Lap Woon Cheung

Purpose: The ultrasound-guided peripheral venous access (USGPIV) was reported as difficult for novices to perform. Smart glasses equipped with teleconference systems can display real-time ultrasound images to sonographers and consultants which can increase the success rate of this procedure. The purpose of this study was to assess the effectiveness of employing smart glasses for USGPIV. Patients and Methods: A randomized, simulation study was conducted in emergency medical service (EMS) providers at Srinagarind Hospital, Thailand, from January to April 2023. We randomized participants into two groups which included participants who wore smart glasses during procedures requiring USGPIV (the smart glasses group) and participants who performed USGPIV with no smart glasses (the non-smart glasses group). After participating in USGPIV cannulation training, the simulations were carried out. The primary outcome was the first-attempt success rate, with secondary outcomes including the procedure time and subjective difficulty. Results: Fifty participants were recruited for the study. The smart glasses group was superior to the non-smart glasses group both in terms of first-attempt success rate with no statistically significant (64% vs 60%; P = 0.460) and also demonstrated a shorter procedure time than the non-smart glasses group (25.5 sec vs 42.3 sec; P = 0.003). The participants reported the subjective difficulty score was higher in the smart glasses group (the visual analog scale, VAS = 8). Conclusion: In simulation scenarios, the smart glasses-assisted USGPIV could shorten the procedure time. However, our study did not find significant differences in the first pass success rate of USGPIV between the two groups.

Purpose: Globally, emergency departments (ED) are faced with an overcrowding problem. This issue is further compounded due to the multitude of contributing factors. Point of Care ultrasound (POCUS), especially when performed in prehospital care, that is before the patient is admitted to the ED has a high potential to reduce time of diagnosis and time of investigation which leads to shorter ED length of stay (LOS). The primary focus was on variances in ED LOS between the prehospital POCUS group and the standard care group. Patients and Methods: A cross-sectional study was conducted on prehospital patients who were admitted to the ED at Srinagarind Hospital, Thailand, from January to December 2021. We divided patients into two groups including patients who obtained prehospital POCUS (the prehospital POCUS group) and patients who received standard care treatment in which there was no prehospital POCUS performed (the standard care group). POCUS and ED medical records were documented and submitted for analysis. Results: Of 1348 prehospital patients, 840 were enrolled in this study: 169 with prehospital POCUS and 671 with standard care. Median LOS in the prehospital POCUS group was 159 min (IQR 89,289) versus 165 (IQR 102,330) in the standard care group (p = 0.125). Further imaging diagnostic test which affected ED LOS more than four hours was lower in the prehospital POCUS group (adjusted odds ratio [OR], 0.92; 95% confidence intervals [CI], 0.729– 1.666) than in the standard care group. The factor associated with increased odds of ED LOS more than four hour in the prehospital POCUS group was admission to hospital (adjusted OR 1.88; 95% CI, 1.230-2.239). Conclusion: Patients evaluated with prehospital POCUS had a shorter LOS than the only standard care treatment without statistical significance.

Introduction: The motorcycle ambulance is used for quick access to patients. The response time to reach the patient takes less time than with a van ambulance. Moreover, accidents involving ambulances tend to be higher. However, at present, there is no study regarding the appropriate situation used of motorcycle ambulances in Emergency Medical Services (EMS) in Thailand. Study Objective: This study aims to optimize the travel distance and the operation time of motorcycle ambulances used. Methods: This study was a prospective, randomized controlled study at the EMS unit of Srinagarind Hospital, Thailand. The data collection period was from November 2021 through May 2022. All data involving dispatch of both ambulances in need were collected. Results: A total of 2,398 cases of EMS operation were examined. The mean age of the patients in the motorcycle ambulance group was 42.5 (SD = 6.5) years, and 51.3% (n = 616) were male. The response time for motorcycle ambulances and van ambulances during the operation time between 6:00am-9:00am was 6.2 minutes and 9.1 minutes, respectively. The response times for motorcycle ambulances and van ambulances regarding distance traveled from 0-5km were 4.2 minutes and 7.5 minutes, respectively (P <.001); distance traveled from 5-10km were 6.3 minutes and 8.2 minutes, respectively (P = .010). Conclusion: The motorcycle ambulance can reach patients faster than the ambulance at the operation time from 6:00am-9:00am and 3:00pm-6:00pm. This study focused on the distance less than 10 kilometers.

Point of care ultrasound (POCUS) competency is now required learning for emergency medicine trainees. However, there is a wide range of areas that need to be assessed when determining competence. Therefore, this study aims to evaluate competence levels of POCUS skill acquisition including the areas of image acquisition, image interpretation and clinical integration of the emergency medicine residents while on shift in real clinical practice situations. This was a retrospective descriptive study. This study was conducted at Srinagarind Hospital, Thailand from January 2021 through December 2021. The data were collected and reviewed from electronic medical records, ultrasound images and video clips. All POCUS competency skills were assessed by researcher staff. Our results demonstrated that our learners had overall satisfactory competence of image acquisition, satisfactory image interpretation skills, and good clinical integration skills. However, obstetrics and gynecology (OB-GYN) ultrasound scores were poor and cardiac ultrasound had the most varied score of image quality. This study clearly showed the measurable benefits of a POCUS course being integrated into real clinical practice.

BACKGROUND: Knowledge of prehospital scene care for injured person in road accidents is essential for improving outcome and saving lives of traffic accident victims. However, the situation of the COVID-19 pandemic may cause people’s inability to access in-person first aid training. AIM: This study aimed to determine the effect of first aid self-learning web application for road accident victims on the knowledge and satisfaction of the web application users. METHODS: A prospective, single-arm, and educational cohort study was conducted among second-year physical education participants at Khon Kaen University attending first aid self-learning web application for road accident victims in July 2021. All participants were attended ten lessons covering important content of first aid for an injured person in road accidents. Each lesson includes reading texts, 3-min animation videos, and pre-test and post-test. Data analysis includes a comparison of the pre-test and post-test knowledge scores using the paired t-test. The participant’s satisfaction was analyzed using descriptive statistics. RESULTS: The 42 participants were participated in this study. Sixty-two percent of the participants had no previous first aid experience for an injured person in road accidents. The mean pre-test and post-test scores were 25.31 ± 3.87 and 27.50 ± 2.91, respectively. There was a significant difference between the pre-test and the post-test scores (p < 0.001). The participant’s level of satisfaction score was very good (4.25 ± 0.95). CONCLUSIONS: The first aid self-learning web application significantly improved the first aid knowledge of the web application users. Moreover, most participants reported good level of satisfaction for using this tool. This emphasized that the first aid self-learning web application was the great tool in COVID-19 learning.