"Hello, I'm an emergency doctor, and the old man ** is injured? "The Beijing emergency center team received a notice from the 120 emergency dispatch command center that an elderly woman fell and injured herself and needed an ambulance for treatment. On the way to the scene, Lu Shuchun, the doctor on the car, and his colleagues confirmed the patient's injury to the policeman, inquired about consciousness, breathing, and other conditions, and gave corresponding first aid guidance.
10 minutes later, the crew arrived at the scene and found that the patient had been injured by rolling down a step about 3 meters high. "The patient was snoring, unresponsive to calling, vomit and blood stains around him, bleeding from the head was checked to see that the bleeding had coagulated, and the eyes were bruised and swollen. Lu Shuchun said that the preliminary judgment was "fall injury, scalp laceration, severe head injury". * Blood pressure is measured immediately, blood glucose and electrocardiogram (ECG) are performed, oxygen is given after safe lift to the ambulance, ECG monitoring, and intravenous access is established. Subsequently, they set up a green channel with the receiving hospital and quickly sent it to the hospital for further examination.
According to the official website of the Beijing Municipal Health Commission, from 8:00 on December 4, 2023 to 8:00 on December 11, 2023, the Beijing Emergency Center dispatched a total of 19,214 ambulances. Among them, according to the caller's complaints, there were 2,333 cases of trauma, ranking first; 2181 cases of cardiovascular disease, ranking second; There were 2,030 cases of respiratory diseases, ranking third.
According to the "Report on Cardiac Arrest and Cardiopulmonary Resuscitation in China (2022 Edition)" released by the National Health Commission and the Chinese Center for Disease Control and Prevention, the overall incidence of cardiac arrest in China is 971 100,000. In our country, more than 80% of cardiac arrests and sudden deaths occur outside the hospital.
The optimal rescue time for cardiac arrest is 4 minutes; 4-6 minutes after cardiac arrest, irreversible damage to the cerebral cortex occurs. If the patient is not surrounded by people with basic first aid knowledge, it is easy to miss the "**4 minutes" even if the doctors set off as fast as possible. Therefore, while continuously improving the 120 pre-hospital emergency system, it is also important to vigorously promote the construction of social first aid capacity.
In November 2023, at the 4th China First Aid Conference, seven cities in China launched a pilot project of "4-minute mutual rescue system in public places", and Beijing is one of them.
On January 20, 2024, at the 120 First Aid Science Popularization Class, the National First Aid Day Initiative Activity, Li Ang, deputy director of the Beijing Municipal Health Commission, introduced that at present, Beijing has certified 31 social first aid training bases, and established the Beijing Social First Aid Quality Control and Improvement Center to supervise and guide the city's first aid training; Released the "Beijing Social First Aid Training Teaching Course Syllabus", published a series of standardized teaching materials, and certified more than 300 first aid instructors; At the same time, we have vigorously promoted the deployment of AEDs (semi-automatic external defibrillators) in public places, and 5,089 AEDs have been located in 120 systems. Since 2021, 300,000 people in high-risk positions in Beijing have received first-aid training, and the Beijing subway has used AED to save the lives of six cardiac arrest patients.
The Beijing Emergency Center has conducted first aid training for key groups in public places, including subway staff, flight attendants, teachers, etc., for many times. In addition to the use of cardiopulmonary resuscitation AED, the content also includes some on-site emergency treatment of medical and surgical emergencies.
In 2024, the training of the Beijing Emergency Center will be mainly carried out for the community, and Chen Zhi, chief physician of the Beijing Emergency Center, said that the community is the grassroots system of the city and the largest health security system. "Some community health care systems are not perfect, and some community workers lack experience and capacity for first aid. He said that training for grassroots managers in the community, especially doctors in community medical service centers, will help build a community first aid system, so that patients can get self-help and mutual help in the first place. The community training will continue to last for 3-5 days at a time, covering hundreds of communities in Beijing.
Lu Shuchun is one of the first aid instructors in this community training. He introduced that since all the trainees who participated in the training were medical staff from grassroots community health service centers, the training was divided into two parts: the first two days were student classes, which were taught by lecturers to improve their own first aid skills; The last three days are a lecturer class, and the trainees will receive a first aid instructor certificate. In the future, each community health service center will become a first-aid training base to "popularize first-aid science into the community", and these trainees will form a team of community lecturers, so that the public can learn first-aid skills more easily and conveniently.
Li Miao, a doctor from the Jinzhan No. 2 Community Health Service Center in Chaoyang District, Beijing, participated in the training. She said: "I work in the front line of clinical practice, and often encounter emergencies such as anaphylactic shock and myocardial infarction, and I have increased my first aid knowledge by participating in the training. She feels that she has benefited greatly from the teachers' quick diagnosis of emergencies.
In Li Miao's view, although she learned first aid knowledge in college, in actual operation, it is not easy to achieve effective and high-quality cardiopulmonary resuscitation. "The depth and frequency of compressions when doing cardiopulmonary resuscitation can be operated entirely by the rhythm of one's own heart without the assistance of AED, which is easy to be inaccurate, which requires constant practice. She feels that the teachers' strict control of skills can help students use these first aid methods in a more standardized manner.
In Li Miao's view, it is very important for not only doctors, but also patients and their families to have basic medical knowledge. Not long ago, Li Miao participated in the first aid of a patient with acute bleeding, female, about 65 years old. "She woke up from her sleep, and when she got up, she suddenly sat on the floor and couldn't get up, and she was bleeding. When Li Miao and her colleagues arrived at the scene, the patient's family had already helped to do a simple cleaning, but the family did not know where the bleeding was, and the patient himself could not describe it clearly. "This caused some difficulties in assessing the condition, not knowing if it was **bleeding or **bleeding. Li Miao said that as a relative, if you can provide more valuable clues, patients may be able to get more timely and effective **.
Lu Shuchun introduced that after finding someone who needs first aid or requests first aid, everyone can help him, which is the meaning of first aid science. "For people who have not learned first aid knowledge at all, helping to call first aid** is also rescue, or you can take first aid under the guidance of the dispatcher. Lu Shuchun reminded that after dialing the first aid, try not to leave, "because there are some injuries that we may have to communicate with him, and he can observe the changes in the patient's condition at any time at the scene."
What should I do if someone close to me has suffered a cardiac arrest? Chen Zhi said that it is necessary to identify the environment first, observe whether it is safe, and then identify the state of the patient. If the patient is unconscious or breathing, he or she should call emergency **120 as soon as possible, and at the same time take the surrounding AED to the scene for emergency resuscitation as soon as possible. For people who have not been trained in cardiopulmonary resuscitation, you can dial 120 and operate under the guidance of **.
Heart attacks, such as acute myocardial infarction, myocarditis, arrhythmias, acute attacks of hereditary heart disease, pulmonary embolism, acute cerebrovascular disease, acute fulminant pancreatitis, trauma, etc., are prone to cardiac arrest. Chen Zhi suggested that everyone should pay attention to the management of chronic diseases in their daily life: people with hypertension, hyperlipidemia, high blood sugar, heart disease and other diseases should take medicine regularly and have regular examinations; At the same time, do not overexert and exercise vigorously; Stress, emotional agitation, staying up late, eating irregularly, etc., can all have adverse effects on the heart.
China Youth Daily, China Youth Network Intern Reporter Li Danping Reporter Liu Changrong **China Youth Daily.