Perspectives of Emergency Medical Services Providers on Pediatric Emergency Medical Services in Thailand

Abstract

Injuries are the leading cause of death in children under 15 years of age. During 2015-2019, the mortality rate ranged from 15.0-16.0 per 100,000 population, with an average of 1,799 deaths per year or 5 deaths per day. The emergency medical services system played a crucial role in reducing injury and disability rates. However, children were a vulnerable group requiring specialized care skills. Understanding the perspectives and experiences of emergency medical services personnel was essential for service system development. This study aimed to explore the perspectives of emergency medical services personnel regarding pediatric emergency medical services in Thailand. The study employed qualitative research methodology using focus group discussions. The informants were 102 emergency medical services personnel from command operational units and medical operational units at all levels in Chiang Mai, Khon Kaen, Chonburi, Nakhon Si Thammarat provinces, and Bangkok. Data were analyzed using content analysis. The study findings revealed that neonates and young children primarily presented with conditions including high fever, difficulty breathing, seizures, choking on food or toys, and foreign body airway obstruction. School-aged children mainly presented with road traffic accidents, drowning, and falls. Access to services varied according to local contexts, with parents typically choosing to transport children to hospitals themselves rather than calling emergency services. Major problems identified included limited personnel with inadequate specialized skills in pediatrics, inappropriate equipment for children, unsystematic coordination and referral processes, and barriers to healthcare rights for vulnerable children, such as migrant children or neonates without legal documentation. Emergency medical services personnel proposed developing pediatric-specific protocols, establishing provincial coordination centers, developing specialized training curricula, increasing pediatric equipment, and implementing telemedicine technology to assist decision-making in emergencies. This study highlighted the need for comprehensive development of pediatric emergency medical services systems, encompassing policy, professional standards, resources, and technology, as well as raising public awareness of the role of emergency medical services, to ensure that all children receive safe, timely, and high-quality emergency care in accordance with international standards.