Dr. Kanit Wittayavanichai , MD. FRCST.

Dr. Kanit Wittayawanichchai, Head of the Surgery Unit, Thammasat University Hospital

From the bus fire incident on Vibhavadi Rangsit Road on October 1, 2014, which was a tragedy with many deaths and injuries, there are reports about the care of patients by doctors.

The first case was 9 years old. Her body was burned on her face and arms at a level of severity 2-3, approximately 30 percent. Her vital signs were normal, but she still needed to be intubated. Her eyelids, conjunctival surface, and cornea were all abraded and clouded. She was treated with a procedure to place the amniotic membrane over the entire conjunctival surface, helping to protect and restore damaged conjunctival tissue and cornea. In addition, she was given intravenous antibiotics and mineral replacement, along with antibiotics to prevent infection and reduce inflammation.

Another patient, aged 7 years, had approximately 20 percent burns on his face, hands, and both arms. His vital signs were normal, but he still needed to be intubated. An endoscopy of the airway revealed that the airway was swollen and red, with sputum mixed with soot. He was initially given intravenous antibiotics and electrolyte replacement. In addition, he had a rather deep wound over his eye, which required extensive eye lavage and a procedure to place the amniotic membrane, along with antibiotics to prevent infection and reduce inflammation.

Both patients have received continuous care from specialist doctors in each area, especially in terms of vital signs, swelling, and inflammation. The next 3-5 days are still critical, and the parents have been talked to and reached an understanding. Initially, it is still not possible to assess whether the two patients can still see normally or not. We will have to wait until 3-5 days have passed and the ventilator is removed before we can communicate with the patient.

Dr. Kanit Wittayawanitchai, a plastic surgeon, said that the first 24 hours for a burn patient is considered a critical period. It has been found that a 9-year-old female patient has high blood pressure in her hand and may need surgery today (October 2, 2024) to relieve the pressure and allow her to function normally in the future.