Thailand 2002: An Ocean Away, But Close to the Heart

We participated in three days of conferences, beginning April 5, 2002. Our first day held the 7th Teaching Course in Cardiac Catheterization, focusing on acute coronary syndromes. During the next two days, we attended the 4th Thai Cardiovascular Invasive Society (TCIS) and Society of Invasive Cardiovascular Professionals (SICP) joint RCIS Review Course and Annual Meeting for TCIS. Three Days of Education in Thailand The 7th Teaching Course in Cardiac Catheterization. On Friday, April 5th, Dr. Douglass Morrison, Director of the Cardiac Catheterization Laboratory at the Department of Veterans Affairs Medical Center in Tucson, Arizona, was the keynote speaker. He presented on current medical trials, summarizing them clearly and adding a historical perspective. After his presentation, in recognition of his contributions and support to Cardiology Division at Bhumibol Adulyadej Hospital RTAF, Dr. Morrison was presented with a plaque by Air-Vice Marshall P. Prateeprat. Many Thai cardiologists presented in English regarding current theories on vulnerable plaque. Complex and controversial case studies were presented and discussed by a panel of local and international experts. Dr. Gumpanart Veerakul presented on the experience of Bhumibol Adulyadej Hospital RTAF regarding revascularization therapy during myocardial infarction by PCI in a hospital without cardiac surgery. His hospital was the first in Thailand to employ this aggressive treatment. Dr. Veerakul completed Cardiology and Invasive Cardiology Fellowships at the University of Colorado School of Medicine. He also studied with Dr. Morrison while on rotations at the Denver VA Medical Center. It was during this period that Dr. Veerakul first met Charles Barbiere, RN, RCIS. With Mr. Barbiere’s help and the help of the SICP, Dr. Veerakul, Dr. Sathienchoak, and Thai cath lab staff from around the country established TCIS. Other SICP officers who have contributed to this effort are Chris Nelson, RN, RCIS and Tom Maloney, RTR, RCIS. TCIS is Thailand’s version of the SICP. It has about 250 members and is quite active. Both societies have collaborated on standards of care and scope of practice issues. Charles Barbiere has been instrumental in fostering the relationship between the two societies. He is both a past president of the SICP and a consultant to TCIS. Annual Meeting and Joint RCIS Review Course. The Nurse and Technologist Symposium was the 4th Annual Joint RCIS Review Course co-sponsored by the TCIS and SICP. It was held April 6“7th, 2002 at the Central Chest Hospital in Bangkok. The conference included lessons on: Fundamental hemodynamics; Lab safety; Ergonomics; Information management; Emerging technology reviews; An electrophysiology review (including biventricular pacing); News of multiple research projects underway at various labs in Thailand. The conference was conducted in both English and Thai. Very little interpretation was necessary, as the accepted medical language for conferences is English. Notably, one of the guests was the President of Thailand’s Nursing Council. Discussions were held regarding the basic and advanced needs of the Thai people, including the need for trained professionals in the cardiac catheterization laboratory. Suggestions for care initiatives to treat rural populations were also discussed. Both the TCIS and SICP promoted recognition of the RCIS credential (Registered Cardiovascular Invasive Specialist) as evidence of a minimum level of cath lab knowledge. Review courses, followed by the Cardiovascular Credentialing International (CCI) RCIS examinations, have already taken place in Thailand. Mr. Barbiere facilitated these sessions and was also presented with a special award for his extensive work. Visiting Bangkok’s Central Chest Hospital Our group was also able to tour the cardiac imaging center at Bangkok’s Central Chest Hospital. We were guided by the Chief of Cardiology, Dr. S. Tansupaswadikul. This hospital has two Siemens Hicor cath labs with Siemens physiologic monitors (Iselin, NJ). The archival system is filmless and uses CD-R for storage. Disposable equipment was well-stocked and of current technology. The only difference was the presence of a resterilization room. In Thailand, catheters are cleaned and tested for reuse. The hospital also has cardiac surgery capacity. Central Chest Hospital’s cath lab performs approximately 1500 caths/year. Similar procedures are undertaken as in U.S. cath labs, with the exception of increased numbers of balloon valvuloplasty. At Central Chest Hospital, two physicians, one operator, and one scrub member staff the room. An RN and a RTR complete the staffing pattern. The RCIS credential is slowly taking root in Thailand. They do not have CVT schools yet, but there is growing interest in is setting up a CVT program and publishing a textbook for Thailand’s cath labs. A Final Note The spirit of the Thai people was playful and friendly. I couldn’t help but feel welcome. I was also impressed by the advanced level of care delivered in Thailand. This country also faces fiscal challenges, much as we do in the U.S. The officers and members of TCIS are to be commended for their dedication and persistent efforts to provide quality education to their members. Through these efforts, the whole community advances, with the end result of improved patient care. I would also like to thank Dr. Punee Sathienchoak, President of TCIS, and Dr. Gumpanart Veerakul, for the invitation to share my thoughts with the TCIS membership. Cath lab professionals who live overseas or work in small rural hospitals often find educational opportunities inaccessible. Some are seeking to become registered (RCIS) but don't know how to prepare for it. Spokane Community College is currently offering an online course, facilitated by Wes Todd. Two review courses are underway which cover major areas of the RCIS exam. Students may begin during any quarter. Each of the two RCIS Review classes is 11 weeks long, and has a different technical emphasis. The contact information to enroll is: Non credit registration at: Tel. (800) 248-5644, ext. 8010, or (509) 533-8010, direct.

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