Pre Hospital Care System, Khon Kaen Model (1994-2004)

Abstract

Background: The aims of care for victims of accident and emergency are to avoid preventable death and disabilities. Studies worldwide have shown that death could be prevented in many cases that die before reaching the hospital. Many complications resulting in disabilities could also be prevented with good pre hospital care. Pre hospital care system are much well developed in all developed countries but much less developed in Thailand.

Objective: To develop an effective pilot model of pre hospital care system in Khon Kaen Province and to advocate the necessity of pre hospital care system in Thailand.

Materials and Methods: Model development by setting up organization structure, provincial wide command control center in Khon Kaen hospital together with extensive campaign through public media, recruiting and developing qualified personnel. Setting up ambulance standard, pre hospital care network and zoning, setting up rules and regulations and software program to monitor the system. Multiple seminars, lectures were held.

Results: A well developed pre hospital care model has been established in Khon Kaen province. In the year 200:3, 23 ambulance stations had been set up provincial wide. 1 40 pre hospital care nurses had been trained, 9s EMT had been produced, and thousands of volunteers had been trained. Ambulance missions had been progressively increased every year. In 2003, there were more than 7,000 missions. 89% of the ambulance missions left the hospital within 1 minute after the call and 80% of the ambulance missions reached the scene within 10 minutes. The quality of critical care run by personnel had progressively improved. Four National Seminars were held in 1999, 2000, 2001, and 2002.

Conclusions: Pre hospital care system is one of the major components in inclusive trauma care system. This system is still much less developed in Thailand. Khon Kaen province has developed the pilot project of pre hospital care model since 1994 and has resulted in well developed system provincial wide and it is promising that all accident and emergency in the province would be well covered and people in Khon Kaen are well accessible to this system. The next step of countrywide generalization required more complicated, multisector collaboration, master plan establishment, financial consideration and strong political commitment.