How the ARCH Project has Contributed to the Development of the ASEAN Regional Collaboration Mechanism on Disaster Health Management.

OBJECTIVE: This paper aims to clarify how the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) strengthened regional collaboration mechanisms on disaster health management (DHM) in ASEAN. METHODS: The political process and the relevant documents of the ARCH Project were reviewed. RESULTS: The ARCH Project established the Regional Coordination Committee as a coordination platform for providing strategic direction to the project and strengthening the regional coordination of DHM. Also, the Project Working Groups and Sub-Working Groups were set up as implementation bodies for the project activities with representatives of ASEAN Member States (AMS). With support from DHM experts of Japan and Thailand, a series of discussions were conducted for the development of a Standard Operating Procedure (SOP) for the Coordination of International Emergency Medical Teams (I-EMTs), regional tools, and collective measures supporting AMS to overcome challenges, and thereby meeting the minimum requirements set by the WHO EMT Initiative. The progress and outputs of the ARCH Project are subsequently elevated to the ASEAN Health Sector for endorsement, the updates are further shared to the Joint Task Force to Promote Synergy with Other Relevant ASEAN Bodies on Humanitarian Assistance and Disaster Relief (JTF-HADR) for the implementation of the ASEAN Declaration on One ASEAN One Response. The initiation of the ARCH Project in July 2016 has resulted in the development of the ASEAN regional collaboration framework, including the establishment of the Regional Coordination Committee on Disaster Health Management (RCCDHM), the SOP for ASEAN I-EMT coordination, and regional tools, such as forms for Medical Record for Emergency and Disaster and Health Needs Assessment. Moreover, further discussions on ASEAN Collective Measures that aim to support AMS to meet the WHO EMT minimum standards and strengthening I-EMT coordination capacity were also conducted. As adopted by the ASEAN Health Ministers Meeting (AHMM) in 2019, the RCCDHM was established as one of the mechanisms to operationalize the Plan of Action to implement the ASEAN Leaders' Declaration on DHM. CONCLUSION: The contribution of the ARCH Project to strengthen the ASEAN regional capacity in DHM has enhanced the regional coordination platform, with a formalization of RCCDHM as ASEAN's official regional mechanism, and of the on-going integration process of the SOP for EMT coordination into the ASEAN SASOP.

Acupuncture Treatment for Acute Ankle Injury in the Emergency Department: A Preliminary Case Report.

Acupuncture is an ancient medical treatment that is increasingly attracting the interest of the public. It is a complementary therapy that is widely used for management of pain, especially chronic discomfort caused by migraine, low-back pain and osteoarthritis of the knee(¹â»³). The evidence base for the effectiveness of acupuncture and its clinical applications is controversial, and although its efficacy and safety in the management of acute pain have been demonstrated, the quality of this modality is still questionable. The present study reports a case of acute ankle injury, which was treated with acupuncture. A 33-year-old man presented with acute twisted ankle injury. He had pain with swelling around the ankle, and he was experiencing difficulty in walking. His clinical diagnosis was acute ankle sprain with severe pain. Several drug treatments are used for pain control, but in this case, we used acupuncture. After treatment, his pain diminished significantly with a decrease in VAS pain level from 8 to 4 in 20 minutes. At follow-up after one month, we found no skin infection in this case.

Stability of adrenaline in ambulance and drug storage room Narenthorn Center, Rajavithi Hospital.

BACKGROUND: The stability and quality of Adrenaline medications were advocated 2 to be stored in temperature labeled at 2 degrees C to 8 degrees C at drug storage room. Thailand is located in a tropical area with the average room temperature within 25 degrees C. There was no previous study of adrenaline medication stability and quality in Thailand. OBJECTIVE: To assess the stability and quality of Adrenaline stored at room temperature in Ambulance and drug storage room of Narenthorn center, Rajavithi Hospital. MATERIAL AND METHOD: Forty vials of Adrenaline Bitartrade were stored at the temperature in each season for a period of 4 weeks. Half were stored in one Ambulance and the other half in a drug storage room. Samples were then analyzed for their appearance, pH and using stability indicating High Performance Liquid Chromatography (HPLC). RESULTS: The average temperature in the drug storage rooms were 30 degrees C, 28 degrees C and 27 degrees C in hot, rainy and cool seasons respectively; and 34 degrees C, 32 degrees C and 31 degrees C in Narenthorn Ambulance. The appearance of adrenaline was not changed as it was still clear. The average pH is 3.18 to 3.36. Adrenaline was found to be stable when storage in both ambulance and drug storage room. The percent drug remaining was 90 Ia% to 115 Ia%. There was no significant difference in between drug quality the two storage places (p = 0.792). No significant difference was found in the percent drug remaining between the hot and cool season. There was significant difference in the percent drug remaining between the rainy season from other seasons (p < 0.005). CONCLUSION: Even though the temperature in the drug storage room and Ambulance was higher than recommended storage temperature, adrenaline stability and quality were not changed when testing by HPLC.