Thai cave boys in hospital

Wuzzie · Jul 11, 2018

Thailand cave rescue: First pictures emerge of boys in hospital - BBC News
There's a video of the Thai cave rescue boys in a Thai hospital that is fascinating. First of all, why the elaborate isolation protocol? What about being in a cave would warrant this?
It appears that Thai hospitals are strict about visiting. In America my feeling is that immediate reunification with family would be a priority.
I notice that this is more of a ward system with many patients sharing the same room. Everyone is wearing masks, a practice that seems to be more common in east Asia.

They were exposed to bat and bird feces that carry some fairly serious infectious agents as well as fungi from the damp cave environment. They are being isolated until they are evaluated for these illnesses.

In the earlier days of the rescue they did not identify the boys or re-unite them out of concern for the families of the boys that were still in the cave. They weren't absolutely sure they would be able to get all of them out. They did not want to panic the parents. At first I thought it was a horrible idea but then I thought about it a bit and could understand why they did it.

MunoRN, RN · Jul 11, 2018

The aggressive isolation procedures are reported due to a concern of "cave disease", aka histoplasmosis, even though just standard precautions are the generally accepted standard for patients with histoplasmosis.

Part of the reason for the excessive infection prevention measures might have something to do with Thailand being the world's most popular medical tourism destination, any chance to publically promote a squeaky clean image of their facilities is good PR.

Flatline, BSN, RN · Jul 11, 2018

I was recently in Thailand touring several of the hospitals throughout the country which was absolutely fascinating. I am sure some of this is for genuine concern due to their exposure to some pretty nasty diseases as was discussed earlier but much of it may be for PR as was also discussed.

Many of the hospitals are highly specialized and sponsored and so their funding can vary greatly. For example, there is a monk hospital, police hospital, etc. Each of the members of the royal family sponsors a different hospital as well and will only go to that particular hospital so depending on the royal member and their status the hospital may have more or less benefit.

With the level of attention that hospital is receiving you can be assured that the boys were not only given a private room to be together but almost certainly their own wing of the hospital. Some of the more wealthy expat and foreigner hospitals would shut down floors routinely when VIPs arrive.

Thailand is very unusual in southeast Asia in that the care provided there at some facilities will meet or beat U.S. standards while some are definitely from a developing country but overall providing a higher level of care than most of Asia (and Europe for that matter). Many of the physicians I met were U.S. or British trained with more than a few coming via Mayo.

A Thai prince (the grandfather of the current king) was a physician and brought a lot of attention to Thai healthcare.

Wuzzie · Jul 11, 2018

Thailand is very unusual in southeast Asia in that the care provided there at some facilities will meet or beat U.S. standards while some are definitely from a developing country but overall providing a higher level of care than most of Asia (and Europe for that matter). Many of the physicians I met were U.S. or British trained with more than a few coming via Mayo.

Funny you should say that. I was noticing the modern beds (nicer than ours) and how CLEAN and up to date the hospital looks.

**canoehead, BSN, RN** · Jul 14, 2018

Even without the contagion issues, its probably wise to keep a lid on who comes and goes from the room. The media would be packing the hospital if they thought they could interview them. Masks help keep the boys anonymous as well, if they wish it.

blondy2061h, MSN, RN · Jul 14, 2018

What I find interesting is not a single IV bag to be seen for boys that were dehydrated, malnourished; and probably needing antibiotics.

Night__Owl, BSN, RN · Jul 14, 2018

I also don't see any obvious personal effects in the pictures either, or any family members around in iso garb (which they have apparently been allowed to do at the time of the pictures.) The simplest explanation would be that the photos are heavily "posed" to look as neat, clean and happy as possible.

MunoRN, RN · Jul 14, 2018

What I find interesting is not a single IV bag to be seen for boys that were dehydrated, malnourished; and probably needing antibiotics.

That might be because none of them had any inability to eat or drink to fix either of those problems, and they had no indication for antibiotics.

blondy2061h, MSN, RN · Jul 14, 2018

That might be because none of them had any inability to eat or drink to fix either of those problems, and they had no indication for antibiotics.

That's what I figured but you can bet in the US they'd be on IV something

Flatline, BSN, RN · Jul 16, 2018

Since most interventions and medications are directly paid for by the family at the point of care treatment can be conservative. In the U.S. and Western Europe we throw in an IV with KVO fluids because it makes us feel good. When your family has to pay for the IV, the IV tubing, the dressing, and the fluid by going down to the pharmacy and paying cash for them and then bringing the supplies back up for the nurse to use you better have a good reason.

MunoRN, RN · Jul 16, 2018

That's what I figured but you can bet in the US they'd be on IV something

If a US hospital knew ahead of time their patient care was going to get the same type of coverage, they'd probably all be on ECMO, CRRT, Total hearts, etc, at the very least we would make sure the machine that goes "PING" is there:[video=youtube_share;arCITMfxvEc]