Pre-hospital and Emergency Care of Neurosurgical Care in Thailand Chaiwit Thanapaisal MD., FRCST, FRCNST Khon Kaen University Thailand

Thailand Area 513,120 sq.Km. Population 67million

Each region Cover 4.5 – 5 million population 13 Regions of Health Care Each region Cover 4.5 – 5 million population

Pre-hospital Care

Private Foundation run pre-hospital care more than 100 years

Medical Emergency all over the country Call 1669 Medical Emergency all over the country

Emergency Care

Motorway Fast Track Transfer System Multiple injury / Head injury STEMI Stroke Critical Newborn High risk pregnancy Sepsis

Mortorway Fast track

Delayed @ emergency room Delayed CT Scan Delayed Operation Major Problem of HI Delayed @ emergency room Delayed CT Scan Delayed Operation

Head Injury Fast Tract

Moderate to severe head injury Need craniotomy Head Injury Fast Tract Inclusion Moderate to severe head injury Need craniotomy

Key Indicators for HI Fast Tract Time in Emergency Room < 60 min. Door to CT Scan < 120 min. Door to OR < 240 min.

Results ( one 500 beds provincial hospital with 2 neurosurgeons) Before After Goal ER Time < 60 min. 41% 62% 90% Door to CT Scan < 120 min. 67% 85% Door to OR < 240 min. 55% 82% Over all Mortality 37% 31% 20%

Easy numbers Total Thai Doctors 50,000 Total Thai Surgeons 5,000 Total Thai Neurosurgeons 460 10 % of Thai Surgeons 1% of Thai doctors Quotes from some Foreign visitor in MICE industry that came to Thailand along the political crisis but it’s shown that Thailand remains a welcoming MICE destination and that it’s business as usual throughout the country.

Thai Neurosurgeon Total 460 Active 430 Female 18 (4%) Working in Bangkok 195 (45%) Working outside Bangkok 235 (55%) Provincial hospital have NS 80% Quotes from some Foreign visitor in MICE industry that came to Thailand along the political crisis but it’s shown that Thailand remains a welcoming MICE destination and that it’s business as usual throughout the country.

Training Institute Bangkok. 7 Chiangmai. 1 Pratumtani 1 Songkla Training Institute Bangkok 7 Chiangmai 1 Pratumtani 1 Songkla 1 Khon Kaen 1

Current Status Total 27 resident position/year New neurosurgeons 20-25/year Female neurosurgeons 3-5/year Total Neurosurgeons 460 The country needs 400 more neurosurgeons

Full moon lunar day of the 3rd month for 3 days (Makabucha day) Annual Meeting Full moon lunar day of the 3rd month for 3 days (Makabucha day) 20-22 February 2017

Thank You for your attention