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Background: Airway management is an important aspect of care in emergency medical services (EMS) used to prevent obstruction of the respiratory track and inadequate oxygenation. The laryngeal mask airway (LMA) is an easy-to-use supraglottic airway device developed in 1988 that has a high success rate in both adults and children. However, there have yet been no studies regarding LMA use in EMS in Thailand. Objective: To determine the success rate of LMA in EMS and factors associated with successful LMA insertion. Materials and Methods: This was a cross-sectional study consisting of Srinagarind Hospital EMS patients over 18 years of age who underwent LMA airway management between March 2016 and March 2020. Data were collected from the Srinagarind Hospital EMS operation database and hospital information database system. Results: A total of 154 patients were enrolled with a mean age of 43.1+8.5 years, 89 (57.8%) of whom were male. Non trauma patients accounted for 72.7% of all cases. The average oxygen saturation before and after LMA use were 71.4+12.3% and 94.4+3.2%, respectively (p = 0.022). Students in their first and third year of residency training were able to successfully perform LMA airway management on the first attempt in 83.3% and 98.4% of cases, respectively (p = 0.025). Conclusion: Airway management using the LMA had a high success rate on the first attempt, required less time for insertion than other comparable devices, and resulted in a high level of oxygen saturation. Keywords: Laryngeal mask airway, Emergency medical services, Airway management, Internship and residency

Background: The present study was conducted to assess the learning outcomes of mechanical cardiopulmonary resuscitation device training course for emergency medicine residents from Laos. The course was part of a collaborative project among Tsukuba University in Japan, the University of Health Sciences in Laos, and Khon Kaen University in Thailand. Objective: To evaluate the learning outcomes a mechanical cardiopulmonary resuscitation device course for emergency medicine residents. Materials and Methods: The cross-sectional study was conducted in emergency medicine residents from Laos who participated in a training course on the use of mechanical cardiopulmonary resuscitation devices, which took place between January and March 2020 at the Srinagarind Hospital emergency department (ED). Assessment exams for individually with standard checklists for Thais’ emergency medicine residents. Results: A total of eight emergency medicine residents from Laos were enrolled. The mean age was 33.7+3.5 years, and 62.5% (n = 5) of the participants were female. We found that participants’ mean score had increased from 4 to 8 points after the training course (p = 0.010). Participants rated the ease of the procedure as 8 out of 10 (1: very difficult). Conclusion: The mechanical cardiopulmonary resuscitation device training course was successful in terms of sharing both medical knowledge and equipment management techniques. Keywords: Internship and Residency, Laos, Cardiopulmonary resuscitation, Emergency medicine

Background: Cooperation between Japan (Tsukuba University), Laos (The University of Health Sciences), and Thailand (Khon Kaen University) had been established in order that the teaching of doctors in the Emergency Medicine Training Program in Laos could be developed so that these doctors could have the opportunity to be the observers of EMS in Thailand. However, as of this time, no studies related to the pre-hospital care perspective in the International Rotational Program for residents of Emergency Medicine have been conducted. Objective: To survey the perspectives of pre-hospital care for residents from Laos, who were participating in the International Rotational Program of Emergency Medicine. Materials and Methods: This was a retrospective cross-sectional study conducted between January and March 2020 with thirdyear residents in Emergency Medicine from Laos, who had come to gain practice at the EMS of Srinagarind Hospital in Thailand. Before starting the session, data was collected from all participants, which consisted of responses to a multiple-choice test, demographic data, and satisfaction surveys. Results: A total of eight emergency medicine residents were enrolled and were then divided into three groups. Under normal conditions, the EMS duration time was thirty-two hours for each group. During the first week of the course, knowledge was disseminated through lectures. During the second week, the participants were placed on duty. After that, they received calls from the 1669 center and were dispatched with the EMS operation team. Finally, over the duration of a two-week period, they were placed in the role of being observers on ambulance duty. When comparing the Pre-test and Post-test assessment of their EMS knowledge, a significant increase in their scores from 3.4 to 8.5 (p = 0.010) was found. In addition, the medical oversight had increased from 2.4 to 8.4 (p = 0.005), while the EMS systems had significantly increased from 4.2 to 8.6 (p = 0.014). Conclusion: The International Rotational Program for Emergency Medicine residents, which had focused on the EMS aspects with EMS knowledge, Medical Oversight, and on the EMS systems, was found to be successful for the doctors from Laos. Keywords: Emergency medicine, Internship and Residency, Emergency Medical Services, Learning

Background: The emergency department (ED) can be thought of as the “front door” to the 2019 coronavirus (COVID-19) pandemic. However, there have yet been no studies conducted examining ED patients in this situation. Objective: To determine the numbers of ED visits by level urgency during the COVID-19 pandemic. Materials and Methods: This was a cross-sectional study. The sample consisted of patients who presented at the Srinagarind Hospital ED from January 13 to April 21, 2020 (the date of the first confirmed case of COVID-19 in Thailand according to the Ministry of Public Health and day 100). We compared these data with those from the same period over the past three years. Results: In 2020, the total number of ED visits was 13,263, with a mean patient age of 50.14+6.40 years. Over half of these patients (56.2%; n = 7,467) were female. Most visits (50.6%) occurred between 4.00 PM to 0.00 AM (afternoon shift). The majority of were walk-ins (84.2%) and ESI 3 (non-urgent; 79.9%). The average numbers of ESI 3 patients who visited the ED over the same period in 2017 to 2020 were 152.3, 171.5, 153.0 and 105.9 per day, respectively (p

Background: The spread of the novel coronavirus 2019 (COVID-19), emergency medical services (EMS) work flow to be different from the normal situation such as avoid advanced airways management that perform aerosol generating. However, no studies examining EMS operation have been conducted at Srinagarind Hospital. Objective: To compare EMS operation time and procedures during COVID-19 spreading and routine period. Materials and Methods: This cross-sectional study examined all cases in which EMS were dispatched from Srinagarind Hospital during 13th January to 21st April 2020 compared with last year. Data were collected from the Srinagarind Hospital EMS operation database and hospital information database system. Results: Five hundred forty-five EMS operations were examined. The mean age of the patients in 2020 was 50.4+6.2 years, and 70.9% (n = 195) were male. The average times from 1669 center call receipt to arrival on scene (response time) for 2019 and 2020 were 12.44+4.12 minutes and 7.32+2.40 minutes, respectively (p = 0.016). The nebulizer mask procedure was performed in 16.1% of cases in 2019 group compared with 7.1% in the 2020 group (p