Island ER sets mark for fast critical care

Island ER sets mark for fast critical care

Medics acclaimed for handling of transfers to shore

A small hospital in Koh Sichang is serving as a role model for emergency medical services in the government's flagship Eastern Economic Corridor (EEC).

Koh Sichang Hospital only has 30 beds but provides care to 4,000 residents as well as the scores of tourists who flock to the island each year.

Despite its small size and equally small budget, the hospital, located on the island 14km from the shore of Chon Buri province, has been praised for its emergency medical care.

It also has an admirable track record of managing to transfer critical cases to larger hospitals on shore within 20 minutes -- a generally accepted benchmark for transfers of this kind.

There are around 15 such cases each month that require facilities only available at larger hospitals, 90% of which involve locals.

"We have had positive feedback not only from local people but also from foreign patients who were transferred to the mainland hospital in good time. Despite our small team, we do our best in often tough circumstances. We understand that every minute is important for critical patients and their families," said Napavinee Yotiphai, 30, who has been working for the hospital for four years.

Training for disaster: Medical staff of Koh Sichang Hospital participate in an emergency response drill to help drowning victims in Chon Buri.

While a distance of 14km might be a relatively straightforward ride for an ambulance, for sea transport, which can heavily be affected by the monsoon season, the process carries far greater risks.

The small state hospital does not have its own hydro ambulance boat, so it enlists the help of privately-owned speed boats to ferry patients to shore.

Most of the transfers are to Chon Buri Hospital and Laem Chabang Hospital, Dr Napavinee said.

During the transport, paramedics provide emergency care and the boats must have enough electricity to power medical equipment such as resuscitation equipment.

Despite its good record, once in a while a patient fails to survive.

The latest death after the trip to shore was the case of a Chinese man who sustained severe heart and lung damage in a motorcycle crash.

The hospital arranged to transport him to a private mainland hospital but, despite still achieving a sub-20 minute transfer, he died on arrival.

Staff providing him with care during the trip believe the strong waves prevented the on-board ventricular assistance device from working effectively.

Hospital director Anasith Salyapong said the facility's emergency service still has room to improve and is discussing with the local administration how they can better services provided on-site and also ways to minimise risks to patients during the occasionally arduous boat transfer to shore.

One idea under debate is the purchase of a pontoon-stye pier that would allow patients to be moved on and off boats with more ease than afforded by the current fixed pier.

In the same vein, they are also looking into enlarging access routes into town so that medics can transport patients to and from the facility with even more efficiency.

Paranee Wasusatein, an inspector for the Public Health Ministry, said during a visit to the hospital last week that the ministry has a new policy to improve medical emergency response services for hospitals located in the EEC.

One particular aspect of this approach would be a more integrated system for sharing vital patient data between hospitals and emergency rooms, she said.

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