The relationship between first aid and emergency health

First aid is not a branch supplement of emergency health, but the frontline core line of defense of the latter. The two are a two-way linkage between "first-time on-site treatment and professional medical follow-up support", which together form a complete protection chain under sudden health risks. This is the most intuitive conclusion I have come to after four years of grassroots emergency science popularization.

A while ago, I was doing a spring first aid drill in the community, and I happened to encounter a real emergency: 62-year-old Aunt Zhang had a heart attack when she came back from shopping for groceries and walked to the door of the community. Her face was as white as paper, and she fell to the ground. There happened to be a retired emergency nurse standing next to her. Without saying a word, she knelt down to perform chest compressions. The property manager ran back to get the AED distributed by the community last year. Aunt Zhang resumed breathing on her own just after the defibrillation. When 120 was called to the hospital, the emergency doctor said that if she were delayed by 3 minutes, there would be a high probability of irreversible brain damage even if she was rescued.

Don't think this is an exception. There are actually two voices in the academic community regarding the relationship between the two: one is the "standard front-end" group, which believes that first aid must strictly comply with the guidelines of the AHA (American Heart Association). Only those who have received systematic training and certificates can perform on-site treatment, otherwise it will cause confusion in subsequent emergency medical treatment. ； The other school is the "scenario adaptation school", which is also the view I personally prefer - ordinary people do not need to pursue 100% compliance with operational standards for first aid. It is enough to dare to use it and minimize the damage. After all, the core of emergency health is "reducing losses", not "perfect treatment".

Many people have misunderstandings about the relationship between the two. They always think that "emergency health is a matter between 120 and the hospital. I am not a doctor, so knowing first aid is useless." Seriously, that's not the case at all. Emergency health covers the entire process from risk occurrence to full recovery, and the "blank window" of 5-15 minutes before professional medical forces arrive at the scene can only be filled by people on the scene using first aid skills. Just like someone suffering from heat stroke outdoors in the summer, you first drag the person to a cool place, untie the collar, and feed him two mouthfuls of light salt water. This is first aid, and it directly determines whether the subsequent emergency medical treatment can be done by just prescribing Huoxiang Zhengqi water, or whether he has to go to the ICU to rescue heat stroke. I once met a young man who had a fish bone stuck in hot pot. He swallowed it hard and cut through his esophagus. When he arrived at the hospital, he was already coughing up blood. In fact, as long as there was one person at the table who knew the Heimlich maneuver, he could take out the fish bone in 10 seconds, so he would not suffer the consequences later.

The most common question I get asked when doing science popularization is “I don’t have a certificate, will I be held responsible if I am rescued?” ”This was actually a point of great controversy before: Some people think that the entry threshold for first aid should be raised to prevent non-professionals from indiscriminately rescuing problems. ； Some people also think that the threshold for participation in first aid should be comprehensively lowered so that more people dare to get started. Now there is actually a relatively balanced solution: on the one hand, the Civil Code clarifies the immunity of rescuers in good faith. As long as they do not cause harm intentionally, they do not need to be held liable. ； On the other hand, what is being promoted now is "fool-style first aid". When the AED is turned on, a voice will teach you step by step how to apply the electrodes and what buttons to press. The Heimlich maneuver just remembers the "rock, paper, scissors" formula. Even elementary school students can learn it, and there are not so many advanced thresholds at all. Last year, a young man on Metro Line 2 suffered from ventricular fibrillation. The patrolling security guard, who had never passed the first aid certificate, followed the AED's voice prompts and defibrillated him twice to save him. Later, he said, "My hands were shaking at the time, but I could do whatever the machine said."

To use an inappropriate analogy, emergency health is like a city’s fire protection system. There are fire stations, fire hydrants, and a complete firefighting and rescue plan. First aid is the small fire extinguisher in your home and the fire sprinkler in the corridor. If there is really a fire, in the ten minutes or so that you wait for the fire truck to arrive, you can spray it twice with a fire extinguisher. Maybe you can put out the small fire in the bud and prevent the whole building from burning down. Data from last year's China Cardiovascular Disease Report can also support this: in areas where public first aid equipment has been deployed and popular training has been conducted, the success rate of rescuing sudden cardiac death outside the hospital has increased from less than 1% before to 11.3%. This extra 10 percentage points is all earned by on-site first aid.

Of course, this does not mean that first aid can be a universal solution. I have encountered someone suffering from a sudden cerebral hemorrhage before. The family members shook the patient around and gave him antihypertensive drugs, which actually aggravated the bleeding. This also just confirms the linkage between the two: if the first aid is done correctly, it will pave the way for subsequent emergency medical treatment, but if it is done incorrectly, it will hinder the progress. Therefore, basic science popularization is still necessary. It does not need to learn the level of medical care. At least you can distinguish what situations can be used and what situations should not be acted upon.

After all, emergency health provides a bottom line for everyone, and first aid advances this bottom line by more than ten minutes. These ten minutes are not long, maybe you are just waiting for milk tea and watching short videos, but if you really catch up with something, these are the most precious ten minutes in your life.