The relationship between first aid and emergency health

First aid has never been the end-of-life link in the emergency health system that is “used only in the event of an accident.” The two are mutually supportive and bidirectionally penetrating symbiotic relationships—first aid is not only the core implementation method of emergency health in emergency scenarios, but the construction of the entire emergency health chain in turn determines the effectiveness of first aid and the final health outcome. This is the most intuitive feeling after 7 years of pre-hospital first aid and 3 years of community emergency health training.

Last week, I met Aunt Zhang in my old community with whom we had practiced emergency drills. She was carrying vegetables to show off to me, saying that her 3-year-old grandson downstairs had a jelly stuck in the jelly three days ago. She rushed up and used the Heimlich maneuver to remove the foreign object in 30 seconds. When the child started crying, the 120 call had not yet been dialed. In the past, I might have just said, "Your operation is too standard." But now I know better that this is not "good luck" at all. The community has included first aid training as a required component of residents' emergency health screening for three consecutive years. Aunt Zhang practiced it no less than ten times before she dared to use it when something really happened.

There are actually two different opinions on the relationship between the two in the industry. Most scholars in the field of public health tend to fully integrate first aid into the public service framework of emergency health. They believe that the first aid penetration rate should be the same as the average life expectancy of a person and should be regarded as the core KPI of regional emergency health level. Currently, less than 2 out of every 100 people in China can correctly perform cardiopulmonary resuscitation, which is far lower than the penetration rate of more than 30% in developed countries. This itself is an obvious shortcoming of the emergency health system. But many emergency directors I know have different opinions: last year, their department received three cases of secondary injuries caused by incorrect rescue by non-professionals. Some patients with myocardial infarction were fed nitroglycerin indiscriminately to the point of hypotensive shock, and some were randomly dragged by passers-by with spinal injuries, causing paraplegia. They believe that the core of first aid is "professional access". Instead of blindly popularizing half-baked operational knowledge, it is better to first set up emergency health hardware such as community first aid points and AED layout to reduce the risk of non-professional rescue from a rule level.

Both views are reasonable. I experienced this when I went to the suburbs for medical treatment last year. A fruit farmer was stung while picking a hornet's nest, which triggered anaphylactic shock. The villagers had just participated in the town's emergency health training last month. Some people remembered that in the training, it was said that in case of anaphylactic shock, epinephrine should be administered as soon as possible. Others found a rope and tied the proximal end of the sting site. When we arrived, the patient's blood pressure had stabilized, and he was discharged from the hospital a week later. If we had waited until we reached the mountain road after running for 40 minutes, the NPC would have probably been gone. But on the other hand, I have also encountered something outrageous: a young man learned CPR half-heartedly through short videos. He saw a drunk person lying on the roadside unresponsive, so he pressed the button. It turned out that the person fell asleep due to alcohol poisoning. In the end, he broke three ribs and the dispute lasted for half a year.

Don’t think that first aid is just a big scene on TV where you press your chest until it flies up and blow air from mouth to mouth. It really comes down to daily life. You know, don’t swallow too much food if a fish bone is stuck, shower in cold water for 15 minutes if you get burned, and move to a cool place to untie your collar if you have heatstroke. These are all first aid, and they are also the most practical content in emergency health. An old man came to a popular science class before and said, "Why should I learn this if I'm not a doctor?" I gave him an example: installing a smoke alarm in your home is not to catch fire every day, but to buy you ten more minutes to escape if something goes wrong. First aid knowledge is a smoke alarm for your health. You say you don’t even know how to sound the alarm, so what’s the use of a thick disaster prevention manual?

In the final analysis, emergency health is a safety net for everyone's health. First aid is the densest strands of this network. It is usually invisible, but if it really fails, it will be the first to catch you. As for whether we should popularize first aid knowledge among the people first, or make up for the shortcomings of emergency health hardware first, the academic community has been arguing and there is still no standard answer. But for us ordinary people, it is better to learn two more useful first aid common sense than to stand on the sidelines with numbness in our hands and feet when something really happens, right?