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Pre-medical assistance - What you need to know?

Pre-medical assistance - What you need to know?

News 01 Feb 2019

As you know, a characteristic function of the development of civil society is the search and implementation of means of socialization, which as a result reduces people's alienation and directs them to socially useful affairs. And what can be more socially useful than knowledge about preserving human life?

The fact is that at the beginning of 2019, in the Verkhovna Rada of Ukraine (by way of a legislative initiative), the draft Law "On Amendments to Some Laws of Ukraine Regarding the Improvement of First Aid" was registered. The essence of these changes is, first of all, that from now on "the victim cannot file a lawsuit for wrongly provided first aid, if it was provided in good faith, for the best reasons and without expectation of possible compensation." That is, under such guaranteed legislative conditions, the fear of legal liability should decrease, level out, and those who wish to provide adequate first aid, on the contrary, should increase many times. The initiative is good, but how many years will have to wait before its implementation is currently unknown.

Each of us has known since childhood that in order to best remember the material, it is necessary to illustrate it - "to integrate the theory into everyday life", as the outstanding physicist Richard Feynman said. And in the case of knowledge directly related to human life, it is better to adhere to the standards of Finnish education - "we do not prepare for exams, we prepare for life." So, we offer a three-level integration of knowledge - literature, life, expert opinion.

The most successful example in literature will probably be the vivid monologue of Andriy Buslai in the play "The Threshold" by Oleksiy Dudarev: "So, it was in... There is one stop there, it's called "Nameless". They survived: there is nothing to call a stop! And so, opposite this very stop, there lived a candidate of sciences in medicine. He is a doctor, a laureate, and he himself is sick with this disease, just like her... Oh, diabetes! Once upon a time, this laureate was renovating his apartment. He put on an old jacket, torn trousers, worn-out shoes... His face was plain and in this outfit he was a khanyga-khanyga... Well, without changing his clothes, he went to the store with his diabetes to buy something. He got to the stop, and then he got hold of it - he was knocked so hard that he barely made it to the bench. Sit down Then he lay down - and ku-ku! After 7 hours, they raised the already stiff one. In 7 hours not a single person approached! This laureate is to blame! Are you going to the store? Put on a tie, put on your medal! And so, isn't there a lot of people lying around there? Then I went to this same stop, "Nameless". He sat on the bench where the candidate of medical sciences gave his soul to God. I'm sitting, so there are buses coming and going. I am sitting, counting people. I counted 203 people in 1 hour. 203 by 7?! It's scary to think! And after all, they still saw him... I wouldn't have approached either."

We often witness situations when someone (at a public transport stop, in a park, near a store, in a theater, on the sidewalk...) needs help. And usually, we remain only outside witnesses. But, perhaps, it is precisely from our help, from our purposeful and quick actions that a person could be saved. Undoubtedly, by calling an ambulance or calling the police, we will also help a person. But, in the conditions of megacities, the rapid response transport will need at least 10-15 minutes to reach the scene. Sometimes the victim may not have this time - according to the statistics of the Ministry of Health, help provided in the first 4 minutes increases the chances of rescue by a significant 30%.

Unfortunately, Ukrainian news feeds are full of stories when a person simply did not wait for help from others. At the beginning of December last year, in the very center of Kyiv, in a surprisingly crowded city (near one of the metro stations), a tragic incident occurred, when those fateful first 4 minutes were irretrievably lost thanks to the cold indifference of those around. The price of this disregard is the death of a man who suddenly had a heart attack. Perhaps the majority did not learn about this case, if it were not for the medical student, Serhiy Nagnybedyuk, who 15 minutes later, passing by, desperately rushed to resuscitate the already blue man. Later, the young man will make a video: it was a kind of blatant manifesto about human inaction and indecision, which lasted for 10 long minutes...

So, is it really so difficult to master the rules and skills of first aid, as well as about various aspects related to this issue, we talk with Roman Babich, an instructor of first aid and tactical medicine:

Roman, please explain what "home medical care" is and why each of us should master its skills?

90% of deaths occur before the arrival of emergency medical services. Therefore, everything depends on the actions of people who are nearby. What you should do, how to act, how to properly call an ambulance so that they arrive on time, how to properly explain to the emergency medical dispatcher that you have an emergency - these are all included in pre-medical care. Pre-medical care is everything that happens before the arrival of qualified doctors. First aid is a clear algorithm of actions that is easy to use and helps save a person's life before the arrival of an emergency medical team. These are brought to automatism, to muscle memory, the actions of a person, which he performs without the use of special medical tools. Only hands, desire and responsibility are needed. The tool is not a doctor's - the head (we identify the problem) and the hands (we fix the problem).

If a person witnessed an accident or an accident, what are his actions?

First of all, you need to be confident in your abilities, knowledge and skills, not to panic. If fear prevails over a cold mind, it is better to do nothing. The main rule of first aid is to do no harm! Secondly, there is a specialized protocol-order based on international standards and practice, approved by the Ministry of Health of Ukraine in 2014 (from June 16, No. 398). So, the action algorithm should be as follows:

  1. Inspect the scene and make sure that the provision of assistance will be safe: ensure your own safety, as well as the safety of the victim and people around.
  2. Assess the victim's condition (consciousness, breathing, pulse).
  3. If necessary, call an emergency (ambulance) medical team, as well as other emergency services (police, emergency rescue service, gas service, etc.).
  4. Assess the presence of critical bleeding and stop it.
  5. Ensure patency of the respiratory tract.
  6. If the victim has no signs of life and there is no critical bleeding (or you have already eliminated it), start cardiopulmonary resuscitation.
  7. Transfer the victim to a stable position (on the side, facing you, hand under the head, leg bent at the knee), if there is no suspicion of injuries to the spine and pelvic bones and cardiopulmonary resuscitation was successful.
  8. Do not leave the victim and monitor the state of his vital functions until the arrival of emergency services.

How to protect yourself while providing medical assistance to a stranger?

In order to provide help to a stranger, but at the same time, not to harm your own health, you should have 2 things with you - medical gloves and valve film. These two things will be a reliable barrier to prevent the rescuer from coming into contact with the victim's biological fluids (saliva, vomit, blood) during mouth-to-mouth artificial respiration. Provided that it is quite difficult for an average citizen to find a film-valve, then "mouth-to-mouth" can not be done.

What are the most common myths in providing medical care?

The most popular is the myth about breath testing, when you have to bring a mirror to your mouth. Agree, a mirror is an item that not everyone carries with them. Women - it's clear: you can find everything and even more in a women's handbag. But men hardly have it in their pockets. Therefore, in order to check a person's breathing, a simple technique should be used - hear, see, feel. But before that, the airways must be opened: a person in an unconscious state is relaxed, and the tongue is a muscle, which in this state can collapse and block the airways. Therefore, it is necessary to straighten the head of the injured person and align the airways. Next, for 10 seconds we have to feel, hear, see her breaths. Normally, the breathing rate is 12-18 breaths per minute. Accordingly, in these 10 seconds we should feel, hear, see 2-3 breaths. If a person has not done any during this time, then there are only 4-6 minutes - then the cerebral cortex dies. Here, the rescuer must remember the so-called "chain of survival" (order of actions that reduces mortality in the event of cardiac arrest):

  1. Early recognition of the situation and calling for help.
  2. Early cardiopulmonary resuscitation - buy time in death (to buy time in death before the arrival of an ambulance with a defibrillator).
  3. Early defibrillation (defibrillators should be available and accessible in public places; this link in the chain has the greatest value for survival). But, unfortunately, there are automatic defibrillators only in large cities of Ukraine, such as Kyiv, Lviv, Dnipro. They were purchased specifically for Euro-2012. That is, they cannot be found in a regional city or in some urban-type settlement. Despite the fact that the use of a defibrillator increases the chances of an adult's survival by 30-36%, because the cause of sudden death of a person older than 45 years is 66% of cardiovascular diseases. Children are not affected by the use of a defibrillator: as a rule, they have another reason for stopping breathing - foreign objects in the respiratory tract, spasms.
  4. Treatment of post-resuscitation illness – qualified medical assistance.

According to statistics, the most common emergency condition in adults is sudden cardiac arrest? Yes, it is important that each of us knows how to help a person in such a situation and perform cardiopulmonary resuscitation. Again, according to the 2014 protocol, the sequence of actions by non-medical workers is as follows:

1) make sure there is no danger;

2) check consciousness;

3) if the victim does not respond → call for help → restore the patency of the airways and determine the presence of breathing using the “hear, see, feel” method, determine the presence of breathing within 10 seconds → if there is no breathing, then call the emergency medical team and start cardiopulmonary resuscitation: perform 30 compressions on the chest with a depth of at least 5 cm (no more than 6 cm), with a frequency of 100 compressions (no more than 120) per minute, 1.5 - 2 per second; take 2 breaths using a film-valve (in the absence of protective equipment, do not perform artificial respiration); performing 2 breaths should last no more than 5 seconds; after 2 breaths, continue chest compressions (principle 30/2) → if breathing has not been restored, continue cardiopulmonary resuscitation continuously until the arrival of medics.

Roman, what are the mortality statistics for failure to provide timely medical care in Ukraine?

The numbers are disappointing - only 15 percent out of 100 - such are the statistics of effectively performed resuscitations. Only one in 10 survives. You see, calling an "ambulance" is not resuscitation, but in 10-15 minutes until the medical team arrives, a person cannot be saved. The biggest flaw of our people is shifting responsibility. In particular, and on doctors. Why are Ukrainians dying out? Because they treat their life and health irresponsibly. Only systematic training, constant updating of knowledge and practice of acquired skills allows you to be confident in yourself and your actions in unpredictable situations. Simple things save, simple things kill - on the one hand, this is a simple logical algorithm, on the other - someone's saved life. There is always a choice, but not everyone has the courage and sense of responsibility to make it.

And what about modern trends: is the number of people willing to master the knowledge and skills of providing medical care increasing?

You know, until 2014, before the Revolution of Dignity, no one was interested in this topic.

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