The impact of the three-level collaboration exercise on collaboration and leadership during scenario-based hospital evacuation exercises using flexible surge capacity concept: a mixed method cross-sectional study.

Background: Hospitals play a crucial role in responding to disasters and public health emergencies. However, they are also vulnerable to threats such as fire or flooding and can fail to respond or evacuate adequately due to unpreparedness and lack of evacuation measures. The United Nations Office for Disaster Risk Reduction has emphasised the importance of partnerships and capacity building in disaster response.

The Feasibility of Implementing the Flexible Surge Capacity Concept in Bangkok: Willing Participants and Educational Gaps.

The management of emergencies consists of a chain of actions with the support of staff, stuff, structure, and system, i.e., surge capacity.

Hypertensive crisis in patients with obstructive sleep apnea-induced hypertension.

Background: Hypertensive crisis is an urgent/emergency condition. Although obstructive sleep apnea (OSA) in resistant hypertension has been thoroughly examined, information regarding the risk factors and prevalence of hypertensive crisis in co-existing OSA and hypertension is limited. This study thus aimed to determine prevalence of and risk factors for hypertensive crisis in patients with hypertension caused by OSA.

Comparison of Accuracy and Speed in Computer-Assisted Versus Conventional Methods for Pediatric Drug Dose Calculation: A Scenario-Based Randomized Controlled Trial.

Pediatric emergency care is prone to medication errors in many aspects including prescriptions, administrations, and monitoring. This study was designed to assess the effects of computer-assisted calculation on reducing error rates and time to prescription of specific emergency drugs. We conducted a randomized crossover experimental study involving emergency medicine residents and paramedics in the Department of Emergency Medicine at Ramathibodi Hospital.

Characteristics of Pediatric Emergency and Risk Factors for Life-saving Interventions.

Pediatric emergency patients are vulnerable population and require special care or interventions. Nevertheless, there is limited data on the prevalence and risk factors for life-saving interventions. This study is a retrospective analytical study.

IQ-CPR Meter for Chest Compression Monitoring During Simulated Cardiopulmonary Resuscitation; a Comparative Study.

Introduction: Adequate chest compression is crucial for cardiopulmonary resuscitation (CPR). There are several chest compression monitoring devices with different costs. This study aimed to evaluate the agreement rate of Improved Quality of Cardiopulmonary Resuscitation meter (IQ-CPR meter) and automated external defibrillator (AED) in chest compression quality monitoring.

Clinical Predictors Influencing the Length of Stay in Emergency Department Patients Presenting with Acute Heart Failure.

Acute heart failure is a common problem encountered in the emergency department (ED). More than 80% of the patients with the condition subsequently require lengthy and repeated hospitalization. In a setting with limited in-patient capacity, the patient flow is often obstructed.

Diagnostic properties of a portable near-infrared spectroscopy to detect intracranial hematoma in traumatic brain injury patients.

Traumatic brain injury (TBI) is a major public health issue worldwide. A portable near-infrared spectroscopy (NIRS) is a non-invasive device to detect intracranial hematoma. The advantages of the NIRS include real time results and non-radiation exposure.

Are full-face helmets the most effective in preventing head and neck injury in motorcycle accidents? A -analysis.

Motorcycles are the most common type of vehicle involved in traffic deaths in developing countries. Although helmets can provide protection against injury, there is limited evidence available regarding which type of helmet best protects against head and neck injuries in this setting. This review was conducted based on articles in the PubMed, Scopus, and Web of Science databases.

Adrenaline use as a poor predictor for the return of spontaneous circulation among victims of out-of-hospital cardiac arrest according to a national emergency medical services database.

Objective: This study aimed to determine additional predictors of cardiopulmonary resuscitation success using a national emergency medical services (EMS) database.

Methods: This retrospective study was conducted by retrieving data from the Information Technology of Emergency Medical Service, a national EMS database. The inclusion criteria were adult patients (18 years old or over) who suffered from out-of-hospital cardiac arrest and received emergency life support.

Bag-Valve Mask versus Endotracheal Intubation in Out-of-Hospital Cardiac Arrest on Return of Spontaneous Circulation: A National Database Study.

Background: Out-of-hospital cardiac arrest is the main issue for pre-hospital emergency care. There are several airway managements during the out-of-hospital cardiopulmonary resuscitation (CPR) such as endotracheal intubation (ETI) or alternative airway device: bag-valve mask (BVM). Data comparing both methods showed inconclusive results on survival and limited results on CPR outcome.

Prehospital prediction of severe injury in road traffic injuries: A multicenter cross-sectional study.

Background: To develop and validate a risk stratification model of severe injury (SI) and death to identify and prioritize road traffic injury (RTI) patients for transportation to an appropriate trauma center (TC).

Methods: A 2-phase multicenter-cross-sectional study with prospective data collection was collaboratively conducted using 9 dispatch centers (DC) across Thailand. Among the 9 included DC, 7 and 2 DCs were used for development and validation, respectively.

Clinical predictive score of intracranial hemorrhage in mild traumatic brain injury.

Background: Mild traumatic brain injury (TBI) is a common condition at the Emergency Medicine Department. Head computer tomography (CT) scans in mild TBI patients must be properly justified in order to avoid unnecessary exposure to X-rays and to reduce the hospital/transfer costs. This study aimed to evaluate which clinical factors are associated with intracranial hemorrhage in Asian population and to develop a user-friendly predictive model.

Predicting Difficult Intubation in Emergency Department by Intubation Assessment Score.

Background: The difficult intubation is associated with failure of emergency tracheal intubation. This study aimed to develop and validate a model for predicting difficult intubation in emergency department (ED).

Methods: A cross-sectional study was conducted in the ED.

Clinical Factors Predictive for Intracranial Hemorrhage in Mild Head Injury.

Patients with mild head injuries, a GCS of 13-15, are at risk for intracranial hemorrhage. Clinical decision is needed to weigh between risks of intracranial hemorrhage and costs of the CT scan of the brain particularly those who are equivocal. This study aimed to find predictors for intracranial hemorrhage in patients with mild head injuries with a moderate risk of intracranial hemorrhage.

Is a mechanical-assist device better than manual chest compression? A randomized controlled trial.

Background: Chest compression quality is a determinant of survival from sudden cardiac arrest. The CPR RsQ Assist Device (CPR RAD) is a new cardiopulmonary resuscitation device for chest compression. It is operated manually but it does not pull up on the chest on the up stroke.

The RAMA Ped Card: Does it work for actual weight estimation in child patients at the emergency department.

Background: In emergency conditions, the actual weight of infants and young children are essential for treatments. The RAMATHIBODI Pediatric Emergency Drug Card or RAMA Ped Card has also been developed to estimate actual weight of the subjects. This study aimed to validate the RAMA Ped Card in correctly identifying the actual weight of infants and young adults.

Is a mobile emergency severity index (ESI) triage better than the paper ESI?

This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI.

The CPR outcomes of online medical video instruction versus on-scene medical instruction using simulated cardiac arrest stations.

Background: Non-traumatic cardiac arrest is a fatal emergency condition. Its survival rate and outcomes may be better with quick and effective cardiopulmonary resuscitation (CPR). Telemedicine such as telephone or real time video has been shown to improve chest compression procedures.

FACTORS ASSOCIATED WITH EXTENDED SPECTRUM β-LACTAMASE PRODUCING ESCHERICHIA COLI IN COMMUNITY-ACQUIRED URINARY TRACT INFECTION AT HOSPITAL EMERGENCY DEPARTMENT, BANGKOK, THAILAND.

Urinary tract infection or UTI is most commonly caused by Escherichia coli. This study investigated the prevalence of and risk factors for extended spectrum β-lactamase-producing (ESBL) E. coli in community-acquired UTI presenting at the Emergency Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Low oxygen saturation is associated with pre-hospital mortality among non-traumatic patients using emergency medical services: A national database of Thailand.

Background: Pre-hospital emergency medical services are an important network for Emergency Medicine. It has been shown to reduce morbidity and mortality of patients by medical procedures. The Thai government established pre-hospital emergency medical services in 2008 to improve emergency medical care.

The appropriate troponin T level associated with coronary occlusions in chronic kidney disease patients.

Background: High-sensitivity troponin T (HS Trop T) plays an important role as a diagnostic marker for acute coronary syndrome. It is also related to cardiovascular outcomes. HS Trop T levels may be varied in individuals with renal dysfunction.

An online tool for nurse triage to evaluate risk for acute coronary syndrome at emergency department.

Background. To differentiate acute coronary syndrome (ACS) from other causes in patients presenting with chest pain at the emergency department (ED) is crucial and can be performed by the nurse triage. We evaluated the effectiveness of the ED nurse triage for ACS of the tertiary care hospital.

What clinical factors are associated with biphasic anaphylaxis in Thai adult patients?

Background: Anaphylaxis is an emergency condition and may be fatal. Approximately 20% of patients with anaphylaxis may develop recurrent episodes of anaphylaxis within 72 hours or biphasic anaphylaxis. The severity of biphasic anaphylaxis can be either more or less severe than the first episode.