Essay on the relationship between first aid and emergency health

First aid is not an isolated execution link under the emergency health system, nor is it a medical operation that only belongs to the category of clinical emergency. The two are a two-way coupled symbiotic relationship - first aid is the implementation of emergency health on the individual and scene sides, and the construction of the emergency health system provides full-chain support for the effective implementation of first aid. The synergy between the two directly determines the success rate of dealing with sudden health risks.

Last fall, I followed the emergency response team of the district disease control to the Xingfu Community in the old city for a drill. As soon as I set up the AED (automated external defibrillator) demonstration table, I heard a noise at the entrance of the community. Aunt Zhang, the vegetable seller, squatted on the ground and covered her chest. Her face was as white as paper. Sister Li, who danced square dances with me next to her, had just received first aid training from us last month. I rushed to feel the carotid artery and found that she was in cardiac arrest. I turned around and ran back to the community activity room to get the AED that was issued last year. The defibrillation was completed in 3 minutes and 40 seconds. By the time 120 arrived, Aunt Zhang had already resumed breathing on her own. During the follow-up, the attending doctor said that if she were delayed by 2 minutes, she would most likely still be in a vegetative state even if she was rescued.

After this incident, we held an internal review meeting, and the two groups of people argued fiercely - the doctor with a clinical background felt that this was a typical successful case of pre-hospital emergency care. In the final analysis, it was due to the implementation of operational standards and had little to do with emergency health in a broad sense.； Public health colleagues feel that without three consecutive years of emergency health education in the community, AED deployment to the community in advance, and popular training for residents, Sister Li would not have dared to get started and would not have the tools available. This is essentially the result of the implementation of the emergency health system. I tried to persuade both sides in the middle. In fact, both sides are right. They just hit the two most common cognitive biases in the current academic circles about the relationship between the two: either narrowing first aid to a simple medical technology, or reducing first aid to an end-implementation tool for emergency health, without realizing the real connection between the two.

Let’s start with the part that ordinary people can most perceive. If you look up any current version of the residents’ emergency health literacy evaluation scale, first aid skills mastery accounts for more than 40% of the weight. If you say that you have high emergency health literacy, but you don’t know whether to slap someone on the back or use the Heimlich maneuver when you encounter someone who chokes, or you apply toothpaste on a burn, that’s all false. A middle school asked us for training before. I taught the key points of the Heimlich maneuver to the second grade students for 20 minutes. As a result, a child saved his deskmate who was stuck in the throat by jelly in the second week. Do you think this is the credit of first aid or the credit of emergency health education? Inseparable at all.

The same applies to the entire public health system. Many people think that emergency health is just for dealing with major disasters such as epidemics and earthquakes, and is usually useless. In fact, if you call 120 every day, you can get through, there is an AED downstairs in your community, and your company's administrator can do cardiopulmonary resuscitation. These are all part of the emergency health system, and the first aid network is the front-end sentinel of this system. When the flu peaked at the end of last year, the number of incoming calls to our 120 dispatch center tripled. It would have been too busy to dispatch all the vehicles according to the previous rules. Later, we connected the emergency health duty point with the 120 dispatch system. Consultations for mild cases were directly transferred to the community duty point, and community doctors were sent directly to the community if necessary. With this adjustment, the dispatch pressure of 120 was reduced by 40%. Do you think this is the optimization of the emergency system or the filling of the emergency health system? Another unsettled account.

Of course, there are a lot of debates in the industry now, and the core one is where to invest resources: One group thinks that money should be invested in first aid hardware, with more AEDs and more first aid points built. Once the hardware is in place, the success rate will naturally increase.； The other group believes that we should first carry out national education on emergency health. Once the people’s awareness rises, they will be able to use the equipment if it is available. Last year, I conducted pilot projects in two commercial housing communities with similar structures. One community spent 200,000 to purchase 8 AEDs and provided first aid training to all property owners and security guards. ； Another community spent 150,000 yuan on a three-month public education program, distributed first-aid kits door-to-door, and held free training courses. After half a year, the difference in the success rate of first-aid incident handling between the two communities was less than 5%, but the difference in per capita investment more than doubled. To be honest, there is no standard answer. In the old city, where there are many elderly people living alone and it takes a long time to arrive at 120, it is definitely right to invest in more hardware. ； For industrial parks with many young people and strong receptivity, it is more cost-effective to do missionary work first.

It's quite helpless to say that we have been doing promotion for so long, and the biggest obstacle we encountered was not that we couldn't learn the skills, but that people didn't dare to save us. There was a delivery boy who learned CPR from us before. He met a fainted man on the road and did not dare to go in, for fear of failing to save his family and blackmailing him. This is actually not a problem with first aid itself, but a failure of the emergency health protection system to keep up. Our current good person clause in the Civil Code and the first aid exemption regulations issued by various places are originally the protection part of the emergency health system, but 90% of ordinary people have no idea. Isn’t this the most obvious disconnect between the two?

I have been doing emergency health promotion at the grassroots level for almost 6 years. Every time someone asks me what the relationship between first aid and emergency health is, I don’t want to use the definition in the textbook, so I tell them the example of Aunt Zhang. Emergency health is never a thick plan hanging on the wall, nor is it an unfamiliar system that is activated only in major events such as epidemics and earthquakes. It is the iodine and band-aids you prepare at home, the community emergency phone numbers saved in your mobile phone, and the Heimlich maneuver you learned while watching short videos. First aid is these scattered preparations that can firmly catch a life in the most critical minutes.

The relationship between the two has never been about one containing the other. If either one is missing, they cannot be connected.