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BANGKOK 21 July 2019 06:55
userabcd

Motorcycle accident and patient comatose

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Posted (edited)

Yesterday afternoon my wife received a call that a distant relative (14 years old) had a motorcycle accident in Udon T. He was riding a motorcycle with no helmet, no license (yes all not legal) to a local store and was making a turn across the road to the store when a car coming from behind had hit him. Photos show the youngster lying in the road with this guy looking at him unconscious in middle of the road.

 

Bystanders called an ambulance and he was taken to a private hospital in Udon for an Xray (this is what the parents say) The doctor there diagnosed that he had blood on the brain and stated that an operation had to be performed but they apparently said they could not treat him as they did not have enough material and transferred him to a government hospital which they stated had the facilities and material to treat him? 

 

The doctors at the govt hospital, looked at the Xray and said there was no bleeding on the brain. The patient was placed in a ward where there are many other comatose patients and was put on a bed and given oxygen where he is still like that, nothing further done to him. From what my wife tells me he was very slightly responsive to family talking and touching him yesterday but today this is diminished.

 

My question is if there is any medical advice anyone could provide for such type of patient and injury which the doctors should be motivated to perform which could be relayed to the family.

Edited by userabcd
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If you have the money then talk to some medical specialist maybe in a nearby private hospital.

 

I think it's very unlikely that the doctors in a public hospital will listen to some internet advice.

If you want to motivate try money or some connection to some local influential person. Sorry, that's hard but realistic.

 

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29 minutes ago, Sheryl said:

CT scan should be done if it has not already been.

 

Is it possible the "Xray" was actually a CT? That would be more usual. It is not possible to determine if there is a blood clot present from an Xray.

 

What level of government hodpital is this? He needs to be at a regional level one and under the care of a neurosurgeon.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

Dear Sheryl,

 

Thanks for the reply.

 

I said to my wife that it is probably a CT scan that was performed for this condition. They paid 9000 Baht for this Xray so it probably was a CT Scan.

 

The govt hospital is the main one in Udon Thani city which I am told patients from all the area go to so it maybe the regional level one hospital to which you refer.

 

The family will check if the young guy is receiving treatment under supervision of a neurosurgeon but I'm hearing them say it's the weekend and they were told the doctor will only be available on Monday?

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17 minutes ago, userabcd said:

They paid 9000 Baht for this Xray so it probably was a CT Scan.

They didn't pay this themself, this was either paid through the compulsary insurance of the bike or through the 30 THB scheme.

 

30 minutes ago, userabcd said:

The family will check if the young guy is receiving treatment under supervision of a neurosurgeon but I'm hearing them say it's the weekend and they were told the doctor will only be available on Monday? 

According to my GF, who worked at another government hospital in Udon Thani, the hospitals have doctors on standby, and even if the doctor is not on standby they would try to get him in if it is really required. If they would be unable to get such a doctor they would transfer the patient to a hospital which does.

So in your case most likely the doctor who diagnosed the patient didn't see a need to consult with a neurosurgeon immediately

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Posted (edited)

Neurosurgery at Udon Thani provincial hospital is quite good. 

The X-ray must have been a CT (if it cost 9000). Most private hospitals in Udon would not be in position to treat a child with suspected intracranial bleeding in a CT scan (treatment is not necessarily an operation,  but a neurosurgeon should be consulted). The private ones who could handle this are Bangkok Hospital and Aek Udon (probably better).

Dr Somsith is an experienced neurosurgeon, working in the provincial hospital. If needed he works at Aek Udon. It is certainly easier (and more expensive) to access him through Aek Udon.

There are other neurosurgeons, too. 

 

If the consciousness of the patient deteriorates that is not a good sign. 

It must be reported to the nurses, and a doctor (not necessarily a neurosurgeon) should examine the patient to confirm it.

If confirmed they may want to repeat the CT scan to check if an operation has become necessary. 

 

I doubt much will be done during sunday night but relatives should be there tomorrow early morning.

Edited by uhuh
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Many years ago a young family member had a symilar motorbike accident and was placed in a bed, given blood tranfusions and leg plastered.

The short story is, when I got to see him and look at the x-ray, he had both the tibia and fibia broken, not reset and just put in plaster, bleeding away.

I arranged with (Convent hospital Bangkok), to send down an ambulance (at midnight) to pick him up. He was operated on, leg pinned and he lived.

 

So the question is, how much trouble do you want to go to to get this person to competent medical help?

Maybe the hospital is doing all it can.

You have to go and assess the situation for yourself and make your decision.

 

Sorry, I didn't see all the other posts. I only saw your initial post that I responded to.

 

 

 

 

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Government Hospital in Udon Thani is a major facility. I would recommend you to discuss with the MD dorecly whether there is any incracerebral hemorrhage or any indication for surgery. Should you still doubt in MD opinion, you may seek consultation and taking CT Brain result to other doctor. Moreover, you should asses the patient consciousness if he is getting better there is signs of improving. If he has drownsiness or panda mark in eyes, that might be other issues to discuss with neurosurgeon. Transfer to Bangkok is taking more risk during transfer and incecessary cost unless the patient covered by travel insurance or health insurance. If you, please contact your insurance.

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Queen Sirikat in Khon Kaen is a good hospital.

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4 hours ago, Sheryl said:

 

Upcountry locations especially, large government hospitals are best. And when it comes to motor vehicle accidents/trauma that would be true in Bangkok as well.

 

Yes, few upcountry locations have private hospitals that are as good or better than the government hospitals.  Udon is one of them. The one place where private hospitals are really much better is Pattaya.

 

In Bangkok, victims of vehicle accidents are often brought to the Police hospital. There are many better hospitals than this,  public and private

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