An emergency medical service system in Thailand: providers' perspectives.

BACKGROUND: Emergency medical services (EMS) in Thailand have been established for more than 20 years. However evaluation of EMS is limited The present study aimed to determine providers 'perspectives on EMS in Thailand MATERIAL AND METHOD: The present study was conducted at the tenth Academic Annual Meeting of Emergency Medicine between February 9 and 13, 2009 at Rajavithi Hospital, Bangkok. All participants at the meeting were eligible and randomly selected for the survey Subjects were physicians, nurses, or paramedics who worked in Emergency Department/Room at hospitals in Thailand. The survey was performed by self-rated questionnaire. RESULTS: Four hundred fifty questionnaires were distributed and 425 were returned completed (94.4%). Of those, 365 subjects (85.9%) were female, 359 (84.5%) were nurses, 103 (24.5%) worked at the ER for more than 10 years, and 284 (67.6%) worked at the community hospitals. The most three common issues of EMS system were insufficient medical personnel, insufficient medical devices, and lack of knowledge of medical personnel. At the ER, overcrowding was the most common issue, while problems with medical devices, collaborations with other organizations, and communication devices were main problems at the pre-hospital EMS. The average satisfactory score of EMS was 2.86 out of 5. CONCLUSION: EMS in Thailand requires improvement in terms of numbers ofmedical personnel, well-equipped ambulance, and collaborations among organizations.

How the ARCH Project Could Contribute to Strengthening ASEAN Regional Capacities on Disaster Health Management (DHM).

OBJECTIVE: The Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) developed Regional Collaboration Drills (RCDs) and is proposing an ASEAN Academic Network to strengthen capacity in disaster health management (DHM) in ASEAN Member States (AMS), as well as developing a standard training curriculum in DHM. This study aims to clarify the impacts and sustainability of the ARCH Project. METHODS: The four previous RCDs and the enhancement of academic activities were reviewed. RESULTS: The ARCH Project developed the RCDs with simulation exercises based on possible disaster scenarios in each host country to test and validate the capacity of AMS International Emergency Medical Teams (I-EMTs), the Standard Operating Procedure (SOP) for I-EMT coordination, and regional tools, as well as the relevant domestic SOPs of the host countries for receiving international assistance. Following the RCD in Thailand, three AMS: Viet Nam, Philippines, and Indonesia, all of which are considered disaster-prone, successfully hosted RCDs with significant improvements. The project also established a sub-working group (SWG) to develop a standard curriculum in DHM. Two curricula developments, the Basic Course on DHM and In-Country Course for Coordination on EMTs, are on-going as part of the project activity. The establishment of the ASEAN Academic Network and the ASEAN Institute for DHM (AIDHM) are currently in the endorsement process of the ASEAN health sector. CONCLUSION: The RCDs are very effective to test and to validate the SOP and regional tools developed, providing opportunities for AMS I-EMT to familiarize the tools, as well as for host countries to assess their coordination capacity for receiving international assistance and identifying the country's specific challenges, and verifying ASEAN regional coordination mechanism. The development of the standard curriculum can enhance regional capacity both in supporting disaster-affected countries and in receiving international assistance. A sustainable capacity development mechanism in DHM is envisaged through the establishment of the ASEAN Academic Network and AIDHM toward the goal of One ASEAN One Response.

A lost world disease: Copra itch outbreak caused by Tyrophagus longior mite.

An outbreak investigation of copra itch revealed a cluster of six suspected cases with skin dermatitis, with 11-32 years of age, belonging to a single family, between June and July 2016 in Phang Nga province, Southern Thailand. Epidemiologic investigation of these suspected cases revealed five probable cases developing multiple discrete erythematous papules with intense pruritus on the body rather than the extremities and one confirmed case whose skin was infested with domestic mite, Tyrophagus longior (Gervais) (Ascari: Ascaridae). This mite was also found in unused coir mattresses outside their bedrooms. Household infestation with T. longior mites rendered these family members to become more susceptible to expose indoor biting of T. longior adult mites that were adapted well to the domestic environments with poor hygienic conditions. Human exposure to mite bites was more likely to be a direct contact than an indirect contact. Findings from this copra itch outbreak investigation provided understanding of natural disease of copra itch and factors that favored the outbreak, and could guide diagnosis for physicians, surveillance and response for surveillance and rapid response teams (SRRTs), and prevention and control for entomologists and public health personnel.