.

I couldn't believe this when I first arrived in Thailand and yet the roads are cleared and coordinated whenever any dignatories etc are travelling - so it CAN be done! Let's hope.......

[Prakanong]

No body gets out of the way of Ambulances! Down here they use fire engines to water the plants.

It's not that long back when I was following a local Piu Yai, when I noticed an ambulance behind me. I pulled over while she continued hogging the middle of the road for 5K doing 50kph

And in today's Bangkok Post is says it will now be a criminal act to make a hoax call to an emergency number - you mean its was not illegal before????

What a country!

[chanman]

Amazing! Everyone complains that there is no such legislation and then when some one has the balls to try and pass some all you guys can do is knock it. It is a step in the right direction I hope it is taken through to fruition.

[Andiamo]

Amazing! Everyone complains that there is no such legislation and then when some one has the balls to try and pass some all you guys can do is knock it. It is a step in the right direction I hope it is taken through to fruition.

I don't think anybody is knocking that this legislation is WELL overdue - I am simply questioning the HOW! Surely a valid issue? HOW is this going to be enforced/implemented?

Is there going to be a corresponding Media/TV/Radio publicity campaign to alert and "educate" Drivers? I do hope so!

Of course, we can all see the HUGE benefits of ambulances being able to reach incidents and then swiftly transfer injured people to Hospitals. I was merely raising the question of "training/educating" the other NUMEROUS drivers on the road as to the "Process."

[opengoal]

In my country there is a 'give and go' etiquette , this country only has the latter. If the warning for 'stop I am coming thru' is flashing headlights what is the sign for 'oh its ok you go first'. As my wife always tells me you will not see change in your life time, as I say as long as my bottom is pointing south.

Having seen 6 blind people, with one able bodied person, stranded in the middle of the highway for over 2 minutes whilst the loonies drove around them without stopping I tend to agree with her.

You think anybody other than a farang is going to pull over to make way for an ambulance, dont hold your breath

[Greenside]

Basic driver education, road marking and effective policing of existing laws would all lower the fatality rate far more effectively than imposing targets on already stretched and under trained emergency crews, nevertheless any attempts to improve the situation are welcome.

[brahmburgers]

60,000 road deaths per year - that works out to 165 per day. Maybe not too much for a population of 60+ million. Still seems high to me.

That's like 3 big buses crashing each day, or one passenger jet a day.

Thais don't pull aside for ambulances with their sirens blaring - because (a) they don't know to do it, and/or ( regular drivers have to somewhere to go, and nothing should slow them down and/or © drivers are so innured to noise, that any added noise just blends with the ordinary cacaphony of everyday life.

It also interests me that, for all the posturing to revere the Sangha, Thais won't slow or stop to allow monks to cross the road. Same for elderly.

[junkofdavid2]

Thais don't pull aside for ambulances with their sirens blaring - because (a) they don't know to do it, and/or ( regular drivers have to somewhere to go, and nothing should slow them down and/or © drivers are so innured to noise, that any added noise just blends with the ordinary cacaphony of everyday life.

d) Because regular drivers know that siren drivers abuse the siren privilege to bypass traffic for personal reasons, when oftentimes it's not really an emergency.

Too bad for the victims in the few genuine cases though...

[thaigene2]

Isn't this actually a good thing?

Presently there is no effective centralized ambulance/paramedic service. Isn't this a step in that direction?

[thaigene2]

60,000 road deaths per year - that works out to 165 per day. Maybe not too much for a population of 60+ million. Still seems high to me.

That's like 3 big buses crashing each day, or one passenger jet a day.

Thais don't pull aside for ambulances with their sirens blaring - because (a) they don't know to do it, and/or ( regular drivers have to somewhere to go, and nothing should slow them down and/or © drivers are so innured to noise, that any added noise just blends with the ordinary cacaphony of everyday life.

It also interests me that, for all the posturing to revere the Sangha, Thais won't slow or stop to allow monks to cross the road. Same for elderly.

My personal read on that is that Thai drivers (and I must admit me too!) assume the driver is just a lazy idiot who just wants to avoid the traffic and turns on the lights and siren everytime he sees lots of cars. Though I must admit I move for the ambulance..as I give it the benfit of the doubt. To prove my point a bit more, I often wonder if it is a life saving case, why do they just sit there in traffic with the lights and sirens going? Why don't they take evasive measures to GET GOING?

Edited January 2, 2008 by thaigene2

[Old Man River]

No body gets out of the way of Ambulances! Down here they use fire engines to water the plants.

It's not that long back when I was following a local Piu Yai, when I noticed an ambulance behind me. I pulled over while she continued hogging the middle of the road for 5K doing 50kph

Exactly! How on earth is this going to be implemented. A totally radical change of mindset of Thai Drivers is going to be needed!!! Will it happen....... Mmm, sorry to be pessimistic but I think I'll Wait and See.

I couldn't believe this when I first arrived in Thailand and yet the roads are cleared and coordinated whenever any dignatories etc are travelling - so it CAN be done! Let's hope.......

My wife and I saw something a few weeks ago in downtown Bangkok traffic that really surprised us. An ambulance was desperately trying to get through the usual horrible traffic, and unbelievably drivers pulled as far as they could to either side of their lanes (or the next lane) and created a space for the ambulance driver to drive through. It was like parting of the Red Sea. Perhaps people are starting to get the idea.

[PhilHarries]

The Emergency Medical Service Act, which requires rescue workers to reach accident victims within 10 minutes, will be implemented next April, Public Health Minister Mongkol Na Songkhla said yesterday.

Okay, no problems with that. Muchos kudos if they even come close, they'll probably be better than many western countries if they do but the traffic, paricularly in Bangkok, remains the biggest hurdle.

According to ministry records, 60,000 people die in emergencies and road accidents each year. Mongkol said if resฌcue teams reach victims within an hour 6,000 to 18,000 lives could be saved.

I'm no specialist in rescue situations but I would have thought if the condition was life threatening even a half hour is way too long.

The act will also prevent patients being sent to certain private hospitals where rescue vans take them in order to receive commissions.

This system is regarded as particularly unfair for patients who do not have the funds to be admitted to private hospitals.

Moreover, all hospitals across the country will be punฌished if they refuse any patient who does not have funds availฌable for treatment.

It will be interesting to see this implemented, not a moment too soon if they do but I'm not holding my breath.

Trained staff would ask callers about the condition of victims before dispatching a rescue team to reach the acciฌdent site within 10 minutes.

This slightly bothers me in that it holds the dispatch of the ambulance until after the condition of the victim has been verified. Do these trained staff then have to make the decision life threatening or not? Remember they may well be talking to a distressed relative or a complete stranger with no medical knowledge at all.

A good step in the right direction, let's hope the implementation is carried out professionaly and without interference from the various vested interests.

btw traffic not making way for ambulances is not confined to Thailand, many other S. E. Asian nations have the same problem.

[jackspratt]

60,000 road deaths per year - that works out to 165 per day. Maybe not too much for a population of 60+ million. Still seems high to me.

That's like 3 big buses crashing each day, or one passenger jet a day.

Have another look at the OP. It talks about 60,000 deaths from emergencies and road accidents.

The (disputed) figure from road accidents seems to be about 20,000.

[Payboy]

Exactly! How on earth is this going to be implemented.

the public shall cooperate and have accidents closer to the rescue workers lots.....

[mark131v]

Exactly! How on earth is this going to be implemented.

the public shall cooperate and have accidents closer to the rescue workers lots.....

[mark131v]

Exactly! How on earth is this going to be implemented.

the public shall cooperate and have accidents closer to the rescue workers lots.....

sorry got that wrong

dont post very often so forgive me, back to the point. Who exactly are going to crew these rescue vehicles. Have had a couple of experinces with these rescue types both not good. Iam a UK State Registered Paramedic serving in the Forces during the summer i witnessed an accident in Soi Buikhow in which a guy was hit by a trailer. He was out cold lying on his back with a big crowd of people just stood around looking at him so i went over and maintained his airway and had a quick check of his neck and head. During this i found a bleed on the back of his head and a possible fractured skull. Couple of minutes later the rescue turned up so i tried to hand over to them, was completly ignored. There treatment was probably as dangerous as the accident. They did not check for any injuries at all and instead wrestled the guy into a spinal collar without sizing it up or placing it correctly then forced the guy onto a spinal board even though he was actively fighting them by this stage. Iam not an anally retentive type who always does everything strictly by the book after all all situations are different but i can honestly say that his treatment was shocking and he would have been better off and safer without it

A couple of week ago was in walking street saw the usual fellows larging it up as tourist police trying to look important when i noticed an ambulance with a fallang in uniform sat in the back. Went over and told the guy what i do and enquired as to what qualifacations people require to work on the ambulance at this he started to look a bit uncomfortable. His reply was that if you had some first aid knowledge that was usefull bit disturbing really when you see the amount of RTAs round Pattaya involving bikes and cars etc

In my opinion some of situations these people could be responding to (the guy i spoke to had no real medical training) then they probably are killing or certainly making bad situations worse. The first rule of any doctor or medic is to do no harm without training and regulation it is inevitable that some where along the line that must happen!! Untill the training and regulations regarding total amateurs driving around responding to potentially complex medical emergencys are addresed the rest of the points are moot. Pointless having world class hospitals and surgeons in thailand if some joker has just left you paralysed or dead at the side of the road through not being properly trained or even worse doing the job for the wrong reasons, a yellow jacket and an ambulance does not equal paramedic!! Just my toughts getting people to move out of the way or driving faster on blues does not make for a better service

Mark

[Tony Clifton]

Great post Mark.

[Andiamo]

Great post Mark.

Agreed! Valid points made.

[astral]

Wouldn't it be an idea to have trained people in these "ambulances", well pick up trucks????

[PhilHarries]

Good points, and what training do the "trained staff" manning the phone lines have?

Another point. In the absence of a national emergency number how do people know who to call in the event of an emergency. So a farang tourist is riding his rented motorbike through the remote lanes when he comes across an accident where the victims are all unconcious. Who does he call and if he does will anyone one the end of the phone speak English?

Apologies in advance if such numbers are prominantly displayed but I can't recall seeing anything but the Tourist Police number.

[Scott]

Once again the insanity of things. A 10 minute limit--how about "as quickly as possible." That may mean 3 minutes, it may mean an hour. It is a step in the right direction on some points, but there is a lot of work to be done to make it effective.

[Payboy]

great thoughtful post # 19 - but wait, did u just mention the "t" word? come on man, thai's dont need any training in anything when there's an amulet for every occasion.

as for the farangs moving around here in various types of uniform, most of them are living out nothing but their childhood fantasies....

[mark131v]

great thoughtful post # 19 - but wait, did u just mention the "t" word? come on man, thai's dont need any training in anything when there's an amulet for every occasion.

as for the farangs moving around here in various types of uniform, most of them are living out nothing but their childhood fantasies....

Your probably right mate,

that said the training doesnt need to be deep, just the ability to triage and to know when something is serious.Perfect world have a limited number of doctors on call who could be called to work on the serious cases, really it is not brain surgery. On New Years Eve saw a lot around several with nurses in the back. These were not in the hearse type but the ones that the fallang on walking street were in and appear fairly well equiped with the basics. That said if you dont know how to use the basics, collars back boards O2 entonox etc pointless carrying it because it can make things far worse (collars in particular if you dont know how to size them or use them properly you can really f%^k some one up) i realise you probably are not going to get a western service right away but from my limited experience what you have at the moment is bloody dangerous and is probably leaving a few people paralysed or dead in their wake.

If i was injured like the guy in Soi Buikaow i think i would rather have a concerned bystander do their best and stick me in a taxi than the dangerous morons who turned up. There is a saying that a little medical knowledge can be a dangerous thing and they deffinatly had very little and no common sense at all. As for fallangs in uniform if theyhave some knowledge by all means use it if you were a nurse, doctor, paramedic, technician, or whatever medical proffesional in your previous life its a good thing and the training you could give would be priceless. If however you are a Walter Mitty that wants to stand around looking important or looking at accident accident victims and dead bodies that is very disturbing and dangerous, again just my opinion based on limited experience watching and talking to these guys

Mark

[abdulrahman]

Your probably right mate,

that said the training doesnt need to be deep, just the ability to triage and to know when something is serious.Perfect world have a limited number of doctors on call who could be called to work on the serious cases, really it is not brain surgery. On New Years Eve saw a lot around several with nurses in the back. These were not in the hearse type but the ones that the fallang on walking street were in and appear fairly well equiped with the basics. That said if you dont know how to use the basics, collars back boards O2 entonox etc pointless carrying it because it can make things far worse (collars in particular if you dont know how to size them or use them properly you can really f%^k some one up) i realise you probably are not going to get a western service right away but from my limited experience what you have at the moment is bloody dangerous and is probably leaving a few people paralysed or dead in their wake.

If i was injured like the guy in Soi Buikaow i think i would rather have a concerned bystander do their best and stick me in a taxi than the dangerous morons who turned up. There is a saying that a little medical knowledge can be a dangerous thing and they deffinatly had very little and no common sense at all. As for fallangs in uniform if theyhave some knowledge by all means use it if you were a nurse, doctor, paramedic, technician, or whatever medical proffesional in your previous life its a good thing and the training you could give would be priceless. If however you are a Walter Mitty that wants to stand around looking important or looking at accident accident victims and dead bodies that is very disturbing and dangerous, again just my opinion based on limited experience watching and talking to these guys

Mark

Very good post,Mark,next time I'll have a problem will wait for the slower,more expensive,ambulance from a good,expensive,hospital,and don't trust the amateur rescuers.Not that I did trust them before!

Sorry,joking,but only a little,and with my hide.Regards,

[dsys]

thai's dont need any training in anything when there's an amulet for every occasion

[astral]

Perfect world have a limited number of doctors on call who could be called to work on the serious cases,

Even the doctors on duty at some hospitals seem to lack basic knowledge.

My son was in a motorcycle accident.

When he got to the local government hospital they spent time and money on CT scans and x-rays,

but failed to perform basic First Aid and stop the bleeding from his head.

Fortunately I arrived and had him transferred to a private hospital.

They took one look and he was straight off the operating theatre to repair

a ruptured artery on skull.

I was told that he almost bled out.

He was so weak that they did not even try to repair his knee, until 2 days later

when he had recovered a little.

I am pleased to say that he did recover, and that is his son on my Avatar.

[Flatouthruthefog]

Good points, and what training do the "trained staff" manning the phone lines have?

Another point. In the absence of a national emergency number how do people know who to call in the event of an emergency. So a farang tourist is riding his rented motorbike through the remote lanes when he comes across an accident where the victims are all unconcious. Who does he call and if he does will anyone one the end of the phone speak English?

Apologies in advance if such numbers are prominantly displayed but I can't recall seeing anything but the Tourist Police number.

Being the first able bodied people at the scene of a serious accident gives us terrific opportunities to help save lives IF we know what we are doing.

Does anyone have any contacts with Ford Motor Co in UK or Thailand? When the Fiesta was a new car (1972 or 3?) Ford UK produced a terrific film in which father and son (in a new Fiesta of course) came round the corner of a country lane to find 2 cars 'welded together' at a junction and several causalties. Dad sent lad back to a phone box to call the ambulance (and yes Phil I've no idea how we do that in Thailand!) then set about turning off engines to lessen the fire risk and went to the SILENT casualties first. I learned enough from this film to be able to help people on several occasions since.

It would be a great boon to Thailand if someone found this film, dubbed it into Thai and circulated it.

OK I hear you cynics already - who would watch or remember etc etc - but the process must start somewhere!