The relationship between first aid and emergency health

First aid is the front-end core processing link of the emergency health system. The two are nested in a relationship between "immediate filling" and "global support" - first aid fills the golden rescue window of emergency health in emergencies, while emergency health provides system support for the whole chain of health recovery after first aid. Both are indispensable, and together form a protective network for sudden health risks.

Last spring, Uncle Zhang in our community suffered a heart attack during his morning exercise. A neighbor who often came to the community to participate in first aid training happened to be nearby. He rushed over and felt that his pulse was not beating. He immediately took out the automatic external defibrillator (also commonly known as AED) next to the fitness equipment and operated it. The defibrillation was completed in 4 minutes. By the time the 120 ambulance arrived, Uncle Zhang had already regained consciousness. Later, I went through emergency thrombolysis and postoperative rehabilitation follow-up. The whole process was through the green channel for cardiovascular and cerebrovascular emergencies of the community emergency health system. I was discharged from the hospital in more than half a month, and now I can still go downstairs and walk as usual. If no one dared to provide first aid at that time, no matter how smoothly the green channel behind was built, it would not be able to keep up with the 10% drop in the rescue rate of cardiac arrest for every 1 minute of delay.

When I first started doing emergency science popularization in the industry, I thought first aid was all about emergency health. It wasn’t until I participated in the handling of several public health emergencies that I discovered that the relationship between the two is much more complicated than many people thought, and the industry still has different focuses.

Most of the colleagues doing on-site rescue work are "first aid first aid" people, and the data they have is very hard: the rescue rate of out-of-hospital cardiac arrest in my country is less than 1%, and more than 80% of the cases are that no one dares to rescue or can rescue within the golden 4 minutes. Therefore, they have been calling for emergency health resources to be tilted to the front end, invest more in AEDs, provide more free first aid training, and fill in the most critical gaps first. Shenzhen has invested more than 20,000 AEDs in public places in the past five years, with an average of 1.5 units per 10,000 people, and has provided millions of first-aid services. Now the rescue rate for sudden death outside the hospital has risen to 14%. This improvement is real.

But Chen, who has been engaged in the construction of emergency response systems for ten years, does not see it that way. He has worked at the Centers for Disease Control and Prevention before and participated in several medical rescues after disasters. He belongs to the "system synergy faction" and feels that no matter how quick the first aid is, it will only pull the first trigger of safety, and it will still be useless if the chain behind it is broken. He told me about the case of the July 20 flood in Zhengzhou. A drowning elderly man was rescued on the spot. On-site first aid restored his breathing and heartbeat. If there were no temporary medical centers for infection prevention and control and no follow-up for chronic diseases, many elderly people with underlying COPD may have suffered from subsequent cold-induced acute attacks even if they escaped drowning. In addition, when the epidemic was under control a few years ago, many asthma patients in the community used emergency medicine on the spot. If there were no special passages set aside by the emergency health system in advance and well-connected designated hospitals, they might still be in danger. The views of this school are also very practical: first aid is to save the "temporary", emergency health is to protect the "whole process", and no part of it is missing.

Interestingly, the general public’s perception of the connection between the two is more grounded. I was doing first aid training for the street a while ago, and an aunt held a notebook and asked me: "I learned cardiopulmonary resuscitation. If the person I save has complications later on, or the person can't keep up with the follow-up recovery, who's responsible?" 」In fact, this question just hits the gap between the two - the first aid you do on site is to help people get through the gate of hell, and the subsequent treatment of complications, rehabilitation guidance, and even liability protection for rescuers are all the bottom line that the emergency health system must cover. Now many cities have included the protection of the rights and interests of first aid witnesses and the green channel connection of post-emergency patients into emergency health plans, which is to fill this hole.

Many people tend to ignore the reverse correlation between the two: proactive prevention of emergency health can actually reduce the number of situations requiring first aid from the source. Last year, during the Emergency Health Awareness Month in our community, we distributed a convenient medicine box containing nitroglycerin, hemostatic packs, and scald ointment to every household. We also conducted three popular science campaigns on emergency treatment of chronic diseases for the elderly. According to statistics in the past six months, 30% more cases of elderly people suffering from angina pectoris who took medicine before being sent to the hospital, and the number of extreme cases requiring on-site cardiopulmonary resuscitation decreased by 40%. You see, you don’t need to wait until something goes wrong to call for first aid. Taking health warnings in advance is itself part of emergency health, and it also reduces the pressure on first aid.

In the past few years, I have visited more than 20 communities to do science popularization, and my deepest feeling is that you should not separate these two things. First aid is like the lighter you carry with you. When you see a small flame while walking, you can put it out with your hand and prevent it from burning into a big fire. ； Emergency health is the fire protection system of the entire community. There are fire hydrants, patrol teams, and post-fire resettlement points. None of them will work. Don’t wait until something goes wrong to learn first aid, and don’t think that everything will be fine if you install a few AEDs. Only by combining immediate treatment and system support can you really have double insurance for your health.