Lessons Learned from Emergency and Disaster from Thailand Orapan Thosingha, RN,DNS WHOCC, Faculty of Nursing, Mahidol University Mahidol University, Wisdom of the land

Mahidol University, Wisdom of the land Scope of the presentation 1.Major disasters in Thailand from Nov 2013-Oct 2014 : with a focus on health problems and nursing contribution. 2.Researches conducted by nurses in the area of emergency and disaster 3.Workshop, meeting and training in the area of emergency and disaster 4.Curriculum development on disaster nursing in Surat Thani (Southern part of Thailand) 5.Collaboratively work with the network members

Mahidol University, Wisdom of the land Major emergency and disaster in Thailand from November 2013 to October 2014 Mass gathering From October 2013 – May 2014

Mahidol University, Wisdom of the land Mass gathering From October 2013 – May 2014 Amnesty law protest More than 100,000 people gathering on Rajdumnean Road, Bangkok Oct – November 2013 Protest to force the government to resign from their position November – December 2013 More than 2,000,000 people gathering on every main road in Bangkok Raise up the protest to cover many province in Thailand, walk rally activities, shut down Bangkok activity Request the government to resign /people need country reform January - May 2014

Mahidol University, Wisdom of the land Health problems found Infectious diseases, diarrhea, Acute symptoms among people with non communicable diseases, ie, DM, hypertension, heart disease, COPD

Mahidol University, Wisdom of the land Health problems found Heat stroke, injuries, eye injury from tear gas, mass casualty incidence

Mahidol University, Wisdom of the land Establish a working group called Caring Thais Nursing network

Mahidol University, Wisdom of the land Activities 1.Form the mobile clinic to perform need assessment of people 2.Conduct primary medical care for people who gathering in the protest mob 3.Fund raising to help people who were injured and became disable during the protest 4.Establish an on line network to update the current situation and providing information to prevent communicable diseases and injuries

The Earth Quake 5 th May 2014 at 6.39PM (Thailand local time) 5.8 Ritters, cover the area of 24 square KM in Chieng- Rai, the northern province of Thailand Mahidol University, Wisdom of the land

Mahidol University, Wisdom of the land practice guidelines development Develop and implement a national Guidelines on Earth Quake preparedness and response Ms. Saikaew Yapalohit, RN,MNS (adult nursing) ER, Chieng Rai Prachanukraw General Hospital

Mahidol University, Wisdom of the land Research in area of emergency and disaster 1.The accuracy of Modified Early Warning Score (MEWS) on emergency patients triage. Objective: to evaluate the effectiveness of MEWS Setting: Emergency room in the provincial hospital Results : (preliminary report) 150 patients age Years, MEWS can be used to identify physiological deterioration 2.Factors related to time to get access to trauma level I among patients with Road Traffic Injuries. Objective: to evaluate if injury severity, perceived severity of injury, type of responders, distance from the scene to the hospital could co predict time to get access to trauma care

Mahidol University, Wisdom of the land 3.The coping mechanism of family members of severe injured patients from Mass casualty incident during ICU stay. Objective: to evaluate the coping mechanism of family members. 4.Factors related to The accuracy of Emergency Severity Index (ESI) among patients with trauma Objective : To explore the relationship between (a) patient characteristics (age, symptom presentation), (b) RN characteristics (age, years of experience, years of ED experience, and education), and (c) accuracy of ED RN triage and level designations the Emergency Severity Index (ESI) triage tool.

Mahidol University, Wisdom of the land 5. Factors predicting circulatory failure among severe trauma patients in emergency phase. Objective: to explore if patient temperature, level of injury severity, transportation time can predict patients circulatory failure (measure by Shock Index). Sample: 130 trauma patients Results: level of injury can predict patients circulatory failure (measure by Shock Index). 40 % of Patients experienced shock (circulatory failure) within 2 hours after their arrival to ER.

Mahidol University, Wisdom of the land Curriculum development There are 26 Colleges of Nursing under the governance of Ministry of Public health Thailand. There is not a special subject on emergency and disaster management. Surat Thanee College of Nursing developed an additional contents on disaster preparedness, response and facilitation during the recovery phase. Using 2 days lecture and 1 day workshop.

Mahidol University, Wisdom of the land Revision of the teaching style Faculty of Nursing, Mahidol University Emergency and disaster nursing 2 credits (30 Hours lecture & workshop)

Mahidol University, Wisdom of the land To be more active learning using scenario to improve student engagement

Mahidol University, Wisdom of the land Students had more satisfaction and higher achievement

Mahidol University, Wisdom of the land Continuing Nursing Education text book on disaster management Sponsored by Thailand Nursing and Midwifery Council 15 Chapters Editors: Orapan Thosingha, Piyaporn Yauwaresh, Kedsiri WongKongkum Authors: Mahidol University, Thailand Red Cross CON, Royal Air Force Hospital, Ministry of Public Health (will be published and distributed in December 2014)

Mahidol University, Wisdom of the land Collaboratively work with network members Dr Lidia Mayner serves as a co advisor for Thai graduate nursing students.

Mahidol University, Wisdom of the land Collaboratively work with the other community of practice nurses group to add knowledge of disaster preparedness Reach out from the network

Mahidol University, Wisdom of the land Work with the Infusion Nurses Network of Thailand (INNT) Establish a group work to develop national guidelines on IV care Evidence selection, appraisal, analysis and synthesis Content on IV care during limited resources from emergency and disaster are added Public hearing in Jan 2015 /present to HA national forum in March 2015

Mahidol University, Wisdom of the land Keys to success 1.Work with others 2.Engage in different group 3.Always remember to insert the essence of emergency and disaster in all areas 4.The succession plan is needed (indeed)