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Problem To control the increasing spread of coronavirus disease 2019 (COVID-19), the government of Thailand enforced the closure of public and business areas in Bangkok on 22 March 2020. As a result, large numbers of unemployed workers returned to their hometowns during April 2020, increasing the risk of spreading the virus across the entire country. Approach In anticipation of the large-scale movement of unemployed workers, the Thai government trained existing village health volunteers to recognize the symptoms of COVID-19 and educate members of their communities. Provincial health offices assembled COVID-19 surveillance teams of these volunteers to identify returnees from high-risk areas, encourage self-quarantine for 14 days, and monitor and report the development of any relevant symptoms. Local setting Despite a significant and recent expansion of the health-care workforce to meet sustainable development goal targets, there still exists a shortage of professional health personnel in rural areas of Thailand. To compensate for this, the primary health-care system includes trained village health volunteers who provide basic health care to their communities. Relevant changes Village health volunteers visited more than 14 million households during March and April 2020. Volunteers identified and monitored 809 911 returnees, and referred a total of 3346 symptomatic patients to hospitals by 13 July 2020. Lessons learnt The timely mobilization of Thailand's trusted village health volunteers, educated and experienced in infectious disease surveillance, enabled the robust response of the country to the COVID-19 pandemic. The virus was initially contained without the use of a costly country-wide lockdown or widespread testing. Probleme Pour lutter contre la propagation croissante de la maladie a Coronavirus (COVID-19), le gouvernement de Thailande a ordonne la fermeture des espaces publics et commerciaux a Bangkok le 22 mars 2020. Par consequent, de nombreux travailleurs au chomage sont retournes dans leurs contrees natales au cours du mois d'avril 2020, augmentant le risque de dissemination du virus dans l'ensemble du pays. Approche En prevision de ces vastes mouvements de travailleurs au chomage, le gouvernement thailandais a forme des volontaires de la sante deja presents dans les villages afin qu'ils puissent detecter les symptomes de la COVID-19 et sensibiliser les membres de leur communaute. Les bureaux provinciaux de la sante ont constitue des equipes de surveillance de la COVID-19 composees de ces volontaires en vue d'identifier les personnes revenant des zones a haut risque, d'encourager le respect d'une quarantaine spontanee de 14 jours, mais aussi de controler et signaler l'apparition de tout symptome suspect. Environnement local Malgre un renforcement recent du contingent de soignants dans le but de repondre aux objectifs de developpement durable, la penurie de professionnels de sante subsiste dans les regions rurales de la Thailande. Pour y remedier, le systeme de soins de sante primaires fait appel a des volontaires specialement formes dans les villages, qui prodiguent des soins de base aux membres de leur communaute. Changements significatifs Les volontaires de sante dans les villages ont rendu visite a plus de 14 millions de foyers en mars et avril 2020. Ils ont identifie et suivi 809 911 rapatries et oriente un total de 3346 patients symptomatiques vers les hopitaux au 13 juillet 2020. Lecons tirees La mobilisation rapide de volontaires de sante fiables dans les villages thailandais, formes et habitues a surveiller les maladies infectieuses, a permis au pays de reagir avec fermete a la pandemie de COVID-19. Dans un premier temps, la Thailande a pu maitriser le virus sans imposer un confinement couteux sur tout le territoire ni recourir a une campagne de depistage a grande echelle. Situacion Para controlar la creciente propagacion de la enfermedad por Coronavirus (COVID-19), el gobierno de Tailandia impuso el cierre de las zonas publicas y comerciales de Bangkok el 22 de marzo de 2020. Como resultado, un gran numero de trabajadores desempleados regresaron a sus ciudades de origen durante abril de 2020, lo que aumento el riesgo de propagacion del virus en todo el pais. Enfoque En prevision del movimiento a gran escala de trabajadores desempleados, el gobierno tailandes formo a los voluntarios sanitarios de las aldeas existentes para que reconocieran los sintomas de la COVID-19 y educaran a los miembros de sus comunidades. Las oficinas provinciales de salud formaron equipos de control de la COVID-19 con estos voluntarios para identificar a los que regresaban de las zonas de alto riesgo, fomentar la autocuarentena durante 14 dias y controlar e informar sobre la aparicion de cualquier sintoma relevante. Marco regional A pesar de la importante y reciente ampliacion del personal sanitario para alcanzar las metas de los objetivos de desarrollo sostenible, sigue habiendo escasez de personal sanitario profesional en las zonas rurales de Tailandia. Para compensar esta carencia, el sistema de atencion primaria de salud incluye voluntarios sanitarios formados en las aldeas que prestan atencion sanitaria basica a sus comunidades. Cambios importantes Los voluntarios sanitarios de las aldeas visitaron mas de 14 millones de hogares durante marzo y abril de 2020. Los voluntarios identificaron y controlaron a 809.911 repatriados, y remitieron a los hospitales a un total de 3.346 pacientes sintomaticos hasta el 13 de julio de 2020. Lecciones aprendidas La oportuna movilizacion de los voluntarios sanitarios de confianza de las aldeas tailandesas, formados y con experiencia en el control de enfermedades infecciosas, permitio la solida respuesta del pais a la pandemia de la COVID-19. En un principio, el virus se contuvo sin necesidad de recurrir a un costoso bloqueo en todo el pais ni a pruebas generalizadas, Introduction Thailand reported the first case of Coronavirus disease 2019 (COVID-19) on 13 January 2020. On 3 March 2020, the Thai government initiated a mandatory 14-day quarantine for all travellers [...]

Sepsis is a life-threatening organ dysfunction caused by a dysregulated response to an infection that requires early intervention. Prehospital sepsis screening tools have not yet been widely evaluated for their performance in clinical practice. To evaluate the ability of the Prehospital Early Sepsis Detection (PRESEP) score and the Miami Sepsis Score to predict sepsis in prehospital settings. This retrospective analysis included patients with diseases of internal cause who were transported by emergency medical services (EMS) to the hospital and hospitalized between January and June 2020. Data were extracted from the medical and EMS records. The primary outcome was sepsis diagnosis within 48 h of admission. The predictive abilities of the scores were assessed using the area under the receiver operating characteristic curve (AUC). Sensitivity, specificity, and positive and negative likelihood ratios (LRs) were calculated at cutoff values derived using Youden's index. Data from 354 patients were analyzed. The AUC for the PRESEP score was 0.83 (95% confidence interval [CI] 0.79–0.88) while that for the Miami Sepsis Score was 0.80 (0.75–0.85). The sensitivity, specificity, positive LR, and negative LR for the PRESEP score (cutoff was 5) were 0.83 (0.73–0.90), 0.68 (0.62–0.73), 2.59 (2.12–3.16), and 0.25 (0.15–0.40), respectively, and those for the Miami Sepsis Score (cu-off was 3) were 0.81 (0.71–0.89), 0.65 (0.59–0.71), 2.33 (1.93–2.83), and 0.30 (0.19–0.46), respectively. Due to their relatively good predictive abilities to detect septic patients and simplicities, the PRESEP and Miami Sepsis Scores could be used for screening patients for sepsis in prehospital settings. Further prospective validation and evaluation of effect on clinical outcomes are needed. [ABSTRACT FROM AUTHOR]

This paper describes how the Thai health sector developed nationwide emergency medical services (EMS), despite limited resources and we try to extract lessons applicable to other resource‐constrained settings. The government of Thailand has strengthened EMS by integrating it into the general healthcare system and formulating a national development plan and lead agency for EMS. The government emphasized the deployment of low‐cost basic‐level EMS units stationed near the communities, named as 'first‐responder units'. In Khon Kaen Province, which has led the nationwide EMS development of Thailand, the availability of EMS (number of EMS units) and utilisation of EMS (proportion of severe trauma patients transported to hospital by EMS) greatly increased from 2000 to 2017. This success is due to the emphasis on the first‐responder units through consistent national policies. [ABSTRACT FROM AUTHOR]

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Recently, the Thai government introduced a novel program to train health volunteers as first responders to deal with increasing acute illness and injuries. This case study demonstrates the potential of this program to improve public access to emergency care through the integration of emergency care with a community-based health care system, specifically in a rural setting. A 39-year-old man collapsed with cardiac arrest in his village. Lay first responders from his neighborhood attended him immediately, administered chest compressions, and contacted Emergency Medical Services (EMS). They continued chest compressions until the EMS unit arrived. While the EMS transported him to the hospital, the patient attained return of spontaneous circulation and consciousness. He returned to his normal life without obvious neurological problems. The Thai strategy to develop a community-based first responder network through health volunteer training would address the issue of inequitable access to emergency care and improve patients' chances of survival and prognoses. [ABSTRACT FROM AUTHOR]

Background: Road safety for older adults should receive more attention in low-income and middle-income countries with rapidly ageing populations., Methods: Using injury surveillance data from Khon Kaen Regional Hospital in northeastern Thailand, we calculated the proportion of older adults in the total number of patients who were fatally and non-fatally injured in road traffic crashes in each year from 2001 to 2020 and the proportion of road user type in the fatal and non-fatal patients by age groups for the entire study period to examine the extent to which older adults were involved in the crashes and with what mode of transportation., Results: During the 20-year period, there were 5046 fatal and 180 353 non-fatal patients of whom 509 (10%) and 6087 (3%) were aged 65 years or older, respectively. From 2001 to 2020, this proportion increased from 3% to 20% among the fatal patients and from 1% to 6% among the non-fatal patients. Of the fatal and non-fatal patients aged 65 years or older, 50% and 54% were involved in road traffic crashes while driving motorcycles and 28% and 22% while riding bicycles or walking, respectively. Compared with patients aged 65-74 years, those aged 75 years or older tended to be bicyclists or pedestrians in the crashes, though as high as 40% of them were motorcycle drivers., Conclusion: Older adults are increasingly injured in road traffic crashes as vulnerable road users in Thailand. Therefore, road safety efforts should consider their presence on the road., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)