Chatkhane Pearkao

Purpose: Point-of-care ultrasound (POCUS) serves as a critical diagnostic tool in emergency medicine; however, a persistent gap remains between competency acquired during training and consistent clinical application. This study sought to identify barriers and facilitators influencing POCUS examination frequency among emergency medicine (EM) residents and emergency nurse practitioners after institutional training, and to examine the association between individual-level factors and the frequency of POCUS examinations. Patients and Methods: This retrospective study was conducted in the Department of Emergency Medicine at Srinagarind Hospital, Khon Kaen University, Thailand, from January 2024 to December 2025. Cohort 1 included 76 providers (16 EM residents and 60 nurse practitioners) who completed institutional POCUS training between January 2024 and December 2025. Data collected included provider characteristics, competency scores, workload, and responses to a 5-point Likert-scale survey assessing perceived barriers and facilitators. Cohort 2 consisted of 2,097 documented, archived POCUS examinations performed by these providers during a standardized 1-month post-training observation period per provider. Associations were evaluated using correlation coefficients and multivariable linear regression. Results: EM residents demonstrated significantly higher competency scores than nurse practitioners (86.3± 5.7 vs 78.9± 7.4, p=0.002). The most prevalent barriers identified were high workload and time constraints, limited equipment availability, and reduced interpretive confidence. Nurse practitioners expressed greater concern regarding insufficient institutional support (3.88± 0.72 vs 3.06± 0.89, p=0.001) and medicolegal risk (3.65± 0.79 vs 2.94± 0.93, p=0.004), whereas residents rated structured feedback more favorably (p=0.012). Multivariable regression identified competency score (adjusted β = 3.97 per 10-point increase, p < 0.001) and provider type (adjusted β = 9.64, p = 0.007) as independently associated with higher documented POCUS examination frequency, while patient volume per shift was negatively associated (adjusted β = − 1.89 per 5-patient increase, p = 0.010). Conclusion: The findings indicate that formal training alone may be insufficient to achieve equitable competency or utilization. Additional multi-center studies are required to validate these results. The competency score showed a more consistent association with POCUS examination frequency than other variables examined, suggesting it may represent an important, though not exclusive, factor influencing real-world use. As examination quality, interpretive accuracy, and clinical impact were not assessed in this study, higher frequency should not be interpreted as better implementation.

A comprehensive understanding of the experiences of road traffic accident survivors remains limited, especially regarding their recovery processes and the ongoing challenges following injury. The impacts affect physical, psychological, and occupational aspects, making it difficult to return to their former way of living, while also leading to consequences that render survivors a burden to their families. The study aimed to 1) describe the adaptive perspectives of adult road traffic accident survivors in Northeast Thailand and 2) explore the caregiving roles and forms of support provided by spousal caregivers and healthcare team members of road traffic accident survivors. A qualitative descriptive study was conducted. In-depth interviews were conducted from November 2024 to July 2025 with 23 participants, including survivors, spousal caregivers, and an interdisciplinary healthcare team comprising nurses, physicians, physiotherapists, and social workers, representing diverse professional roles in the care and support of survivors. Data were analyzed using thematic analysis. Four key themes were identified: 1) Acceptance, belonging, and resilience; 2) Overcoming burden through the pursuit of independence; 3) Spousal encouragement for strength and healing; and 4) Acceptance, hope, and practical support as facilitators of adaptation. The study advances understanding of the adaptive journey of road traffic accident survivors, highlighting the development of acceptance, a sense of belonging, and resilience. Spousal caregivers and interdisciplinary healthcare teams, including nurses, play a central role in supporting survivors through coordinated, culturally sensitive, and family-oriented care, through sustained engagement, psychosocial support, and effective interdisciplinary communication.

Purpose: Climate extremes are a catastrophic manifestation of climate change. Motorcycle ambulances are an emerging sort of vehicle that is intended to offer quick access in large cities. This study evaluated the effect of extreme weather events on the accessibility of emergency motorcycle ambulance services. Patients and Methods: We conducted a retrospective analysis of motorcycle ambulance operation data from January 2020 to December 2024. Data on motorcycle ambulance operating times, rainfall levels in the operational area, and ground temperatures at the Emergency medical services (EMS) unit were collected. Continuous data were presented as means and standard deviations (SD), while categorical data were reported as frequencies and percentages. Associations between categorical variables were evaluated using the chi-square test. A two-tailed p-value of less than 0.05 was considered statistically significant. Results: With a total of 569 operations documented over the five years, services were postponed during rainy weather and when ground temperatures exceeded 40°C. The availability of operational motorcycle ambulances declined from 81.28% to 34.03%. Increased rainfall (hours lost increased from 1065.1 to 2711.7; p< 0.001) and rising temperatures exceeding 40°C (hours lost increased from 574.9 to 3067.3; p< 0.001) were the main causes of service interruptions. This occurred despite increased utilization of motorcycle ambulances for emergency responses (65 to 165 operations annually; p=0.022) and a growing use of AED-equipped units for cardiac emergencies (4.6% to 23.6% of operations; p=0.014). Conclusion: This quantitative evidence of the impact of climate extremes on emergency healthcare access due to reduced motorcycle ambulance availability. The gradual reduction in operational hours was caused by rising rainfall and elevated temperatures.

Background: The use of alternative health care among people with diabetes remains widespread, especially in rural areas of West Kalimantan, Indonesia. In the Malay ethnic community, alternative health care is not just an issue of access but also deeply rooted in cultural and spiritual practices. However, limited research has explored the symbolic meanings and socio-cultural dynamics that underlie the consistent use of alternative health care by people with diabetes. Objective: This study aimed to explore the cultural recognition and socio-cultural meanings embedded in the use of AHC among Malays with diabetes in West Kalimantan, Indonesia. Methods: A focused ethnography was conducted from July to November 2024 using in-depth interviews, focus group discussions (FGDs), observations, and field notes. A total of 45 participants took part in interviews, including people with diabetes, healthcare providers, traditional healers (Tabib), family members, healthcare volunteers, and community leaders. FGDs comprised five groups, and observations included nine participants. Data were analyzed through content, typology, and matrix analysis. To ensure trustworthiness, triangulation and member checking were employed. The study was guided by three theoretical frameworks: Symbolic Interactionism, Cultural Theory, and Critical Social Theory. Findings: Four main themes emerged: (1) cultural logic and illness meaning, in which illness was viewed as a spiritual and moral imbalance; (2) symbolic meanings in alternative health care practices, highlighting ritual healing and spiritual faith; (3) social structures as pillars of healing, where family and community roles legitimized alternative health care; and (4) social processes that created cultural recognition through intergenerational transmission and community validation. Conclusion: Recognizing AHC culturally is essential for understanding the illness experiences of people with diabetes. For nursing practice, these findings emphasize the importance of providing culturally respectful care, fostering open communication between healthcare providers and people with diabetes, and incorporating alternative healthcare approaches into safe, evidence-based health education.

Purpose: This study evaluates the effectiveness of motorcycle ambulances (motorlances) in delivering emergency medical response at the Khon Kaen International Marathon (KKIM), Thailand, over a three-year period (2023– 2025). Patients and Methods: We conducted a retrospective analysis of emergency medical service (EMS) data from three consecutive annual Khon Kaen International Marathons held on January 28– 29, 2023; January 13– 14, 2024; and January 11– 12, 2025. Data including EMS operation intervals, clinical interventions carried out, and patient outcomes were collected from EMS patient care documents, organized by Srinagarind Hospital, Khon Kaen University, Thailand during the marathon events. A comparative analysis was carried out to evaluate year-over-year operational improvements utilizing IBM SPSS version 27.0, with continuous data expressed as means ± standard deviations, categorical data as frequencies and percentages, chi-square tests employed for associations among categorical variables, and p< 0.05 considered statistically significant. Results: Among 20,681 marathon participants, 132 cases (6.38%) required emergency intervention with motorlance support. The use of motorlances significantly increased from 25 cases in 2023 to 65 in 2025 (p=0.011), with consistently rapid mean response times (5.3– 5.6 minutes each year). Clinical capabilities improved over the study period, evidenced by a rise in advanced interventions such as intravenous glucose administration and pain management (from 0% to 23.1%, p=0.010). Scene time increased in parallel with this expanded clinical scope (from 8.2 to 18.6 minutes, p< 0.001). Importantly, over 90% of patients treated by motorlance were able to continue the race following on-scene care. Conclusion: Motorcycle ambulances significantly enhance the efficiency of emergency medical responses during large marathon events. Notable results indicate a constant increase in motorlance utilization, consistently rapid response times, and enhanced clinical competencies with advanced interventions. Extended scene duration indicated enhanced on-site treatment delivery. Significantly, over 90% of patients treated by motorlance resumed to racing after treatment, indicating the efficacy of prehospital intervention.

Purpose: To implement smart glasses with augmented reality distance measuring technologies in conventional self-assessment techniques, to improve ambulance location accuracy during simulated emergency scenarios. Patients and Methods: Eighty-two emergency medical services professionals participated in this simulation-based study at Srinagarind Hospital, Thailand. Participants positioned ambulances in simulated chemical, biological, radiological, nuclear, and explosives (CBRNE) and non-CBRNE scenarios using traditional self-assessment methods, followed by positioning using smart glasses technology after a 120-minute training session. Smart glasses equipped with a measurement-augmented reality application were utilized. Positioning accuracy was assessed. Results: The participants had a median age of 36.1 years, with males comprising the majority (63.4%). Emergency nurse practitioners and students constituted the largest group (56.1%). Most participants (51.1%) reported over a decade of EMS experience. Smart glasses technology significantly improved positioning accuracy in both scenario types (p< 0.001). In CBRNE scenarios, accuracy increased from 47.6% with self-assessment to 83.3% with smart glasses. In non-CBRNE scenarios, accuracy improved from 66.7% to 83.8%. Conclusion: Smart glasses technology with augmented reality distance measurement capabilities substantially enhances ambulance positioning accuracy, particularly in complex CBRNE scenarios. The technology’s ability to standardize performance across emergency types, and potentially across responder experience levels, suggests significant value for improving emergency medical service delivery, patient care, and responder safety.

Background: Chest injuries are a leading cause of death and disability, accounting for 10% of hospital admissions and 25% of injury-related deaths. About two-thirds of patients with thoracic injuries experience complications such as blood or air in the pleural space, causing lung deflation and poor gas exchange. Proper breathing management, using tools like incentive spirometers, improves lung function and recovery. However, there is a gap in mobile-based gaming apps designed for lung exercise, which could benefit both the general population and patients recovering from lung injuries. Objective: This research aimed to develop and evaluate a mobile app game for practicing lung exercises, accompanied by a prototype device called the Pulmo device. Methods: The study involved a sample group of 110 participants from the general public. It followed a research and development methodology comprising 4 steps. The research instruments included a mobile app game, a prototype lung exercise device, and questionnaires to assess users’ satisfaction and the feasibility of both the app and the device. Results: The findings revealed that the participants demonstrated a high level of overall satisfaction with both the mobile app game and the prototype lung exercise device (mean 4.4, SD 0.4). The feasibility for the mobile app game and the prototype lung exercise device connected to the game was evaluated. The results indicated that the sample group perceived the overall feasibility to be at a high level (mean 4.4, SD 0.5). Conclusions: The research results reflected that the sample group believed the mobile app game for practicing lung exercises and the prototype device developed in this project have a high potential for practical application in promoting lung rehabilitation through gameplay. The mobile app game and the Pulmo device prototype received positive user feedback, indicating potential practical use; however, further validation is required among patients in need of pulmonary rehabilitation.

Introduction: The purpose of this research was to develop a smart helmet, including emphasizing the AI integration and the device’s role in enhancing road safety with a mechanism that stimulates the driver to recognize which vehicle is approaching and the speed levels of the vehicle while it is moving, and to assess the satisfaction and feasibility of drivers while using the smart helmet. Methods: This study included 139 participants who were general people in Thailand. The research model consists of four research and development steps: research, design and development, implementation, and evaluation. The questionnaires included general information, satisfaction, and feasibility of using a smart helmet. Results: The study showed that males had a greater number of participants (63.31%), aged between 21 and 40 years (64.03%), higher education (73.38%), and most of the participants were university students (90.64%). Overall, satisfaction with using smart helmets was high (mean = 4.20, SD = 0.83), and the overall possibility of using smart helmets was very high (mean = 4.33, SD = 0.75). Conclusion: The participants’ reflections indicated that smart helmets can be a possibility for further development and are highly feasible practical application devices. Moreover, the smart helmet is beneficial to riders in terms of warning functions to prevent and monitor accidents. Nurses and health care providers may use these results to develop programs or devices that can encourage people to be aware of harm on the road while riding motorcycles.

Evidence suggests that using a standardised triage system that categorises patients into levels of severity or acuity to prioritise their care can provide the greatest levels of patient safety. The use of a web-based app to record patient triage data can support operational decision-making, reduce the risk of errors and standardise the time it takes to record the data required for accurate triage. This article details one aspect of a three-stage research project undertaken in Thailand which aimed to improve the quality of nurse triage, reduce errors in triage decisions and decrease the time spent on triage through implementation of a patient triage app. The patient information input into the app at initial triage is automatically uploaded into the electronic patient record. The authors report the results of the third stage of the project, which aimed to analyse the feasibility of using the app by evaluating completion of patient records and user satisfaction levels.