EMS – the future of Thailand’s Emergency Medical Services

I am drafting a new series of articles to run alongside the current series ‘Ambulance Design’ which will address the issues relating to EMS specific issues such as training, development, co-operation, funding, collaboration and also, a in depth personal reflection on the current state of EMS in Thailand.

In order to gain a greater insight, your comments, suggestions, views and thoughts would be greatly appreciated.

On face value, all seems OK, but as a colleague who is a trauma doctor with specific involvement in their EMS provision recently said to me ‘…EMS in Thailand is in crisis…‘.

The public don’t have confidence in the ambulance (crew) if they call 1669

This will be the focus of the first article, with a reflective review of what has been achieved in regards of EMSS provision & identifying a number of issues which need urgent or immediate attention. (This article is due to be online mid June 2017)

Needless, prevetable & avoidable deaths have a huge financial impact on the economy and social structure of Thailand (each fatality resulted on an average discounted lifetime cost of 3.05 million Baht source: https://www.researchgate.net/publication/228892674_Determination_of_economic_losses_due_to_road_crashes_in_Thailand) and can be readily alleviated by the provision of adequate training backed up by the ambulance personnel having access to the correct equipment (AED’s, portable suction kits and portable O2 administration sets). Sadly, each and every day, people are dying due to a lack of such simple and relatively inexpensive items. Foundations are literally begging overseas benefactors for simple items which should in reality form the basis of a standardised kit.

To borrow the catch phrase from SJA in the UK, no-one should die from the lack of first aid. Globally, ambulance crews are in very general terms, first aiders with what should be an incredibly enhanced set of life saving and interventionist skills, supported by the correct equipment to enable them to perform these tasks and in turn, supported in turn by advanced clinicians when things are truly out of their skill set. This is sadly not the case at present, instead there is a service in operation which is was fit for purpose at its inception but is lagging behind due to a lack of development and foresight.

Whilst the administrative orgsanisations such as EMIT and the NIEMS have plans, objectives and mission statements, they require someone or a group of people to take ownership of the immediate problem and resolve the various issues. The key areas needing attention and discussion are (in no particular order):

  • EMT training and revalidation review
  • Community based first aid training
  • Vehicle design and specification
  • Funding & ongoing support of volunteer ambulance crews
  • Collaboration between volunteer ambulance crews

Thailand needs and deserves a fit and proper emergency medical services system. The people of Thailand are being denied the access to such a service and this is now the time for change.

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