Journal of Emergency Medical Services of Thailand

Assess the Knowledge and Awareness of Disaster Risks among 15 - 60 Years Old in Bangkok

Mon, 30 Jun 2025 00:00:00 +0700

Bangkok faces significant disaster risks, including floods driven by climate change and rapid urbanization, which compromise its infrastructure and citizen safety. Effective disaster management relies on public awareness, education, and preparedness to mitigate impacts and build resilience. This study aimed to evaluate the knowledge and risk perception of disasters among Bangkok residents aged 15-60 years, analyze factors influencing their perceptions, and suggest measures to improve disaster preparedness. A cross-sectional survey was conducted using an online questionnaire distributed via social media platforms from 15 March to 30 April 2024. A random sample size of 345 participants was calculated using Cochran’s formula; however, 586 respondents volunteered to participate. A set of questionnaire was developed based on Protection Motivation Theory (PMT) and Health Belief Model (HBM); and validated by three experts in disaster management using the item-objective congruence (IOC) method, achieving a mean IOC score of 0.8. Reliability was confirmed through a pilot study with 30 respondents, yielding a Cronbach’s alpha coefficient of 0.85. Demographic data, disaster related knowledge and risk perception levels were analyzed using descriptive and inferential statistics. The participants, predominantly female (61.60%), had a mean age distribution with 24.23% aged 41-50 years. The majority had a bachelor’s degree (45.90%) and resided in families of 3-5 members (70.99%). While 61.26% had first-aid training, 64.85% lacked CPR training. Most respondents demonstrated moderate knowledge of disasters (47.44%) and moderate risk perception levels (38.90%) regarding their residential areas. Regression analysis identified education level as a significant predictor of risk perception (Beta = 0.186, p < 0.001). The findings highlighted a moderate level of disaster awareness and risk perception among Bangkok residents, reflecting the city’s limited experience with severe disasters. Educational interventions tailored to local risks, such as air pollution (PM2.5) and traffic accidents, are crucial for enhancing preparedness and resilience. Instrument validation ensures that the study’s findings are robust and applicable to improving disaster management strategies. These insights underscore the importance of integrating disaster education into school curricula, public campaigns, and community-based training to reduce vulnerabilities and foster sustainable disaster management strategies.

Perspectives on the Value and Implementation of the Maritime Public Health Services in Thailand

Mon, 30 Jun 2025 00:00:00 +0700

This research aimed to study perspectives on the value and implementation of the maritime public health services in Thailand across five provinces. These coastal areas have high economic value in terms of tourism but also experience high rates of illness, accidents, and fatalities in the maritime region. A quantitative research method was employed. The samples consisted of people living in coastal areas, health personnel, and entrepreneurs, totaling 349 participants. The study included an assessment of the healthcare situation, perspectives on the value and implementation of maritime public health services, and their impact on the economy. The study found that the majority of respondents were members of the general public (77.1%), followed by healthcare personnel (18.6%) and entrepreneurs (10.3%). Most participants were female (64.2%), aged between 20 and 39 years (48.7%), employed as wage earners (34.7%), and had resided in the province for more than six months (82.5%). The overall perspectives of the participants on the value and implementation of maritime public health services were quite high (mean=3.55, S.D=0.67). Moreover, it was found that (1) they had perception that should have basic life support (BLS) skills (mean=3.89, S.D=0.96); (2) they should quickly refer patient to hospital (mean=3.89, S.D=1.00); (3) they should develop primary care in area (mean=4.01, S.D=0.96), (4) the ASEAN association should cooperate in developing maritime public health (mean=3.78, S.D=0.95), and (5) maritime public health affected the image of tourism (mean=3.63, S.D=1.01). In the part of perception level regarding the value of the marine public health action plan was high in integrating emergency healthcare response networks in maritime public health crises, as well as the dimensions of maritime public health international standard and excellence. The dimension of the value of maritime public health services affecting economic value is significant in the perspectives of all stakeholders.

Factors Affecting Survival Outcome in Out-Of-Hospital Cardiac Arrest Patients at Emergency Room, Banglamung Hospital, Chonburi

Chayanon Wonglue — Mon, 30 Jun 2025 00:00:00 +0700

Out-of-hospital cardiac arrest (OHCA) has shown low rate of survival. There were benefits from studing factors affecting survival outcome in out-of-hospital cardiac arrest and learned from problems for improving emergency medical services (EMS). These could increase the survival rate of OHCA patients. This retrospective study aimed to study factors affecting survival outcome in out-of-hospital cardiac arrest at emergency room, Banglamung hospital; collecting data from OHCA medical records database, between January 2023 and December 2023. There were 110 patients enrolled; return of spontaneous circulation (ROSC) was observed in 40.9% of the cases, survival to admit 10.9% and survival to refer 9.1%. As for the result from data analysis; significant factor affecting survival outcome (p<0.05) was time to first dose adrenaline within 30 minutes. Thereby OHCA patients who got first dose adrenaline within 30 minutes had greater chance of ROSC, 3.53 times than those who got first dose adrenaline more than 30 minutes (95%CI: 1.49 - 8.34, p<0.05). Therefore, OHCA patients should got first dose adrenaline as soon as possible to increase the chance of survival.

Prevalence and Predictive Factors of Return of Spontaneous Circulation in Traumatic Out-of-Hospital Cardiac Arrest in Samutsakhon Hospital

Arisa Yimdee — Mon, 30 Jun 2025 00:00:00 +0700

Accident-related injuries are the leading cause of out-of-hospital deaths worldwide. Traumatic cardiac arrest has a low survival rate. Currently, there is no clear prognostic factor for predicting the outcome in this patient group. The researchers are interested in studying the prevalence, survival rate, and predictive factors of return of spontaneous circulation (ROSC) in traumatic out-of-hospital cardiac arrest, through a retrospective study involving patients with traumatic out-of-hospital cardiac arrest presenting to the Emergency Department at Samutsakhon Hospital, between October 2017 and September 2025. The study calculated the prevalence and to calculate the prevalence and predictive factors associated with emergency department (ED) survival. Chi-square test or Fisher Exact test was used for categorical data, while independent t-test was used for normally distributed continuous data. In cases where the data were not normally distributed, the Mann-Whitney U-test was applied. The results showed that among the 166 patients with traumatic out-of-hospital cardiac arrest in this study, there were 44 successful resuscitations in the emergency department, accounting for 26.5%, and 4 patients survived to be discharged home, representing 2.4%. Prehospital ROSC was the only factor significantly associated with ED survival, increasing the chance of successful resuscitation in the emergency department by 5.8 times.

Response Time and Perspectives of Practitioners in the Emergency Medical Services System Regarding Emergency Response Time of Critically Patients in Thailand

Suradech Doungthipsirikul, Teera Sirisamutr — Mon, 30 Jun 2025 00:00:00 +0700

This study aimed to assess the relationship between response time and survival rates of critically patients and explore the perspectives of practitioners in the emergency medical services system regarding emergency response times for critically patients. A mixed-methods research design was employed, incorporating quantitative research through a retrospective study of data from the Information Technology for Emergency Medical System (ITEMS) in 2023, and qualitative research using focus group discussions and in-depth interviews with emergency medical practitioners in Chiang Mai, Khon Kaen, Trang, and Bangkok, Thailand, totaling 77 participants. The results indicated that in 2023, the average response time was 10 minutes, with 39% of critical patients receiving emergency services within 8 minutes. An analysis of the relationship between response time and survival revealed that as the response time increased, the risk of mortality for critically patients significantly increased. When examining the relationship between response times and mortality, the response times were categorized into 4 minutes, 8 minutes, 10 minutes, and 15 minutes. It was found that critically emergency patients who received emergency response within 8 minutes had a reduced risk of mortality compared to those with response times exceeding 8 minutes (OR= 0.92, 95%CI = 0.85–0.98). Emergency medical practitioners generally viewed the response time for emergency operations as an important factor influencing the survival chances of emergency patients, particularly in cases of cardiac arrest and accidents. The use of response time for emergency operations as a quality indicator remains essential, as it measures efficiency and demonstrates service standards to the public. Recommendations: (1) set a standard for emergency response time for critically patients at the national level that is consistent with the international standard of 8 minutes, but must focus on solving problems that prevent response within 8 minutes, and (2) consider setting emergency response time at the local level to be consistent with the context of each area, taking into account resource readiness and geography.

Effects of Clinical Practices Guideline for Triage Emergency Psychiatric Patients on Clinical Outcomes in Emergency Psychiatric Department Suan Prung Psychiatric Hospital, Chiang Mai Province

Chutikarn Thongsuk, Jarunee Ratsamesuviwat, Chayanin Thanhanirun — Mon, 30 Jun 2025 00:00:00 +0700

Violent behavior problems in society are increasing. According to statistics from the Ministry of Public Health’s health database system, patients with a high risk of violence have received services from 2016-2022, totaling 27,518 people. Approximately 3 percent of the violent individuals were patients diagnosed with psychiatric disorders and drug abuse. In order for psychiatric patients to receive services quickly, correctly, and safely in emergency psychiatric work, patients must be correctly and appropriately triaged to classify service recipients and prioritize emergency patients to receive emergency medical services in order of emergency medical urgency. This study aimed to improve, evaluate, and compare the correct triage rate before and after implementing the Suan Prung emergency psychiatric triage (SPEPT) guidelines for emergency psychiatric patients at Suan Prung Hospital, Chiang Mai Province. It was conducted as a prospective implementation study. The samples consisted of 3 groups: (1) 8 personnel from the team that improved the emergency psychiatric patient triage guidelines; (2) 20 personnel who used the emergency psychiatric patient triage guidelines; and (3) 500 emergency psychiatric patients who received emergency psychiatric services. The original psychiatric patient triage guidelines, namely the 2021 Suan Prung Hospital emergency psychiatric triage guidelines, were used in July 2024, totaling 250 patients, and the newly revised Suan Prung Hospital emergency psychiatric triage (SPEPT) in August 2024, totaling 250 patients. It was

found that: (1) assessment of the accuracy of screening patients screened using the original triage guidelines, there were 137 correct screenings out of 250 patients, or 54.80 percent, and there were 113 incorrect screenings out of 250 patients, or 45.20 percent. As for the accuracy of patient screening using the revised emergency psychiatric triage form, there were 204 correct screenings out of 250 patients, or 81.60 percent, and 46 incorrect screenings out of 250 patients, or 18.40 percent. (2) The accuracy ratio of screening between patients screened using the original screening form and patients screened using the revised emergency psychiatric triage form found that patients screened using the revised emergency psychiatric triage form had a significantly higher screening accuracy ratio than those screened using the original screening form (p<0.001). (3) The results of the implementation of the emergency psychiatric triage guidelines found that most psychiatrists and nurses followed the guidelines correctly. (4) The results of the study on the satisfaction of personnel who used the guidelines found that the overall satisfaction was at the highest level, with the mean score of 3.85 (SD=0.37).

Basic Life Support Competency and Associated Factors Among Village Health Volunteers in Uttaradit Province: a Multilevel Analysis

Naiyana Intichot, Wiphawan Nualthong, Seubtrakul Tantalanukul, Samak Jaisan — Mon, 30 Jun 2025 00:00:00 +0700

Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide, with 80% occurring at home or in community settings. High-quality and timely basic life support can increase survival rates by 2-3 times. This cross-sectional analytical study aimed to assess basic life support competency levels, analyze individual and organizational factors affecting basic life support competency, and examine the influence of organizational differences on basic life support competency among village health volunteers in Uttaradit Province. The samples consisted of 504 volunteers from 50 sub-district health promoting hospitals, selected through multi-stage random sampling. Data were collected using knowledge tests, attitude scales, competency assessments, and organizational factor evaluation forms; and the data were analyzed using descriptive statistics and multilevel analysis. It was found that only 27.7% of volunteers had good or excellent competency levels, with chest compression quality receiving the lowest scores. Significant individual-level factors affecting competency included self-confidence (β=0.524), training frequency (β=0.442), and education level (β=0.386). Organizational factors in clouded equipment availability (β=0.412) and mentoring system (β=0.385). The intraclass correlation coefficient (ICC) of 0.304 indicated that organizational differences accounted for 30.4% of competency variance. Recommendations include strengthening organizational support systems and providing practice-focused training that builds confidence while considering age and experience differences.

Characteristic of Online Medical Direction of Emergency Medical Service, Khon Kaen Hospital

Mon, 30 Jun 2025 00:00:00 +0700

The emergency medical system (EMS) plays a critical role in saving individuals experiencing medical emergencies. Therefore, the development of the EMS must be comprehensive to ensure the safety and satisfaction of the service recipients. Medical direction is divided into two types: offline medical direction and online medical direction (OLMD). Understanding the nature of OLMD will help identify the challenges associated with its implementation. The objective of this study was to assess the characteristics of online medical direction in the Emergency Medical Service at Khon Kaen Hospital. It was conducted as a retrospective descriptive study that utilized data recorded in the emergency medical direction system through the Google form program, which was collected between June 2022 and August 2024. The data were organized descriptively using descriptive statistics. As for the results, 176 instances of online medical direction were conducted, involving 147 patients. Of these, 60.54% were male patients. The majority of them were over 60 years old, accounting for 54.42%, with an average age of 61.26 years. The emergency response team most frequently dispatched was the advanced life support (ALS) unit, accounting for 76.14%. The most commonly dispatched criteria based dispatch (CBD) was CBD 6 (cardiac arrest), accounting for 17.9%. The highest number of online medical direction instances occurred in the morning 44.89%. The most common outcome of online medical direction was hospitalization, with 46.94% of patients being admitted.

Outputs and Outcomes Evaluation of Emergency Medical Research and Innovation Management of the National Institute of Emergency Medicine

Mon, 30 Jun 2025 00:00:00 +0700

The evaluation of outputs and outcomes from the management of research and innovation in emergency medicine was conducted using a descriptive study (mix-method) approach. Quantitative data were collected through follow-up forms the outputs and outcomes of emergency medical research and innovations funded by the fundamental fund under the Science Research and Innovation (SRI) system for the years 2021–2023, covering 29 projects. Qualitative data were also collected through in-depth interviews with project leaders to explore aspects of emergency medical research and innovation management that influence research outputs and outcomes. Data analysis utilized descriptive statistics and adhered to the OECD criteria for research and innovation management assessment, while content analysis was used for qualitative data. Results: From 2021 to 2023, 29 research projects, with a total budget of 25,171,700 THB, were managed by the Research and Innovation Center. Management mechanisms and tools covered all stages of the research process (upstream, midstream, and downstream management stage). The output monitoring revealed that some outputs exceeded targets, some met targets, and some fell short. Manuscript production, in particular, consistently fell below target each year, indicating a need for improved management in this area. An evaluation based on OECD principles showed that all projects over the three years aligned with the mission of the National Institute for Emergency Medicine (NIEM) and were efficient, withtimely execution. However, in terms of effectiveness, not all outputs were delivered as promised. Most projects successfully translated research and innovation into practical applications, primarily through meetings, training, or dissemination activities. These included studies on emergency psychiatric patients, emergency medical education in schools, elderly care, emergency response times, and emergency medical systems for large-scale sporting events in Thailand. In perspectives on Research Management, most researchers agreed that the research management system effectively supported the delivery of project outputs and outcomes. They also emphasized that enhancing research capacity and expertise is crucial for improving the quality and impact of research outputs and outcomes. Recommendations: to improve the efficiency, outputs, outcomes, and overall impact of research and innovation management, strategic organizational approaches should be employed. These include collaborative direction-setting and research problem identification involving administrators, stakeholders, and researchers. Such strategies ensure that research projects meet user needs and achieve significant impacts. Researchers should also understand and design pathways to maximize research impact. Additionally, efforts should be made to extend and scale up research projects for broader application, supported by both internal and external organizational resources in various formats.

Development of a Blended Learning Program Based on Constructivism to Enhance the Basic CPR Skills of Rescue Volunteers

Tawon Pachua, Yotravee waythongkham, Supanit Areehathairat — Mon, 30 Jun 2025 00:00:00 +0700

In this quasi-experimental research, the objectives were to (1) develop a blended learning curriculum based on constructivist principles to enhance the efficiency of basic CPR and AED skills in accordance with the 80/80 efficacy standard; compares, (2) compare the scores prior to and after the training, (3) compare the scores of the basic CPR skills and the criterion score of eighty percent; and (4) assess the satisfaction of rescue volunteers with the training. The sample population consisted of forty-eight rescue volunteers purposively selected based on the curriculum’s inclusion criteria. The research was conducted in two phases: Phase 1 involved curriculum development to meet an 80/80 efficacy standard and the development of assessment tools. The findings indicated that (1) the developed curriculum achieved effectiveness scores of 87.65/88.50, exceeding the 80/80 threshold; (2) the knowledge assessment test demonstrated a reliability coefficient of 0.76; (3) the basic life support skills assessment (with two rescuers) and (4) the satisfaction evaluation form exhibited reliability coefficients of 0.94. Phase 2 involved data collection and analysis from July 2024. Data were analyzed using frequency, mean, percentage, and standard deviation. The techniques of the independent t-test and one-sample t-test were employed. The study results revealed that: (1) the curriculum’s effectiveness score was 87.65/88.50, surpassing the criterion; (2) post-training knowledge scores were significantly higher than pre-training scores at the 0.05 level; (3) the mean skills score post-training significantly exceeded the 80% criterion at the 0.05 level; and (4) overall satisfaction with the training was at the highest level (mean=4.68). In summary, the blended training curriculum based on the constructivist approach for enhancing basic life support skills has proven to be an effective means of developing the competencies of emergency rescue volunteers. The program integrates diverse learning methods, including online theoretical instruction, on-site practical training, and the use of simulated scenarios combined with web-based lessons to foster comprehensive learning.