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While the standard of emergency-room treatment available in Phuket’s larger hospitals is high, ambulance and retrieval services are not as well developed as in some countries. This is important, because getting an accident victim to the right medical facility quickly can literally be a matter of life or death.

In 1993, a Ministry of Public Health report estimated that bystanders and people without adequate first-aid skills took around 90% of trauma (accident) patients to hospital. The same figure applies to patients who suffer medical emergencies such as heart attacks and strokes.

While all major hospitals in Phuket have ambulances staffed by trained nurses, the groups which most commonly transfer patients to hospitals are volunteer rescue services, such as the Kusornlatham Foundation.

These rescue foundations respond quickly to accidents and rapidly take patients off to hospital. However, they’ve minimal training and very limited resources, often with only a stretcher and, in some cases, an oxygen cylinder. As a result, emergency life-saving treatment doesn’t normally begin until the patient reaches the hospital. Sometimes this is too late and death results in cases where the patient could have been saved had treatment begun earlier.

Research clearly shows that in medical emergencies, patient mortality (death) and morbidity (extent of injury) is significantly reduced when patients are treated and transported to an appropriate hospital in the shortest possible time. The key here is ‘an appropriate hospital’. This means a medical facility that can adequately treat the injury or condition.

Most of us don’t consider in advance where to go for treatment in the event of a medical emergency. To make an informed choice, we need to consider many factors. Does the hospital have doctors on duty around the clock? Are they supported by 24-hour services such as X-ray and lab analysis? Does it have an operating room or blood bank?

Many people believe, falsely, that doctors’ clinics and smaller hospitals can manage any emergency situation, but this is simply not the case. These clinics can usually deal with minor injuries such as simple abrasions and wounds but can’t treat major injuries or illnesses. For example, internal bleeding resulting from trauma can only be stopped
in an operating room. Doctors in small clinics are generally ill-equipped
to perform the required surgery. The decision on where a patient is
taken can be a critical one.

While it’s impossible to completely eliminate all risks of accidents or
emergency medical situations, we can reduce them by maintaining a
healthy lifestyle, using caution and being well prepared to deal with
any emergency that might arise.

Knowing how to phone for emergency services such as an ambulance,
or the police, or the fire department seems easy enough, but in
emergencies people often forget these numbers or don’t have
immediate access to them. To avoid this problem, keep emergency
numbers on your home phone, tape a list of them on the fridge, or add
them to the speed-dial system of your mobile phone. If you’ve young
children, teach them how to call for emergency services and explain
their importance.

In an emergency, be prepared to give the operator clear and relevant
information on the type of emergency, your exact location and any
relevant landmarks, which can assist the emergency response team
in finding you. Also, remember that not all operators speak English, so
if you can’t speak Thai, knowing someone who can speak it on your
behalf, is a clear advantage. Don’t forget to provide a call-back number
so that the emergency team can reach you if they get lost, or need
additional information. If you’re coming to the hospital by your own
means, consider calling the hospital in advance. This will give the staff
valuable time to get prepared for your arrival.

Because the life-saving skills in the community are low, those most
likely to attend to you in case of an emergency will probably have
had little training – and may have no equipment. Therefore, a wellequipped
first-aid kit’s a must. Taking the time to familiarise yourself
with its contents and how to use them is also a good idea; as is taking a
basic first-aid course. Basic first-aid skills are easy to learn and can save
lives. Just ask any doctor or nurse who works in an emergency ward.

Phuket hospitals are generally well-equipped to deal with most
accidents and medical emergencies, but there are some limitations.
Cases that require major open-heart surgery, treatment for major
burns and significant multiple trauma are often best referred to special
facilities in Bangkok, or even overseas. Air ambulances from Bangkok
can be in Phuket within hours of an emergency call. These can be
thought of as airborne mini-intensive care units. They aren’t cheap,
however, with an average cost of around 350,000 baht a trip.

Although helicopters are successful in evacuating war casualties from
the front and provide high drama for the Hollywood film industry,
in reality they aren’t always the best choice for patient transport,
due to long delays in getting airborne. They’re neither designed nor
equipped to transport seriously ill people, and they’re a noisy, difficult
environment for doctors and paramedics to work in, especially at night.

None of us wants to get sick or injured, but it happens nonetheless.
Being prepared to respond to emergencies can make all the difference.

Peter Davison is the Manager International Services
at Phuket International Hospital.
Tel: +66 (0)76 249400. Email: info@phuketinternationalhospital.com.