Accident And Ambulance Response

[sibeymai]

A cautionary tale written from my hospital bed....

Yesterday I was on the farm cutting grass and scrub with one of those cutters you wear and often seen being used alongside roads. Some of the scrub had substantial woody stems and posed greater resistance than plain grass. However, it was nothing I had not cut before with similar equipment.

About 10am part of the cutting blade decided to separate from the whole. Given the shrapnel's 360 degree trajectory possibilities people have better odds of not being struck when these events occur. However, perhaps due to the hard work I'd been putting the machine through the shrapnel decided to take revenge and exit via my left shin causing a large flesh wound and breaking my tibia in the process. The impact on my shin was substantial but it wasn't until I looked at the cutting blade and saw a piece missing, then tried to take a step with my left leg which immediately collapsed under me that I knew I was really in trouble.

Lesson #1: using one of these types of cutters to cut anything other than grass (such as scrub) is a serious health risk, possibly even fatal.

Lesson #2: there is no practical protective gear which will reduce the risk to an acceptable level.

I was about 100 meters from the farm house and without my mobile phone. Nobody was around. I dragged myself back to the house after using my shirt to tie a tourniquet above the knee. I was wearing knee high rubber boots and had no idea how bad the wound was but could feel a lot of blood in the boot. Back at the home I climbed the stairs and managed to open the door and crawl to my phone. Adrenaline, endorphins and shock are amazing things when it comes to doing the seemingly impossible.

Lesson #3: always carry your mobile phone when working away from the house.

Lesson #4: try not to work alone with farm machinery or power tools if it can be avoided.

I called my wife in Bangkok and asked her to call an ambulance. While this was happening I cut away the rubber boot and proceeded to apply pressure to the wound to slow the blood flow. The wound was across the whole from of my leg and as deep as the full depth of the tibia. I'd already guessed my leg was broken but I was seriously worried about blood loss.

30 minutes later at 10:30am I was still waiting for the ambulance which I felt must surely be close by now. I was worried that if I passed out from blood loss the ambulance may not find me. I called my wife back as I was becoming anxious. She had called the local hospital/clinic/emergency center (on highway 304 just west of Klong Rung) who told her that their ambulance was unavailable for emergencies because it was involved in an emergency training session. They didn't have another ambulance or backup procedure and they would not assist to organise an ambulance from another center.

So here I was 30 minutes later with a serious injury and no way of getting to hospital. Panic started to become a possibility. My wife called the friendly local shopkeeper who arrived at the farm about 10:45am, assisted me into my pickup and we arrived at the local hospital in Si Maho Sot 15 minutes later, an hour after the accident occurred.

Lesson #5: if in rural areas (or perhaps everywhere) don't ever rely on an ambulance. Always have your own means of transport to hospital available.

Lesson #6: have the necessary knowledge, equipment and materials at hand to perform effective first aid.

Lesson #7: in the case of serious injury always do as much preliminary first aid to stabilise the patient as is possible as the time to hospital may be a lot longer than you think.

Subsequently I was transferred from Si Maho Sot to Prachin Buri and then on to Bangkok where I finally underwent surgery at 6:00pm. Strangely the crawl across the farm was nowhere near as painful as the ambulance transfers between hospitals in vans which lacked any form of effective suspension made even worse by the poor state of Thai roads.

Aside from this I can not praise the efforts of the hospital staff highly enough in all three hospitals I was treated in. Absolutely professional in every sense and equal to emergency departments in government funded hospitals I've experienced in western countries. The privately funded hospital where I was eventually operated on has also been excellent. I now have a steel plate screwed to my tibia and am expected to make a 100% recovery within 3 months.

Just another memorable day in Thailand, but perhaps not for all the right reasons. TVers, please be careful out there.

[Mario2008]

Better to have a good neighbour then a far friend. Hope you are doing fine and it doesn't hurt to much.

[Mossfinn]

I guess you got lucky Sib!!!

Reminds me of being in an ambulance in Bangkok, flashing lights and siren and horn to boot, and cars were blocking it in, overtaking and cutting it up.

Unbelievable!!

Get well soon

[bikerman]

A cautionary tale written from my hospital bed....

Yesterday I was on the farm cutting grass and scrub with one of those cutters you wear and often seen being used alongside roads. Some of the scrub had substantial woody stems and posed greater resistance than plain grass. However, it was nothing I had not cut before with similar equipment.

About 10am part of the cutting blade decided to separate from the whole. Given the shrapnel's 360 degree trajectory possibilities people have better odds of not being struck when these events occur. However, perhaps due to the hard work I'd been putting the machine through the shrapnel decided to take revenge and exit via my left shin causing a large flesh wound and breaking my tibia in the process. The impact on my shin was substantial but it wasn't until I looked at the cutting blade and saw a piece missing, then tried to take a step with my left leg which immediately collapsed under me that I knew I was really in trouble.

Lesson #1: using one of these types of cutters to cut anything other than grass (such as scrub) is a serious health risk, possibly even fatal.

Lesson #2: there is no practical protective gear which will reduce the risk to an acceptable level.

I was about 100 meters from the farm house and without my mobile phone. Nobody was around. I dragged myself back to the house after using my shirt to tie a tourniquet above the knee. I was wearing knee high rubber boots and had no idea how bad the wound was but could feel a lot of blood in the boot. Back at the home I climbed the stairs and managed to open the door and crawl to my phone. Adrenaline, endorphins and shock are amazing things when it comes to doing the seemingly impossible.

Lesson #3: always carry your mobile phone when working away from the house.

Lesson #4: try not to work alone with farm machinery or power tools if it can be avoided.

I called my wife in Bangkok and asked her to call an ambulance. While this was happening I cut away the rubber boot and proceeded to apply pressure to the wound to slow the blood flow. The wound was across the whole from of my leg and as deep as the full depth of the tibia. I'd already guessed my leg was broken but I was seriously worried about blood loss.

30 minutes later at 10:30am I was still waiting for the ambulance which I felt must surely be close by now. I was worried that if I passed out from blood loss the ambulance may not find me. I called my wife back as I was becoming anxious. She had called the local hospital/clinic/emergency center (on highway 304 just west of Klong Rung) who told her that their ambulance was unavailable for emergencies because it was involved in an emergency training session. They didn't have another ambulance or backup procedure and they would not assist to organise an ambulance from another center.

So here I was 30 minutes later with a serious injury and no way of getting to hospital. Panic started to become a possibility. My wife called the friendly local shopkeeper who arrived at the farm about 10:45am, assisted me into my pickup and we arrived at the local hospital in Si Maho Sot 15 minutes later, an hour after the accident occurred.

Lesson #5: if in rural areas (or perhaps everywhere) don't ever rely on an ambulance. Always have your own means of transport to hospital available.

Lesson #6: have the necessary knowledge, equipment and materials at hand to perform effective first aid.

Lesson #7: in the case of serious injury always do as much preliminary first aid to stabilise the patient as is possible as the time to hospital may be a lot longer than you think.

Subsequently I was transferred from Si Maho Sot to Prachin Buri and then on to Bangkok where I finally underwent surgery at 6:00pm. Strangely the crawl across the farm was nowhere near as painful as the ambulance transfers between hospitals in vans which lacked any form of effective suspension made even worse by the poor state of Thai roads.

Aside from this I can not praise the efforts of the hospital staff highly enough in all three hospitals I was treated in. Absolutely professional in every sense and equal to emergency departments in government funded hospitals I've experienced in western countries. The privately funded hospital where I was eventually operated on has also been excellent. I now have a steel plate screwed to my tibia and am expected to make a 100% recovery within 3 months.

Just another memorable day in Thailand, but perhaps not for all the right reasons. TVers, please be careful out there.

Sorry to hear about your accident, nice to hear local shopkeeper came to your aid when you needed help, let that be lesson to all. Everyone may need help one day and have to depend on Thais for assistance. Hope your feeling better soon. l

[TopDogger]

Lesson #8: Don't work illegally.

Lesson #9: If you must work illegally, don't docuement it online..

[noahvail]

It's sadly ironical that the rescue bus was in a "training" assignment. Nothing better than OJT, eh. Good thinking on your part to keep your wife informed, and that she didn't panic and was able to assist.

I think it's really important to keep a well-stocked first aid (and second aid, as well) kit close to hand. Every time I go back to NZ or the States, I bring back stuff that seems impossible to buy here, like epi-pens. The local hospital and pharmacies don't have any epinephrine in stock - amazing. Of course, if you've got stuff like that, you need the training to use it. That doesn't exist where I am, perhaps in BKK?

[jackdanielsesq]

Cute

BR>Jack

Lesson #8: Don't work illegally.

Lesson #9: If you must work illegally, don't docuement it online.

[ukrules]

So the training is more important than doing the actual job.

[neverdie]

Something also tells me it would be alot safer to get yourself to hospital than to rely on one of those ambulance or rescue drivers , some of the death defying stunts ive seen those guys do

[Maizefarmer]

Nice to hear someone have something good to say about the Thai state health system. I nearly lost my arm (and my life) a couple years back trying to pull some wire out of the front end of my forage harvester. Over confident (".... just another day down on the farm") - didn't switch the engine off!

Quality of the gov hospital ER, doctors & nurses - first class - rival anything a European or USA hospital could offer.

The biggest killer of Thai's in the workplace? Farm machinary (rice harvesters).

If you need hospita treatment - don;t overlookthe Thai government hospitals - they are super good: Chula in Bangkok offers everything the big name big budget private hospitals can offer (and some more....) but at far less cost than what you'd pay in a private hospital. Okay, you may not get a flashy room and you may not get a Western menu - but thats where the differances stop.

[sibeymai]

Lesson #8: Don't work illegally.

Lesson #9: If you must work illegally, don't docuement it online..

If cutting the grass around the house where you live is considered work which contravenes their visa then there are a lot of farangs who could end up deported. This question has been discussed in other threads (eg. can I paint my house ?) and is off topic here.

Maizefarmer, I recall your accident and followed the progress of your recovery on TV. Accidents are just that regardless of whether the injured contribute to their happening in some way. I was well aware of the potential for injury these machines are capable of. While using the machine the thought of "what if" had repeatedly crossed my mind. When "what if" became the reality I considered myself lucky that I my leg wasn't severed completely, which is entirely possible in a worst case "what if" scenario.

When I am mobile again I shall be visiting both the Si Maho Sot and Prachin Buri hospital emergency departments with generous donation cheque in hand.

[lopburi3]

Actually there are other differences at Chula. The rooms are actually as good as most private hospitals (if you get the private rooms in main building - waiting list) but treatment is often by a team rather than one doctor. This in another setting might be advantageous; but in Thailand they are not going to question the team leader - and they are terribly overworked. Unless you understand Thai it would be difficult navigating your way around (even for Thai it is) and there are many very unpleasant workers who seem to enjoy showing there authority. I would not recommend unless the expertise of one of there good doctors is required or the savings in cost is a major factor. Will also note that modern medical tests can be just as expensive as a private hospital (MRI etc). Drugs are much cheaper than a private hospital. But they may sometimes play games as there is no itemized receipt provided - check carefully.

[sanook2me]

These stories are horrible and i happy you are okay and alive.

The pain must have been unbearable i have broken a leg and understand the pain.

This is one aspect of living in Thailand that bothers me..the emergency treatment available on site or on route to a hospital in an ambulance is pratically nill and the inconsiderate drivers never move out the way for blues and twos from ambulances..

get well soon...

[draggons]

Sorry to here about your accident and good to here you're recovering.

Have to disagree with you over your comment "Lesson #2: there is no practical protective gear which will reduce the risk to an acceptable level"

I know it's hot and uncomfortable to ware boots in this heat but there are plenty of metatarsal boots available for use with this types of machinery. I spent a few years working in the forestry woodcutting and during the winter months had a pair of wellington type boots with full frontal protection and a pair of leather boots for the drier months.

There are also combi gaurds available to fit to the cutting head that stops a broken blade from traveling back towards the operator. It's not just the damage that a broken blade can inflict but the infection that it will introduce into a wound.

Be safe. Hope you're up and about soon.

[sibeymai]

draggons, never seen such a boot in Thailand. Will make further inquiries. Must be some fancy steelwork to be light enough to wear but strong enough to stop a high velocity steel projectile from penetrating. I suspect it would still be possible to break a bone but without the added complication of the flesh wound. Will do some internet research.

A substantial cutting head guard fitted to the shaft would help. The plastic one fitted is next to useless.

Thanks for the well wishes. The doctor is happy with the progress. No infection (so far) and should be on crutches tomorrow and out of hospital early next week.

[G54]

Thank heavens for a wife who did keep her head and phone the shop keeper and that you were able to remain focused to be aware of the situation. Very lucky man.

Get well soon.

[webfact]

Not for a first time I saw an ambulance with red light on and sounding horn (obviously in an emergency action) WAITING at a crowded highway toll plaza to pay toll...

Sometimes I have a nightmare. I am picked up by a Thai ambulance...

[toptuan]

So the training is more important than doing the actual job.

Form without substance. Essence of the host culture. Sorry, TIT.

[sibeymai]

Checked the web for protective footwear. Certainly steel toed boots with metatarsal protection to worldwide NFPA standard are essential. However, from the designs I've seen on the web the protection does not extend much higher than the ankle. My wound was several inches above the ankle (thankfully) so tibia protection to at least knee height is needed. Knee high boots are essential for protection in long grass against snake bite. I haven't seen a boot on the internet which can stop the equivalent of shrapnel.

[Golfja]

Calling 1669 will get you the help you needed.

[Kimera]

Lesson #8: Don't work illegally.

Lesson #9: If you must work illegally, don't docuement it online..

If cutting the grass around the house where you live is considered work which contravenes their visa then there are a lot of farangs who could end up deported. This question has been discussed in other threads (eg. can I paint my house ?) and is off topic here.

Maizefarmer, I recall your accident and followed the progress of your recovery on TV. Accidents are just that regardless of whether the injured contribute to their happening in some way. I was well aware of the potential for injury these machines are capable of. While using the machine the thought of "what if" had repeatedly crossed my mind. When "what if" became the reality I considered myself lucky that I my leg wasn't severed completely, which is entirely possible in a worst case "what if" scenario.

When I am mobile again I shall be visiting both the Si Maho Sot and Prachin Buri hospital emergency departments with generous donation cheque in hand.

Cutting the grass on the FARM, 100 mtrs from the house, you sure ?

[draggons]

Sibeymai, give me a couple of days and I'll fine the name of the welly type boots I use to have and I'll PM you.

[sanook2me]

wow! just leaning over my balcony and looking at the sois and wondering why Thai road engineers don't join up main roads and sois etc in a spidersweb much like estates back in blighty. Then i see the normal massive green neons signs of the local hospital in the distance and remembered this post.

i can see it but got not idea how to get there! or what the number is for an emergency ambulance

memo to self..tomorrow..get ambulance and police number in mobile..

get well soon.......

[TheLaughingMan]

The way I read it, they told your wife straight there was never ever going to be an ambulance and to basically fuc_k off. So why is it you had to call your wife back to get this information? Get a divorce if this is the way it played out. Your woman should be bending over backwards trying to help you, not mai phen rai-ing the fact that you will bleed to death "oh well".

[TAWP]

Wow, I crinched reading this story...something about blades/knives and accidents that just gets to me.

Hope your recovery will be speedy.

[sanook2me]

The way I read it, they told your wife straight there was never ever going to be an ambulance and to basically fuc_k off. So why is it you had to call your wife back to get this information? Get a divorce if this is the way it played out. Your woman should be bending over backwards trying to help you, not mai phen rai-ing the fact that you will bleed to death "oh well".

[corker]

It's often wiser to take a cab in BK,than waiting for an ambulance,unless you are really messy.

[MeMock]

Thank heavens for a wife who did keep her head and phone the shop keeper and that you were able to remain focused to be aware of the situation. Very lucky man.

Get well soon.

I would like to know why after 30 minutes of waiting for an ambulance that you thought your wife had called that you had to call her to find out that it wasn't coming. She didn't think to call you back and let you know?

[astral]

The only real ambulances are from the hospitals.

The other guys are all volunteers (Sawang Phatep) and have little training or equipment,

sad to say.