Healthcare Service Providers’ Perspective on Provision of Emergency Medical Services in Security Zones: A Qualitative Study

Authors

  • Preneed Songwatthana Faculty of Nursing
  • โชคชัย ขวัญพิชิต
  • วิภา แซ่เซี๊ย
  • ลัพณา กิจรุ่งโรจน์
  • จินตนา ดำเกลี้ยง
  • หทัยรัตน์ แสงจันทร์
  • วรสิทธิ์ ศรศรีวิชัย
  • วิจัย สกุลแก้ว

Keywords:

emergency medical services, security zones, service providers’ perspectives, qualitative research

Abstract

Abstract:
     Objective:To explore healthcare service providers’ perspective on the provision of emergency
medical services (EMS) in security zones.
     Design: Qualitative research.
     Methodology: Sixty-nine participants were recruited through purposive sampling. They were divided into three groups: 9 administrators, 19 healthcare staff and emergency personnel members, and 41 trained volunteers who were members of the local emergency network in security zones. Data were collected during May to July 2019 through interviews and focus group discussions, using a set of questions pre-developed based on the National EMS Plan Framework. The data were analysed using the content analysis method.
     Results: The study identifed four aspects of security-zone trauma management that differed signifcantly from those of standard emergency medical procedure. Firstly, in the prevention phase, every security zone had a community-engaged vigilance and prevention system in place, with the residents’ lifestyle adjusted to minimise risks. Secondly, during the pre-hospital care, military or police directives and orders were issued to ensure speed and accuracy in coping with the situation, in using proper resources, and in providing express air-ambulance service. Thirdly, during the emergency ward’s care, the priority was on establishing a system of consultation with medical specialists via telecommunications systems and on enhancing healthcare personnel’s potential to provide trauma patients with ongoing care. Fourthly, during the referral phase, the primary emphasis was on ensuring safe zones and rapid transfer. Despite occasional obstacles, provision
of emergency services in security zones still involved collaboration and integration from all stakeholders,
based on the country’s principle of seamless emergency service provision.

     Recommendations: Provision of integrated emergency services in security zones was different
from that in other areas. In security zones, the services had to be provided in a comprehensive manner and in conjunction with other local sectors, especially the police and the military, for effcient coordination, command, and team-working. However, it is recommended that emergency staff’s specialised competency be enhanced using proper technologies. Also, it is necessary that local communities’ space-oriented resources management potential be improved, to maintain self-reliance.

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References

Kanchanasud S. Manual of emergency practice for out of hospital personnel. National Institutes for

Emergency Medicine. Bangkok: Ultimate Printing; 2018. (in Thai).

Binsaleahman N. Songwathana P. Sornsrivichai V. The emergency medical services of local administrative

sectors in the southern borders and related factors. Princess of Naradhiwas University Journal. 2018; 10(1): 41-50. (in Thai).

Deep South Watch Database. Report of conflict situation in deep south/patani. 2018; Available

from: URL: https://deepsouthwatch.org/th/ node/11901 (in Thai).

Kwanphichit C. Songwathana P. Sae-Sia W. Kitrungrote L. Dumgliang J. Sangchan H. at al. Project report of

an integrated model of emergency medical service provision in security areas. 2019; Available from:

URL: https://www.niems.go.th/1/uploadattachfle/2019/ ebook/48519_20191106112651. pdf (in Thai).

Carli P. Telion C. Paris city disaster: Response to the recent terror attacks and lessons learned. Current

Trauma Reports, 2018; 4: 96-102.

Chauhan R. Conti BM. Keene D. Marauding terrorist attack (MTA): prehospital considerations. Emergency

Medical Journal, 2018; 35: 389-95.

Harris LT. An independent review of London’s preparedness respond to a major Terrorist Incident.

[cited 2020 May 08] Available from: URL:https://www.london.gov.uk.

Sriram VM. Naseer R. Hyder AA. Provision of prehospital emergency medical services in Punjab,

Pakistan: Case study of a public sector provider. Surgery, 2017; 162(6): S12-S23.

Kemp M. Expanding the role of emergency medical service in homeland security. [Unpublished Master

thesis]. Monterey: Naval Postgraduate school; 2013.

National Institute for Emergency Medicine. Annual Report 2013 National Institute for Emergency Medicine.

Nonthaburi: Ultimate Printing; 2014. (In Thai).

Songwathana P. Sangchan H. Emergency medical service in the unrest area of three southern Thai border

provinces: a literature review. Princess of Naradhiwas University Journal. 2015;74-87 :(2)7 . (in Thai).

Pannana A. Violence-related injury surveillance and development of emergency medicine system in the

three southern borders; 2018. [cited 2018 August 21] Available from: URL: http://medipe2.psu.

ac.th/~vis/utilization/VIS_EMS.pdf. (In Thai).

Rattanasakul N. Dandsuwan K. Development of caring system for patient with life threatening in

emergency department. Naradhiwasrajanakarindra Hospital. Princess of Naradhiwas University Journal.

; 8(2): 1-15. (in Thai).

Sae-Sia W. Songwathana P. Hirunchuha S. Sangchan H. Continuum of care management for victims and

families assaulted in the social unrest, Southern Thailand: a situation analysis. Nursing Science

Journal of Thailand. 2014; 32(1): 7-14. (in Thai).

National Institute for Emergency Medicine. National Plan for Emergency Medicine No 3-4, 2017-2021.

National Institute for Emergency Medicine. Nonthaburi: First Printing; 2016. (in Thai).

Elo S. Kyngas H. The qualitative content analysis process. J Adv Nurs. 2008; 62(1): 107-15.

Weerakhachon P. Chanthamolee S. Suwan P. Srisupanan M. Development of emergency operation

model for the emergency medical technician in border south provinces. The Southern College Network

Journal of Nursing and Public Health. 2018; 4(3):87-103. (in Thai).

National Institute for Emergency Medicine. Gap of emergency medicine in Thailand: annual report 2557

of National Institute for Emergency Medicine. Nonthaburi: NIEM; 2014. (in Thai).

Sittichanbuncha Y. Emergency management system assessment and primary care for emergency patients.

In Chaiyaporn Yuksen and Yuwares Sittichanbuncha, Eds. Emergency medicine (pp. 1-27). Department

of Emergency Medicine Faculty of Medicine, Ramathibodi Hospital; 2014. (in Thai).

Tadadej C. Mongkolsomlit S. Suriyawongpaisarn P. Evolution of emergency medical service systems in Thailand: a systematic review. Journal of Health Science, 2014; 23(3): 513-23. (in Thai).

Published

2020-07-17

How to Cite

1.
Songwatthana P, ขวัญพิชิต โ, แซ่เซี๊ย ว, กิจรุ่งโรจน์ ล, ดำเกลี้ยง จ, แสงจันทร์ ห, ศรศรีวิชัย ว, สกุลแก้ว ว. Healthcare Service Providers’ Perspective on Provision of Emergency Medical Services in Security Zones: A Qualitative Study. TJNC [Internet]. 2020 Jul. 17 [cited 2022 Oct. 1];35(3):17-35. Available from: https://he02.tci-thaijo.org/index.php/TJONC/article/view/240639

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