OVER THE next six months, a big change to Thailand’s medical-emergency regulations should lead to better-trained rescue workers.
Yet, while the National Institute of Emergency Medicine (NIEMS) believes the upcoming changes will be for the better, several foundations that have long provided emergency help have concerns about them.
“I am worried that the new rule imposed by the NIEMS will not suit the reality in Thailand,” Kusolsattha Surat Thani Foundation member Nitisak Boonmanont said recently.
He was referring to the regulation approved by the NIEMS board on November 15 that will take effect within 180 days of that date. Under the new rule, rescuers must have completed at least 40 hours of training – not just 24 hours.
“We have long voiced our concerns. We believe the rule should be introduced, but only when we are really ready,” Nitisak said.
He said systems must be prepared first to ensure personnel in the field can comply with the requirements.
“Has the NIEMS ever asked people working in the field?” he said.
Nitisak said that, on October 18, the Rescue Network of Thailand had called on Public Health Minister Dr Piyasakol Sakolsatayadorn to suspend introduction of the rule. In response, Piyasakol assigned a legal specialist to talk to representatives of 11 non-profit organisations on November 10. At their meeting, it was agreed that the draft announcement for the rule should be suspended until further review by relevant parties was completed.
“But then, the NIEMS board approved the draft on November 15 and wanted it to go into effect within 180 days,” Nitisak said.
Today, there are three levels of medical-emergency help in Thailand starting from first responders (FR) level to basic life support (BLS) level and advanced life support (ALS) level.
Most personnel in this field have attained the FR level. They are affiliated with foundations and local administrative bodies.
The 1669 Medical Emergency Hotline centre has responded to 1.5 million cases of medical emergency each year. Of them, about a million involved FR teams transporting patients to medical facilities. BLS and ALS teams handled about 200,000 cases each.
Although FR personnel receive some training before they are out in the field, the NIEMS believe they should receive more.
The new rule introduced by the NIEMS will prevent FR teams from transporting patients to medical facilities.
They can only provide pre-hospital care and wait for more advanced teams to handle the transportation.
Nitisak believes that this process may be too complicated, especially given that some patients in emergency cases need immediate medical attention from health professionals. The faster they reach hospital, the greater their chance of recovery.
NIEMS secretary-general Dr Atchariya Pangma, so far, has stood firm by the decision.
“We have introduced this rule in the best interests of patients in medical emergencies. This rule will raise the standards of rescue vehicles that are now in practice,” he said.