First, aid

Besides the reluctance to lend a hand, there persists a lack of training among those who are first to respond to emergencies

Published: 01st May 2019 04:09 AM  |   Last Updated: 01st May 2019 04:09 AM   |  A+A-

Express News Service

CHENNAI: In the last week of February 2019, a two-year-old boy studying at a play school in Washermenpet died after choking on food. The teachers rushed him to the nearest hospital, but he was declared brought dead. His life could have been saved if the teachers were equipped with first-aid skills. Heimlich manoeuvre — a first-aid procedure for dislodging an obstruction from one’s windpipe where a sudden strong pressure is applied on the abdomen, between the navel and the ribcage — could have been performed.The emergency response system in India is still evolving. Many lack the skills to stabilise a patient until an ambulance arrives.

Amit Bandre

Frequent mistakes
Despite boasting world-class hospitals, doctors and ambulances, Tamil Nadu is in need of giving basic first-aid training to the public. While in the US and other countries, lessons on life support are a part of class 6 syllabus, here, we don’t know to use the first-aid kit even if we have it. 

Trained first aiders provide safety and security in any situation and assist casualties until medical assistance arrives, but unfortunately, only a negligible amount of people in the city are trained. First-aid training programmes are not well streamlined yet.

“In case of profuse bleeding, there are 25 per cent more chances of survival if first aid is performed instead of waiting for the ambulance. When it comes to first aid, people do what should not be done, further worsening the condition. For example, in the case of an accident, water is given to the victim. You should never give a trauma patient anything through the mouth as he/she can aspirate into the lungs and die immediately,” said Dr S Saravana Kumar, national secretary, society for emergency medicine and head of accident and emergency department, Dr Mehta’s hospitals. 

“When you suspect a back or neck injury, do not move the affected person. Provide as much first aid as possible without moving the person’s head or neck or it might result in permanent paralysis or other serious complications,” says Kumar.

TN falls behind
The first ten minutes of an injury is critical in saving a life. Any bystander at the scene of the incident with a fair amount of first aid training can be of assistance before an ambulance crew arrives.“We try to establish an emotional connect before we start training. Only if a person understands how precious lives of other people are, will he make an effort to save them. The first-aid awareness in Tamil Nadu is extremely low and we are looking to do the best we can. Individual effort is what is needed,” said Dilip Raj, secretary and first-aid trainer at Alert NGO.   

TN has organisations like GVK EMRI, Alert and other private hospitals extending first-aid training. But, with each organisation promoting their own hospital or training for first responders or emergency volunteers according to their need, a norm is required to include the masses.

Emotional support
“In 2017, I lost control of my bike and rammed into a pole near Mount Road. I felt a sharp pain in my back and I was bleeding profusely. I could not talk but only signal that my back almost feels numb and when I pointed towards my back, people around me thought I wanted to sit and came close to remove the helmet first. Thankfully, a girl in her twenties who received first-aid training in her college asked the public not to remove the helmet or move me till the ambulance arrives. The doctors told me that I could have injured my spine in case the public had lifted me,” said R Madhavan, a resident of Kotturpuram. 

“Panic attack where a person experiences anxious thoughts, palpitations, chest pain, sweating is also a common presentation to emergency rooms. Making the patient relaxed, asking them to take a few deep breaths will help until they receive medical attention. In the case of an accident when so many people gather around him/her, within the eight minutes that the ambulance arrives, the blood pressure of the victim can go up, complicating the condition,” said Dr Vivian Kapil, psychiatrist, Sri Ramachandra Medical Centre.

Make it a mandate
“First-aid training has two major components. One is about developing the ability to recognise an emergency and the second is about developing the skill to do your best and save a life. Handling emergency is a skill that can be taught to any individual through good first-aid training. The next most important component is equipping a trained person with a first-aid kit. Every new automobile when bought comes with a first-aid kit supplied by the manufacturer.

This kit disappears from the vehicle after the first or second service. It should be mandatory for every vehicle driver to get trained,” said B Prabhu Doss, chief operating officer, Emergency Care Services, Bewell Hospitals. Schools, colleges, offices and malls should display first-aid kits prominently so that in case of an emergency, one can have easy access. 

The mandate should also be driven to ensure at least 10 per cent of the population of every institution is trained through a well-organised first-aid training institute providing hands-on training to develop skilled first responders. Social health activists point out that a good first aid given to the victim can increase the survival rate and reduce the chances of disability. 

Important topics covered in First-Aid Training
Recognising an emergency, triaging, dos and don’ts, calling for an ambulance, providing first aid — resuscitating, bleeding control, splinting, immobilising, maintaining position, familiarising on the contents of a first-aid kit, providing reassurance to the person in distress and transferring the victim safely to the ambulance crew.

What should a first-aid kit contain?
Plasters in different sizes and shapes, small, medium and large sterile gauze dressings, at least two sterile eye dressings, triangular bandages, crepe rolled bandages, safety pins, disposable sterile gloves, tweezers, scissors, cleansing wipes, sticky tape, cream or spray to relieve insect bites and stings and antiseptic cream. It may also be useful to keep a basic first-aid manual or instruction booklet with your first aid kit.

common myths

Giving a key to stop seizures: It is not true that giving iron in hand stops seizures. It may harm the patient and cause trauma or fractures if done forcefully. Make them aware that there is no need to panic. Position the patient on a side so that he or she does not swallow saliva or anything else, which will make the person choke.
If someone is having a heart attack, they should lie down: By making someone lie down when they are having a heart attack you are actually making it harder for them to breathe. A half-seated position with bent knees and a supported back is better.
In the case of poison consumption, vomiting must not be induced as the person might choke on their own puke and die.

In the case of an accident, water is given to the victim. You should never give a trauma patient anything through the mouth as he/she can aspirate into the lungs and die immediately.
Sucking onto a snake bite: Slicing into a newly bitten victim and removing the poison by sucking it out does not work. Before seeking professional help, you can tie a cloth (not very tight), 15 cm above the bite.
In case of an accident where you suspect a back or neck injury, do not move the affected person. Provide as much first aid as possible without moving the person’s head or neck or it might result in permanent paralysis or other serious complications, which can be avoided with first-aid training.


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