Recently my GF lost a very good friend of hers ( 25 yo Male ) to a motorcycle accident in Udon. Up near the President Hotel and he collided with a tour bus that was reversing.

Irrespective as to who was right or wrong it did bring the reality of care and treatment that he received to my attention.

Again its not proportioning blame but i wish to highlight a few critical areas that happens when persons receive traumatic injuries. ( Trauma is the energy that passes thru your body during an accident etc , can also include objects or blast waves )

Most accidents will involve some degree of deceleration, meaning that the body will continue to travel forward till it stops ( seat belts , air bags, dash boards , road surfaces etc ) once the body stops the internal organs ( Lungs , brain ,large blood vessels , liver, intestines, heart, kidneys, etc ) still travel forward till they also stop, hitting the ribs, chest wall, ,skull, stomach lining, etc. Bowl of jelly thrown and hits a brick wall at 60 kph is a simple way of explaining this.

This momentum rips, tears, ruptures, and causes soft / hollow organs to bleed internally and this can be quickly or slowly.

The Emergency Service staff ( Paramedics, ER Nurses , ER Medical staff and Surgeons ) in developed countries recognise this and want to know what " The Mechanism of Injury " is, that is how did it happen and what speeds and what restraining devices if any were activated etc. If they can picture the incident from good reporting mechanisms they will know what to expect internally. A fractured leg is obvious to everyone including the patient.

Injured patients may only have bruising on their chest from the seat belt, but the speed of 90 KPH will be ringing alarm bells to the Thoracic Surgeons ( Pulmonary contusions, lacerated Aorta, - Princess Di mechansim )

They may also be walking / talking to you at the accident scene , with some slight signs of discomfort and everybody says, they will be ok and just go home and see a Dr later if things change. Police are not medically trained to assess injured people.

Once things do change and this can be rapidly ( up to 4 hours later ) the Surgeons struggle to catch up and this is in many cases fatal.

If you have or see an accident that looks bad and has major damage to the vehicle, helmet, bruises on the chest or abdomen etc DONT let friends etc tell you they are ok. If a patient shows any signs of discomfort or confusion but no external signs of injury PLS get them to a major ER for assessment.

If you think "Mechanism of Injury " then pls have them assessed.

Its tragic when a young guy says to his parents , he will be ok, coz nobody can see any physical injuries, then 4 hours later, the Surgeons say, they did all they can, but it was too late.

Wazza,with your experience in Thailand as a guide,how would you assess thr local ER's abilities and any recommendations?

Stan

I would be very careful with what goes on.

They underestimate the importance of high concentration O2 and that can be a killer in its own right.

ER 's world wide are always and will always be under considerable pressure, but basic care is often neglected here in Thailand, sadly.

Its not the Nurses / Junior Doctors fault, but i cringe when i hear, we cant use that O2 mask coz its too expensive.

Or those Nitrile Gloves are too expensive, so we just use latex examination gloves and when they tear easily, we use another pair The Nitrile gloves are actually made in Thailand and exported world wide !