The reporter's survey found that the success rate of pre-hospital first aid is low, and the masses have little understanding of first aid knowledge
To save lives, how can we not miss the opportunity?
● Many patients who come to the emergency department can avoid critical situations through the first aid of themselves, their family members or the people around them before the hospital.
But in practice, the success rate or effect of pre-hospital first aid in our country is not satisfactory, and even some worse cases are caused by wrong pre-hospital first aid methods.
● Students' first-aid knowledge and skills training remain on the surface similar to "books", lack of practical drills, lack of confidence and fear to act when encountering emergencies.
The public does not have enough legal knowledge about whether the rescue behavior will be held responsible, and they have doubts about the exemption of the rescue behavior. Some media have one-sided and negative publicity about the case for the sake of blogging. Many people are willing to rescue with love. The contradictory phenomenon of fear of taking responsibility and not taking action is widespread, thus affecting the public's enthusiasm for first aid behavior
● All kinds of schools should take medical first aid knowledge and skills training as the special education content of local courses, and under the guidance of professional organizations, carry out targeted training suitable for the actual situation of the school and the characteristics of students, so as to improve students' safety awareness and self-rescue and mutual rescue ability.
The curriculum for first aid education should also be determined through legislation at the national level, and first aid specialists should be added in public places and mass activities.
□ Zhang Shoukun, a trainee reporter of this newspaper
□ Our reporter Chen Lei
At 10:00 p.m. on September 3, there were still people coming and going in the emergency department of a tertiary hospital in Tianjin. The emergency room was full of family members of patients who were anxiously waiting. There were more than a dozen patients in the corridor of the emergency room who were infusion.
The "Rules of Law Daily" reporter saw that in less than an hour, three stretchers were lifted from the ambulance, and one patient got on the ambulance and was transferred to other hospitals.
Lu Xiao, deputy chief physician of the Emergency Department of the Second Affiliated Hospital of Zhejiang University School of Medicine, told reporters that in general, patients who go to the emergency room include critically ill patients and patients with mild symptoms.
Critically ill patients will enter the rescue and resuscitation room as soon as possible. These patients mainly suffer from severe trauma, such as car accidents, high-speed falls, and some cardiac and respiratory arrests. The most common ones are myocardial infarction, cerebral hemorrhage, etc., and some ordinary emergency patients need to be treated in the emergency room, such as acute gastroenteritis, intestinal spasm, gastric ulcer, etc.
From September 1st to 7th, when the reporter visited five hospitals in Tianjin and Beijing, we saw that no matter it was day or night, whether it was a holiday or a weekday, the emergency room of the hospital was always overcrowded, and sometimes the corridor of the emergency center and near the exit. There are also people who can't fit in the infusion.
According to the doctors and experts interviewed by the reporter, in fact, many patients who come to the emergency department can avoid critical situations through the first aid of themselves, their family members or the people around them before the hospital.
But in practice, the success rate or effect of pre-hospital first aid in our country is not satisfactory, and even some worse cases are caused by wrong pre-hospital first aid methods.
On September 10, it was the 23rd World First Aid Day. The theme of this year's First Aid Day was "Learn First Aid for Life, and Accompany Us with First Aid".
How well do people know about first aid knowledge, and what shortcomings does social first aid currently face?
How can we improve the first aid awareness and level of the whole society?
Reporters launched an investigation.
More patients in need of first aid
Pre-hospital first aid is necessary
On January 7 this year, the Emergency Center of Wenzhou City, Zhejiang Province released 2021 pre-hospital first aid data: 122,927 police were received, 53,131 trips were taken, and 39,488 patients were treated.
In April, 120 Big Data of Wuhu City, Anhui Province released statistics. In the first quarter of 2022, the Wuhu City 120 Emergency Center received a total of 55,346 calls, an increase of 8.45% from the previous quarter, and 9,043 trips, an increase of 3.49% from the previous quarter, to treat patients. 8959 people, an increase of 3.83% over the previous quarter.
Wei Bing, deputy chief physician of the emergency department of Beijing Chaoyang Hospital (West Hospital), told reporters that in addition to trauma, cardiovascular and cerebrovascular diseases and respiratory diseases, such as myocardial infarction, angina pectoris, coronary heart disease, etc., also include cerebral hemorrhage and cerebral infarction, which account for Most situations in the emergency room.
There are also more common upper respiratory tract infections when the seasons change, including chronic emphysema attacks, and some patients transferred from other hospitals.
Late one night, a couple in their 50s came to the emergency room.
The patient's wife told Wei Bing that her husband had a toothache.
At that time, Wei Bing thought it was a little strange - why did he come to the emergency room at night with a toothache?
It turned out that the patient's wife had knowledge about first aid. Her husband's toothache had nothing to do with occlusion and local touch. When the toothache was involved, the neck and back were involved. Later, an electrocardiogram showed myocardial ischemia. It turned out that his toothache was actually a symptom of angina.
After receiving the cardiology department, due to the timely detection and treatment, the patient's life is not in danger.
"If you don't pay attention to this situation, you may not even have the chance to be sent to the hospital." Wei Bing said.
"The treatment time of cardiovascular and cerebrovascular diseases is very strong, and the window period for effective treatment in advance is relatively short. It is also critical for ordinary people to recognize these symptoms." Wei Bing said, if you feel that you can recognize it, or detect something in your body Abnormal, it is best to go to the hospital as soon as possible, so that the damage can be minimized.
There are also some diseases that need to go to the emergency department that are completely preventable by everyone.
For example, in autumn and winter, we should pay attention to keep warm, wash hands frequently and wear masks, and do a good job in respiratory protection, and respiratory infectious diseases can be significantly reduced.
Many doctors interviewed believed that pre-hospital first aid can often determine the fate of patients. Whether the first aid is timely, whether the judgment is correct, and whether the measures are decisive and effective will affect the safety of the patient.
"For example, for a patient in cardiac arrest, in fact, effective CPR performed by bystanders and eyewitnesses can significantly improve the patient's prognosis. Effective CPR by eyewitnesses can make the patient's CPR success rate as high as the doctor's arrival. 10 times, or even more than 20 times, the post-first aid, which is a very big gap." Lu Xiao said.
Wrong first aid is dangerous
lack of social first aid
"If the child's parents don't do this, the child will have no problem at all and will quickly get through the uncomfortable symptoms. But the parents used the wrong first aid method, which led to the child's final death." Recalling this incident on social platforms Wei Zi, an emergency doctor at a hospital in Beijing, still regrets the incident.
One day, Wei Zi received an emergency mission, a child had difficulty breathing, and the first step for the medical staff to get into the ambulance was to call back to guide the rescue, "Come quickly, hurry up! The child is out of breath or not. It's over!" The mother of the child on the other end of the phone shouted heartily, when Wei Zi wanted to ask what was going on, the phone had been hung up and couldn't get through.
Soon, Wei Zi arrived at the emergency scene. At first glance, he saw the parents doing chest compressions for the child, but one thing caught Wei Zi's attention, that is, the child's arm was still slowly lifting, so Wei Zi Run quickly to stop the parent.
When the child was transferred to the ambulance, Wei Zi found that the child's thorax had completely collapsed, his ribs were fractured in many places, and his breathing had basically stopped.
While resuscitating, the medical staff asked the child's parents what was going on. The parents said that the child was disobedient and quarreled with her, and could not breathe because of the quarrel, so they panicked and only remembered that in this case, chest compressions and artificial respiration should be performed.
So he hurriedly moved the child to the open space outside and pressed it hard, but he couldn't wake up.
"Children can't catch their breath when arguing with their parents. In fact, it's because the exhaled carbon dioxide is too much. At this time, people may have difficulty breathing, numbness in the mouth or even cramps. A very simple first aid method is to wear a mask or use a plastic The bag is put on the mouth, and it can be relieved by taking a deep breath. There is no need to do chest compressions at all. In the end, the child was not rescued. It can be said that the child was killed by the wrong first aid method of the parents, but it is difficult for us to tell the real situation. Parents." Wei Zi said.
According to the survey, about 70% of emergencies occur at home, and home first aid is also an important part of pre-hospital first aid.
The doctors and experts interviewed by the reporter believe that this sentence may not be accurate, but there is a certain truth. The success rate of pre-hospital first aid in my country is indeed not high enough. Direct relationship.
Liu Xin, director of the Center for Medical Law and Ethics at China University of Political Science and Law, believes that the current public's understanding of first aid knowledge is very poor.
"Because we don't have this kind of specialized education, we are only some first-aid institutions with relatively better conditions. They will be invited to participate in the first-aid training of enterprises and institutions in the society. Or some public places that undertake group activities, will only think of it. In this regard, some people with first aid knowledge need to be trained. But these trainings are basically charged, and the penetration rate is not high." Liu Xin said.
"At present, we lack specialized teachers. We only have specialized training institutions in several big cities such as Beijing, but there are few such training teachers in other provinces, cities, and counties. If no one comes to train, Even if the public is willing, it cannot be advanced. In addition, who will pay for the expenses and the lack of professional teaching materials are also major problems. These are important reasons for the current lack of basic knowledge of first aid among the public." Liu Xin said.
Wei Bing said: "Actually, the public's desire for first aid knowledge is relatively high. In addition, there are many news reports that people die suddenly after participating in strenuous exercise or some small things. Most of these are young people. Everyone is willing to learn about this aspect. However, there are not many ways to learn first aid knowledge, and there is little formal training. On the contrary, there are too many unscientific opinions among the people. It is useless to do it at all, but it will delay the rescue time."
Automatic external defibrillator, or "AED", is known as "first aid artifact".
It is a portable medical device that can diagnose specific cardiac arrhythmias and deliver shocks for defibrillation.
At present, many scenic spots, business circles and parks, airports, railway stations, rail transit stations and other transportation hubs, libraries, schools and other occasions all have AED configuration.
"But many times, the general public doesn't understand CPR at all, and AEDs are only introduced in advertisements and have not been operated. When someone suddenly stops breathing and heartbeat, and there is no medical staff present, first aid is basically blinded. This cardiopulmonary resuscitation has special technical requirements, and cardiac compression requires strength, so you have not been trained, and you have not performed operation training after the training, it is difficult to master, so in such a social first aid condition Under the environment of scarcity, if someone really has a problem, it is difficult to get the corresponding treatment." Liu Xin said.
Urgent efforts from all parties are needed
Strengthen publicity and education
Last year, the newly revised "Beijing Regulations on Pre-hospital Medical Emergency Services" was announced.
It is mentioned that all kinds of schools should take medical first aid knowledge and skills training as the special education content of local courses, and under the guidance of professional organizations, carry out targeted training suitable for the actual school and students' characteristics, so as to improve students' safety awareness and self-help, mutual Rescue ability.
In addition, the regulations on pre-hospital medical emergency services in Taiyuan, Shanghai and other places have also mentioned this requirement.
Judging from the reporter's investigation, in reality, the effect of this content is not very satisfactory.
For example, some schools have never conducted first aid training, some schools just put a few promotional videos or invite people to give lectures on first aid day, and the rest of the year does not mention first aid.
According to Deng Liqiang, executive director of the Chinese Society of Health Law, this phenomenon is related to many reasons.
Students' training of medical first aid knowledge and skills remains on the surface similar to "books", lacks practical drills, and when encountering emergencies, they appear to lack confidence and fear to act.
The masses do not have enough legal knowledge of whether rescue actions will be held responsible, and they have doubts about the provisions on exemption of rescue actions. Some self-media have one-sided and negative propaganda of cases for the sake of blogging. However, the contradictory phenomenon of fear of taking responsibility and not taking action is widespread, which affects the enthusiasm of the public for first aid.
In addition, the campus and society do not pay enough attention to emergency rescue.
How to strengthen the public's scientific first aid skills and improve the social first aid ability?
Wei Bing suggested that the learning of first aid knowledge for students should not be too high, preferably adults, or to strengthen the identification and guidance of first aid for them in high school.
"Children are too young, it is difficult to distinguish complex things, and if the rescue is unsuccessful, it will also cause trauma to their psychology. Through simple training, they can help others in time in emergency situations, call emergency calls, A simple understanding of first aid knowledge is enough." Wei Bing said.
Deng Liqiang believes that special first aid knowledge education and skills training can be carried out according to students of different ages. For example, the cartoon animation for young children will involve first aid knowledge education and skill training for vivid education; primary school students are active and imitate. Drills for feasible first aid links for this age group, such as how to make an emergency call; for middle school students and college students, normal first aid operations can be guided by restoring realistic scenarios; more encouragement and praise for students’ courageous and willingness to rescue; Parents popularize the interpretation of legal issues related to emergency rescue, list relevant judgment cases, and eliminate their doubts about taking legal responsibility after taking emergency rescue actions.
"In the era of advanced technology, by making full use of multimedia technology, we can try to expand the popularization of public first aid knowledge through pictures, short videos, and even sitcoms, and promote publicity and education training in campuses, enterprises, and crowded public places. First aid skills are the preferred conditions for unit recruitment, employee entry or promotion." Deng Liqiang said.
In order to promote the public's understanding of correct first aid knowledge, Lu Xiao joined the MCN knowledge matrix and shared medical knowledge on multiple social platforms. The Douyin account "Lu Xiao's Emergency Diary" has gained more than 1.3 million followers; Wei Bing's Douyin account " "Dr. Wei Bing from Chaoyang Emergency Department" has also released nearly 100 short videos of medical science popularization, and answered many people's questions in the comment area and private messages.
According to the relevant person in charge of Toutiao, since January 2021, the platform has invited high-quality author "Dr. Zeqiao" to create a video collection with the theme of "Learn First Aid, Immediate Self-Rescue", focusing on "CPR", "How to use AED", "Heimli" Created 17 different scenarios of first aid themed content such as "Rescue First Aid" and "Foreign Objects Entering the Throat of Infants and Young Children", and many people gave positive feedback in the video comment area.
Since 2019, many users have started the #HeimlichFirst aid topic on Douyin, and produced related popular science videos to spread first aid knowledge through the platform.
So far, these videos have been played and learned 3.12 billion times on Douyin.
"In addition, the curriculum for first aid education should be determined through legislation at the national level, and first aid specialists should be added in public places and mass activity places." Liu Xin said that this is a comprehensive project that requires the whole society to gradually understand the first aid problem. The public first aid knowledge and social first aid ability can only be improved after the attention and awareness level are gradually improved.
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