1. Association between Response time and Mortality in Drowning Patients in Thailand Mr.Phichet Nongchang Dr PH 567110001-5 Faculty of Public Health, Khon Kaen University

2. INTRODUCTION INTRODUCTION Injuries account for nearly 10% of total global mortality. Drowning is the 3rd leading cause of unintentional injury death, accounting for 7% of all injury-related deaths, low- and middle-income countries account for 96% of unintentional drowning deaths (WHO)

3. Drowning In Thailand 2008, drowning was the second cause of death in injuries (4,065 cases)

4. INTRODUCTION INTRODUCTION Emergency medical services (EMS) Response time effected improving patient outcomes. It is not yet clear for Thailand

5. To determine association between response times and mortality in drowning patients in Thailand OBJECTIVE OBJECTIVE

6. MATERIALS AND METHODS Cross sectional analytical Thailand EMS database. National Institute for Emergency Medicine (NIEM) Across country (except Bangkok) 2011-2012

7. Study Outcome The primary outcome: mortality of drowning on emergent patients (out-of-hospital) Independent variables: response time Scene time, Transport time CPR, Gender, Age, Region

8. Statistical Analysis Statistical analysis by Stata version 12.0 Descriptive statistics (frequency and percentage) multiple logistic regression Odds Ratios, 95% Confidence Intervals, and p-value.

9. RESOULT Total number of ALS service case (n = 437,770) Drowning Patients (n= 2,047) Drowning Patients (n= 2,047) Emergent of Drowning Patients (Red Code) (n=1,255) Emergent of Drowning Patients (Red Code) (n=1,255) Exclude with other case (435,723) Excluded with Urgent, Non-urgent and other (792)

10. Demographic Characteristics Demographic Characteristics

14. CharacteristicN% Response times (Mean: SD) 1,238 14.0: 16.8 Scene times (Mean: SD) 1,058 9.7: 19.8 Transport times (Mean: SD) 1,182 11.3: 10.8 Death on drowning (Out-of-hospital)1,24313.8

15. Multivariable Analysis CharacteristicOR Adjust 95%CIP-Value Response times 1.010.99 - 1.030.255 Scene times 1.01 1.01 - 1.020.001 Transport times 1.030.99 - 1.070.169 Male 1.230.60 – 2.510.575 CPR 4.532.36 - 8.71<0.001

16. Multivariable Analysis CharacteristicOR Adjust 95%CIP-Value Region Central1 0.007 East0.21 0.07 - 0.62 Northeast0.55 0.28 - 1.08 North0.15 0.03 - 0.71 South0.33 0.10 - 1.07

17. Multivariable Analysis CharacteristicOR Adjust 95%CIP-Value Age Less or equal 121 0.013 13 - 240.39 0.11 - 1.32 25 - 361.41 0.56 - 3.46 37 – 481.19 0.52 - 2.71 49 – 540.87 0.20 - 3.72 55 – 661.70 0.68 - 4.26 67 or greater0.92 0.19 - 4.44

18. DISSCUSSION

19. CONCLUSIONS Response times was no association mortality in emergent drowning Patients in Thailand Further study should be conducted to the pre-hospital factors effect survival of drowning, and the effectiveness of CPR for drowning survival.

20. THANK YOU for your attention