Borwon Wittayachamnankul

Chiang Mai University | CMU · Emergency Department

Comparison of the three methods standing-on-a-stool (SS), one knee kneeling on a stretcher (KS), and kneeling at the same height as the patient’s bed on the kneeling stool (KK) to evaluate the yielded of highest CPR quality and rescuer comfortability. A prospective randomized cross-over study which compares the three different rescuer positions for...

Background Emergency Department (ED) overcrowding is a global concern, with tools like NEDOCS, READI, and Work Score used as predictors. These tools aid healthcare professionals in identifying overcrowding and preventing negative patient outcomes. However, there’s no agreed-upon method to define ED overcrowding. Most studies on this topic are U.S.-...

Background and objective Several studies suggest that air pollution, particularly PM2.5, increases morbidity and mortality, Emergency Department (ED) visits, and hospitalizations for acute respiratory and cardiovascular diseases. However, no prior study in Southeastern Asia (SEA) has examined the effects of air pollutants on ED visits and health ou...

Background The impact of the coronavirus disease 2019 (COVID-19) outbreak on out-of-hospital cardiac arrest (OHCA) has been of interest worldwide. However, evidence from low-resource emergency medical service systems is limited. This study investigated the effects of the COVID-19 outbreak on the prehospital management and outcomes of OHCA in Thaila...

Background Drug-drug interactions (DDIs) are common but less concerning in clinical practice of time-sensitive situations. We aimed to identify factors associated with a basic common DDI knowledge among an emergency physician (EP), an emergency medicine resident (EMR), and an emergency care nurse (ECN). Methods This was a prospective cross-section...

We aim to develop a diagnostic score for acute cholecystitis that integrates symptoms, physical examinations, and laboratory data to help clinicians for timely detection and early treatment of this disease. We retrospectively collected data from our database from 2010 to 2020. Patients with acute abdominal pain who underwent an ultrasound or comput...

The main purpose of the emergency medical system is a timely and appropriate response that significantly impacts health outcomes. In Thailand, due to lack of staff, emergency medical personnel at the dispatch center have to multitask to interview and dispatch the EMS responses. According to these problems the novel triage mobile application “Triagi...

Background: Out-of-hospital cardiac arrest (OHCA) is not common but associated with a low survival rate. There is no evidence investigating the effects of previous Basic Life Support (BLS) training among long-distance runners. The goal of this study is to demonstrate the health characteristics, knowledge, and attitudes towards BLS among marathon r...

Background Simulation-Based Medical Education (SBME) is a teaching method commonly used in undergraduate medical education. Although Thai medical schools have developed a system that incorporates SBME, various aspects of that system require improvement. We surveyed medical school administrators, instructors, and students about SBME in their institu...

Compressions at the left ventricle increase rate of return of spontaneous circulation. This study aimed to identify the landmark of the point of maximal left ventricular diameter on the sternum (LVmax) by using chest computed tomography (CCT) in the arms-down position, which was similar to an actual cardiac arrest patient. A retrospective study was...

Objective This study aimed to explore significant pre-hospital factors affecting the survivability of Out-of-Hospital Cardiac Arrest (OHCA) patients in countries with developing EMS systems. Method A retrospective cohort study was conducted examining data from January 1, 2017 to December 31, 2020 from Utstein Registry databases in Thailand, collec...

Funding Acknowledgements Type of funding sources: Private hospital(s). Main funding source(s): The Faculty of Medicine, Chiang Mai University Fund Background Recently evidence, compression at the maximal left ventricular diameter on sternum (LVmax) maximises cardiac output, stroke volume and rate of return of spontaneous circulation. However, ther...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Faculty of Medicine, Chiang Mai University Research Fund Background An intravenous adenosine with a double syringe technique is an essential treatment in a patient with paroxysmal supraventricular tachycardia (PSVT). Due to its fast metabolisation (app...

Background Intravenous adenosine is the recommended treatment for paroxysmal supraventricular tachycardia (PSVT). There is no official recommended method of giving adenosine. We compared the success rates between a standard and alternative method of first dose intravenous adenosine in PSVT. Methods A pilot parallel randomized controlled study was...

Objective: We aimed to compare the modified National Early Warning Score (mNEWS), quick Sequential Organ Failure Assessment (qSOFA) score, modified Systemic Inflammatory Response Syndrome (mSIRS) score, and modified Search Out Severity (mSOS) score in predicting mortality and sepsis among patients suspected of first observed infections in the emerg...

Severe traumatic brain injury (TBI) is a significant problem and a worldwide cause of disability and death. The purpose of this study was to evaluate the factors predicting the outcomes of severe TBI and undergoing emergency surgery. This was a retrospective study that collected data from all patients with severe TBI, and received emergency surgery...

Objectives: The use of a cardiopulmonary resuscitation feedback device and automated external defibrillator trainer is beneficial in basic life support (BLS) training. Nevertheless, Thailand lacks these devices in BLS support training. This study aimed to compare the efficacy of the Chiang Mai BLS training devices with conventional training devices...

Background & Rationale: Extended length of stay (LOS) in the emergency department (ED) affects LOS in hospital, increased mortality and increased hospital resource uses. Knowing factors affecting extended ED LOS should lead to improved patient’s quality of care. Methodology: The study design was a retrospective analytical study in ED at Maharaj N...

Objectives Upper gastrointestinal bleeding (UGIB) is a common but potentially fatal condition often seen in the emergency department (ED). This study aimed to investigate prognostic factors, including the emergency department length of stay (ED LOS), office hours vs. non-office hours visits, performance of an esophagogastroduodenoscopy (EGD) includ...

Objective: Centipede stings are a common problem in tropical countries. Current treatment guidelines do not include recommendations for antibiotic prophylaxis to prevent the associated bacterial infection since no previous study has assessed the effectiveness of antibiotic treatment in patients bitten by centipedes. Thus, this study aimed to compa...

Ventricular fibrillation (VF) and sudden cardiac arrest (SCA) remain some of the most important public health concerns worldwide. For the past 50 years, the recommendation in the Advanced Cardiac Life Support (ACLS) guidelines has been that defibrillation is the only shockable cardiac arrest option. There is growing evidence to demonstrate that mit...

Background Sepsis drives a worldwide impact on the health care system. The primary problem in treating sepsis is the emergence of multi-drug resistant microbials caused by the improper use of antibiotics. The mortality associated with the improper use of empirical antibiotics consequently adds a burden on the health care system. Objectives To inves...

Objectives Basic Life Support (BLS) should be taught to everyone; however, there is a lack of Automated External Defibrillation (AED) trainers in Thailand due to the cost of the imported equipment. An AED trainer, manikin, and manikin controller system was locally developed which can display training results to help reduce the cost. Methods This is...

Emergency department (ED) usage by older adults tends to be a major health issue due to increase in aging population and their health fragility. Currently, there is no study comparing ED data of older adults with those of younger population in Southeast Asia. The aim of this study was to explore the epidemiologic data of elderly who visited the ED...

Objective: This study aimed to evaluate how BLS courses affect primary school students' knowledge, attitudes, and life support skills; investigate how medical students' knowledge and competence in teaching BLS can improve by serving as instructors. Methods: This experimental study was conducted in a rural primary school. First-year medical stude...

Background: Basic life support (BLS) is pivotal for the survival of patients in cardiac arrest outside the hospital. Knowledge about BLS in compulsory schools’ students practically reflects the curriculum in teaching BLS. Objective: To investigate the level of basic knowledge on BLS among pre-university students as well as to determine the characte...

Background: ITEMS (information technology for emergency medical system) is a software program designed to help emergency medical dispatchers identify the level of emergency condition and assign proper response team to the scene. Objective: This study aimed to explore uses and problems related to ITEMS. Method: This was a cross-sectional survey rese...

Objectives Non-traumatic headache accounts for up to 4.5% of all patients presenting to the emergency department. Non-traumatic headache is generally classified into two categories: primary and secondary headache disorders. Differentiating secondary from primary headache disorders is essential. SNOOP4 is known as a mnemonic for suggesting clinician...

To test the hypothesis that an impaired mitochondrial function is associated with altered central venous oxygen saturation (ScvO2), venous‐to‐arterial carbon dioxide tension difference (delta PCO2) or serum lactate in sepsis patients. This prospective cohort study was conducted in a single tertiary emergency department between April 2017 and March...

Survival of out-of-hospital cardiac arrest of traumatic patients who received medical care from emergency medical service Abstract Background and Rationale: Thailand had the highest road traffic mortality in Southeast Asia at 32.7 out of every 100,000 people. Chiang Mai was the 5 th ranking in Thailand. Emergency medical service system (EMS) can he...

Study Objectives: The use of cardiopulmonary resuscitation (CPR) feedback devices and automated external defibrillator (AED) trainer can be beneficial in basic life support (BLS) training. Nevertheless, instructors need to operate 2 different devices at the same time, causing difficulties and learning gap due to unrealistic environment. Training de...

Study hypothesis: An increased mitochondrial oxidative stress has an association with blood lactate, ScvO2, delta CO2, and survival rate in patients with sepsis. Methods: This was a prospective, observational study. Patients who visited the emergency department with suspected sepsis were included. Blood lactate, central venous oxygen saturation (Sc...

Objective To assess the correlation between duration to achieve therapeutic goals in Early goal-directed therapy (EGDT) protocol in emergency department (ED) for severe sepsis or septic shock patients and in-hospital all-cause mortality as primary outcome. Methods A retrospective descriptive study was conducted in ED, Maharaj Nakorn Chiang Mai Hosp...

Learning-by-teaching strategy of FA-BLS training for medical students is an effective method to improve the knowledge and practice the needed skills. Medical students, both the trainers and the trainees, can benefit from the learning-by-teaching strategy curriculum. Addition of this curriculum as a regular training course in medical school is enco...

Using Emergency Medicine (EM) residents to teach First Aid and Basic Life Support (BLS) for university students was effective as using an emergency physicians, It also enhancing teaching skills for in-training EM residents as a real practice challenging for them.

Objective To study the use of “S-I-C-C-A”, a new bedside ultrasound approach protocol, which was developed in order to rapidly identify the cause of shock and guide for man- agement of these patients in emergency department within the first 30 minutes of arrival. Methods We conducted a prospective historically-controlled study of patients age ≥18...

Objective: The current practice in treatment of severe sepsis and septic shock is to ensure adequate oxygenation and perfusion in patients, along with prompt administration of antibiotics, within 6 hours from diagnosis, which is considered the "golden hour" for the patients. One of the goals of treatment is to restore normal tissue perfusion. With...

Background: Severe traumatic brain injury can cause intracranial hemorrhage, resulting in subsequent functional disability or death. Prognosis in patients with head injuries depend on a variety of conditions such as age, size and location of the blood clot, deterioration of consciousness and intracranial pressure. Current studies aiming to find the...

The National Institute for Emergency Medicine specifies a criteria for triaging patients into five levels according to the urgency of treatment needed. Canadian Triage and Acuity Scale (CTAS) is a five-level triage tool used worldwide that can rapidly assess patients, and is proved to be accurate and reliable. However, no study in Thailand has conf...

Background : The most common problem encountered in clinical practice is lack of experience in estimating the child’s weight, resulting is problems with medication dosing and proper equipment selection. Application of Broselow tape® can help solving this problem, but the accuracy of its use in northern Thai children remains unclear. In clinical pra...

Management of patients with severe hypertension without progressive target organ damage remains controversial. Some guidelines mentioned oral anti-hypertensive medication as a treatment to reduce blood pressure in the emergency department, while others recommended against such treatment. To review the management ofpatients with severe hypertension...

Management of patients with syncope in the Emergency Department now focuses on identifying patients who will be at future risk of serious morbidity. Among the risk stratification scoring systems being used were the San Francisco Syncope Rule (SFSR) and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score. To assess the accuracy of SFSR...

Background: Acute illness and accidents are the leading cause of death in Thailand. Developing a good systematic pre-hospital care can help reducing morbidity and mortality. To achieve this goal, the Ministry of Public health has issued a policy for all hospitals in Thailand to set up an Emergency Medical Service (EMS) system. Nevertheless, this se...