Factors associated with the worsening of COVID-19 symptoms among cohorts in community- or home-isolation care in southern Thailand.

Introduction: This study aimed to investigate factors associated with time-to-referral due to worsening symptoms in patients with laboratory-confirmed COVID-19 in southern Thailand. While underlying diseases have been evaluated to assess COVID-19 severity, the influence of vaccinations and treatments is also crucial.

Methods: A cohort of 8,638 patients quarantined in home or community isolation with laboratory-confirmed COVID-19 was analyzed.

How the ARCH Project has Contributed to the Development of the ASEAN Regional Collaboration Mechanism on Disaster Health Management.

Objective: This paper aims to clarify how the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) strengthened regional collaboration mechanisms on disaster health management (DHM) in ASEAN.

Methods: The political process and the relevant documents of the ARCH Project were reviewed.

Results: The ARCH Project established the Regional Coordination Committee as a coordination platform for providing strategic direction to the project and strengthening the regional coordination of DHM.

How the ARCH Project Could Contribute to Strengthening ASEAN Regional Capacities on Disaster Health Management (DHM).

Objective: The Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) developed Regional Collaboration Drills (RCDs) and is proposing an ASEAN Academic Network to strengthen capacity in disaster health management (DHM) in ASEAN Member States (AMS), as well as developing a standard training curriculum in DHM. This study aims to clarify the impacts and sustainability of the ARCH Project.

Methods: The four previous RCDs and the enhancement of academic activities were reviewed.

Development and Validation of a Scoring Assessment Tool for Hospital Safety: A Pilot Study Comparing Hospital Preparedness in Thailand.

Introduction: Safe hospitals are crucial in the management of major incidents and disasters. A hospital self-assessment tool was developed for Thailand to identify gaps and shortcomings in hospital preparedness. However, this tool lacks the ability to determine the level of preparedness and cannot be used to standardize hospital readiness and enable continuous quality control.

Development of Hospital MCI and Disaster Preparedness Assessment Tool for Thailand.

Introduction: Hospital preparedness is a key component to mitigate the effects of mass casualty incidents (MCIs) and disasters. Improving hospital preparedness requires an assessment of the country's current health system capacity, readiness, and preparedness. Although a variety of assessment tools exist, none are entirely suitable for Thailand's healthcare system.

Non-randomized comparative study on the efficacy of a trauma protocol in the emergency department.

Purpose: Trauma is a major health problem in developing countries and worldwide which requires many resources and much time in an emergency department (ED). Although Advanced Trauma Life Support (ATLS) is the gold standard, operator dependence can affect the quality of care. The objective was to identify differences in numbers and time to lifesaving interventions, investigation, ED length of stay, and mortality between an in-house protocol and conventional practice.

Septic shock in the ER: diagnostic and management challenges.

Sepsis is a common presentation in the emergency department and a common cause of intensive care unit admissions and death. Accurate triage, rapid recognition, early resuscitation, early antibiotics, and eradication of the source of infection are the key components in delivering quality sepsis care. Evaluation of the patient's volume status, optimal hemodynamic resuscitation, and evaluation of patient response is crucial for sepsis management in the emergency department.

Appropriateness of Broad Spectrum Antibiotics for Severe Sepsis and Septic Shock in the Emergency Department.

Objective: Determine the appropriateness of broad-spectrum antibiotics applied in severe sepsis and septic shock in an emergency room and its impact on the survival rate.

Material And Method: This was a prospective observational study in an emergency room setting at a tertiary care facility where early goal-directed therapy (EGDT) was applied for resuscitation of severe septic and septic shock patients. The data recorded were the initial vital signs, SAP II score, time of EGDT goals achieved (ScvO₂> 70), time of antibiotics initiated, type of antibiotics used, organisms that were identified, source of infection, initial and final diagnosis, and outcome of treatment.

Serum Lactate Levels as a Prognostic Predictor of Septic Shock in Emergency Department Patients with Systemic Inflammatory Response Syndrome (SIRS) at Songklanagarind Hospital.

Objective: To determine whether serum venous lactate is associated with an increased risk of septic shock and risk of death in emergency department patients with systemic inflammatory response syndrome (SIRS).

Material And Method: This was a prospective observational study at the Songklanagarind Hospital Emergency Department. Between April 1 and October 31, 2009, 131 consecutive patients met the enrollment criteria of age older than 18 years and fulfilled the SIRS criteria.

Success of applying early goal-directed therapy for septic shock patients in the emergency department.

Background: Since early goal-directed therapy (EGDT) became standard care in severe sepsis and septic shock patients in intensive care units many years ago, we suppose that the survival rate of severe sepsis and septic shock patients improves if the resuscitative procedure is quickly implemented and is initiated in the emergency room.

Objective: We aimed at recording emergency department time to improve our patient care system as well as determine the rate at which EGDT goals can be achieved. The second analysis is to find out how much we can improve the survival rate.

Sustainable Effectiveness of Applying Trauma Team Activation in Managing Trauma Patients in the Emergency Department.

Objective: To determine long term effectiveness of trauma team activation criteria by measuring emergency department length of stay (EDLOS) and 28-day mortality.

Material And Method: A 3-year retrospective cohort study conducted in adult trauma patients who met one of the trauma team activation criteria (shock, penetrating torso injury, post traumatic arrest, respiratory rate of less than 12 or more than 30, and pulse rate of more than 120). Specific demographic data, physiologic parameters, EDLOS, injury severity score (ISS), and 28-day mortality were prospectively recorded into the Trauma Registry database.

Knowledge and practices of Thai emergency physicians regarding the care of delirious elderly patients.

Background: The Society for Academic Emergency Medicine (SAEM) Geriatric Emergency Medicine Task Force recommends assessment of delirium for all elderly emergency department (ED) patients. Little is known about emergency physicians' (EPs) opinions regarding care of delirious elderly patients. We sought to determine the knowledge and practice experience of members of the Thai Association for Emergency Medicine regarding the care of delirious elderly ED patients.

Wound management in disaster settings.

Background: Few guidelines exist for the initial management of wounds in disaster settings. As wounds sustained are often contaminated, there is a high risk of further complications from infection, both local and systemic. Healthcare workers with little to no surgical training often provide early wound care, and where resources and facilities are also often limited, and clear appropriate guidance is needed for early wound management.

Correlation of caval index, inferior vena cava diameter, and central venous pressure in shock patients in the emergency room.

Objectives: This study aims to determine the correlation of the caval index, inferior vena cava (IVC) diameter, and central venous pressure (CVP) in patients with shock in the emergency room.

Materials And Methods: This is a prospective double-blind observational study conducted in the emergency room of a tertiary care center. All patients who presented with shock and had a central venous catheter insertion performed were enrolled.

Predictive factors for a FAST-positive and a therapeutic laparotomy in blunt abdominal injuries at the emergency room.

Objective: Identify the various factors that predict a Focused Assessment with Sonography for Trauma (FAST) positive result and a subsequent therapeutic laparotomy.

Material And Method: The medical records of all patients, aged greater than fifteen-years-old, with blunt abdominal injuries that underwent a FAST examination in an emergency room at a university level I trauma center over a one-year period were reviewed retrospectively. Patient data (demographic, vital signs and revised trauma score) was analyzed to identify the factors that correlated with a FAST-positive result and the need to perform a therapeutic laparotomy.

Gastropleural fistula following a splenectomy for splenic abscess: a case report.

Gastropleural fistula is a rare condition that occurs as a consequence of various thoraco-abdominal surgical procedures and septic conditions. The diagnosis is difficult, it needs a high index of suspicion and appropriate investigations. There are no previous reports of a patient developing a fistula after a splenectomy procedure.