Three major hospitals in Bangkok

Beginning today, our group is splitting up into smaller teams to visit 3 major hospitals in Bangkok. Each team will spend 3 days either Siriraj Hospital, Ramathibodi Hospital, or King Chulalongkorm Memorial Hospital. They will spend time with the clinical teams on the floors and clinics, as well as learn about the drug distribution process and patient care services. Below, Christina Andros, Dan Jaracz, Devon Cornfeld, Jenifer Denormandie and myself were welcomed by Dr. Surakarta Nathisuwan, PharmD, BCPS.  Later in the day, Pharmacy Deputy Director Wilmon Anansakunwatt oriented us to the hospital and coordinated a very informative first day with her pharmacy staff! 

Siriraj

Today marked our first of three days at Siriraj hospital. Siriraj hospital is the largest hospital in Thailand, housing over 2200 beds. Our day consisted of getting orientated to the hospital as well as learning about the hospital's ADR monitoring and prevention unit. The hospital has a team of pharmacists dedicated to monitoring and preventing adverse drug reactions. The unit conducts initial evaluations, followups with patients that had ADRs inpatient,investigates historic ADRs and prevents further ADRs. We initially heard a presentation about the unit itself, the objectives they had, and techniques they would use to evaluate, document, and prevent ADRs. One technique that I though was interesting was giving the patient an detailed ADR card on discharge that they could keep on person. This is similar to the med list that we use in the United States but these ADR cards give providers and patients a detailed list of their ADRs. We then proceeded to visiting a patient who required an ADR consult to identify her ADR. The patient was recovering post operation and instead we spoke to her caregiver. Using opened ended questions, the ADR unit was able to identify the ADR as most likely attributed to an NSAID. The next patient the ADR unit saw was a followup with a patient who developed a rash after receiving clindamycin  and ceftriaxone the previous day. The last patient we experienced with the ADR unit was a Thai monk with a suspected case of Steven Johnson Syndrome. The patient was being treated for a opportunistic infection with Bactrim. It was a very good and rare experience to see a case of it first hand. It looked just like all the pictures we saw in class!

Poison Control Department

After getting a tour of the medication storage facility, we visited the Poison Control Department at Siriraj Hospital. This department is run by five specially trained pharmacists that respond to all drug information questions for the entire hospital as well as respond to drug overdose and poison questions. The students first got a tour of the lab in this department which tests patients' blood and urine for certain drugs and chemicals. This lab completes over 2,700 tests per month. They then listened to multiple presentations from the pharmacists about pediatric HIV, drug information questions, poison control and drugs of abuse in Thailand. They learned about the excessive abuse of tramadol in this country and how their department works with other medical professionals to help the adolescents that have access to this.

The Grand Palace!

Sawatdee ka friends and family! Today in Bangkok, the students had the opportunity to explore The Grand Palace, known to be the residence of the beloved late King, and one of the most popular attractions in Thailand. Although the heat index indicated 108 degrees Fahrenheit, the group braved the heat and was given a tour of some of the most ornate buildings in the world!

 
Here are the Devons imitating the Demon and Monkey!

 Our tour guide

The group in front of The Grand Palace

Changing of the Guards

The Grand Palace

   
     Today we were able to explore a few of Bangkok's biggest tourist attractions. Our day included a visit to the majestic Grand Palace.The Grand Palace complex includes the royal residences, throne halls, government offices as well as the Temple of the Emerald Buddha. The landmarks of the complex include the Chakri Maha Prasat Hall and The Temple of the Emerald Buddha. The hall was originally used as the royal residence but today is used for state banquets. The temple is considered the most sacred Buddhist temple in Thailand, so sacred that photographs inside the temple are prohibited. Both are essential to Thai culture and history.

      While millions have visited the Grand Palace, today's visit was very unique as it was the very first day the palace has been opened for tourism since the passing of his majesty the king. Since the king's death in mid October, the palace complex has been closed to tourist as the nation of Thailand mourns it's loss. The king's body continues to remain at the Chakri Maha Prasat hall as the mourning period continues. The historic experience made us not only travelers but also historians. The end of our visit gave us another unique experience, as we were able to see motorcade carrying members of the roya family arrive at the palace for a ceremony.
 

The Reclining Buddha

After visiting the Grand Palace, we took a short (but very hot) walk to Wat Pho, a Buddhist temple in Bangkok. Wat Pho is also known as The Temple of the Reclining Buddha. We walked throughout this temple and took in the beauty of the massive sculpture which barely fit inside the room.










Afterwards, the students explored a natural Thai medicine fair set up outside the temple and were able to try some of the herbs and drinks the Thai people had prepared.









Christina and Daniel befriended a scout of the World Scout Foundation of Thailand and were pinned as honorary good scouts with an orange ribbon.

Grand Palace

A group shot from the Grand Palace..