The relationship between first aid and emergency health

First aid is the core processing link at the front end of the emergency health system. The two are in a symbiotic and complementary relationship of "immediate interception - system cover-up". They are by no means two independent modules of "emergency rescue" and "disease prevention".

People who have never experienced a real first aid scenario may find it difficult to intuitively feel this binding relationship. I have been in the community first aid volunteer team for two years. Last summer, I encountered something like this: Uncle Zhang, who was working at the chess stall downstairs in the community, originally had coronary heart disease. He was so anxious that day when he was competing for a chess move that he suddenly covered his chest and fell to the ground. There happened to be a high school student who had just received the Red Cross first aid certificate standing next to him. He first felt the carotid artery and found that there was no pulse. I immediately knelt down to perform chest compressions. Someone ran to the convenience store at the entrance of the community to get an AED that had been issued for half a year. Two defibrillations brought the heart rhythm back. I sent him to the hospital through the emergency PCI channel to have a stent placed. Later, the attending doctor said that if he were 3 minutes late, it would be useless no matter how smooth the subsequent emergency treatment process was.

There has been debate in the industry about the weight distribution between the two, and there is no absolutely unified conclusion. One group is the "pre-emergency first aid group". Most public science experts tend to this view: the number of sudden cardiac deaths in my country every year exceeds 540,000, and the out-of-hospital survival rate is less than 1%. The core problem is that the first witness does not know first aid. No matter how perfect the back-end of the emergency health system is, it cannot make up for the golden 4-minute window. Therefore, resources should be tilted towards front-end matters such as popularizing public first aid and deploying AEDs in public places. The other school is the "system support school". Researchers in emergency management mostly hold this attitude: Even if you can revive the person immediately, if there is no 24-hour stroke and chest pain center in the local area, and there is no emergency green channel opened in advance, subsequent emergency health follow-up will not be possible. The effectiveness of early-stage first aid will also be compromised, not to mention that many accidents are caused by inadequate daily emergency health education - for example, people with coronary heart disease do not know to carry nitroglycerin with them, and people at high risk of heatstroke do not know to avoid going out at noon. If an accident occurs, first aid will be half the result with twice the result.

Both views are actually correct, but the positions are different. Last year, I went to a mountain village in northern Guangdong to do emergency science popularization. The village doctor told me about a case that made a deep impression on me: There was an old man in the village who applied pesticides without wearing a mask. He felt sick and dizzy when he came home. His family thought it was heatstroke, so they fed him two large bowls of hot sugar water. Originally, mild organophosphorus poisoning could be relieved by inducing vomiting and washing the exposed skin with water. You see, the misunderstanding here essentially separates first aid and emergency health: family members neither know the early prevention of pesticide poisoning (this is the scope of emergency health education), nor do they know how to deal with poisoning immediately after poisoning (this is the scope of first aid practice). The two links are lost at the same time, which turns a small problem into a big risk.

Many people think that first aid is “a skill only used when life or death is at stake”, but this is not the case. My best friend just learned the Heimlich maneuver last month. Last week, her two-year-old baby got stuck in his throat after eating jelly, and his face turned red from holding it in. She picked him up and patted him five times in the same posture as she learned. The jelly spit out and he didn't even go to the hospital. In this scenario, first aid is no longer a bottom-line action to "save lives", but directly nip the emergency health risks in the bud. To put it bluntly, it is like giving your family's health a traffic accident insurance that takes effect immediately. You can handle minor scratches by yourself without having to go to the hospital every now and then.

Oh, by the way, during the previous COVID-19 epidemic, everyone was learning how to physically cool down children with high fevers, how to judge whether the elderly were prone to serious illness, and stocking up on antipyretics and oximeters at home. These things seemed to be "emergency health preparations", but they were essentially pre-first aid behaviors at the family level - you can't wait until the child's fever reaches 40 degrees and then think about getting antipyretics, right? These fragmented first aid skills are the capillaries at the end of the emergency health system. They may seem inconspicuous, but in practice, they are more effective than any big policy.

I had dinner with a friend from the city emergency center a while ago, and he said that their public science popularization now no longer limits the content to traditional first aid items such as chest compressions and AED use. They also include information on how to deal with hypertensive emergencies, how to wash scratches of cats and dogs immediately, and how to prevent heat stroke when going out on hot days. In essence, it extends the boundaries of first aid to the front end of emergency health, so that ordinary people can minimize risks first without waiting for 120.

In fact, to put it bluntly, first aid is the emergency health that you can reach out and touch, and emergency health is the safety net that underpins all first aid actions. Only when the two come together can we really minimize the risks of those unexpected “events.” After all, no one knows when an accident will come, so it never hurts to know more about things that can save lives, right?