Thursday, August 05, 2004 In case of emergency By Henrylito D. Tacio
WHAT would you do if your friend has hit his head so bad and lost consciousness; has a deep or large cut; is bleeding a great deal; is experiencing swelling that comes on quickly; is unable to put weight on an injured limb or has a heart attack? How would you cope if faced with these kinds of medical emergencies? You may well be the first person on the scene, and what you do can make a difference.
Oftentimes, people call the emergency hot line: 911. But "ambulances take too long to get to places where they are needed most because of horrendous traffic and other conditions they have get through," says Dr Siang Hiong Goh, head of emergency medicine at the Changi General Hospital in Singapore.
In most parts of Asia, including the Philippines, the response time for emergency ambulance calls is between 10-20 minutes. That's beyond the six-minute mark. Experts estimate that once the heart stops, there is a crucial window of four to six minutes to restore circulation.
This is where first aid comes in handy. "First aid is one of those things no one likes to talk about," says Dr. Stephen J. Rosenberg, an American neurologist and expert in geriatric emergencies. "It's like learning how to use your seat belt and oxygen mask in an airplane: you know it's there, but you assume that no one you know will ever need serious first aid."
That's what Marilyn thought, too. Three weeks ago, she was invited by her best friend, Edith, to attend a birthday party. She brought with him her husband, Edward. There were only thirty of them and after eating the food prepared by the host, they watched a very funny movie.
Everyone laughed out loud when Noel, Edith's husband, complained of an excruciating pain in the center of his chest. A few friends closer to Noel laid him flat but it only got worse. "I can't breath," he complained.
"Noel is having a heart attack," Edward, a former flight attendant, told them. "I have seen this things happen several times already. Please call 911 immediately."
Emergency experts want to see people beyond 35 years old with chest pain--especially if it persists past five minutes and is coupled with shortness of breath, sweatiness, and nausea or vomiting--because they might be able to prevent damage. "Heart-attack victims are not aware that they're having a heart attack," says Dr. Rafael Castillo, a cardiologist who works at the Manila Doctors' Hospital. "Oftentimes, they attribute the pain to other causes such as muscle pains."
Dr. Castillo says even younger people with persistent chest pains, particularly if these are accompanied with difficulty in breathing, fainting, and feeling cold and clammy should be brought to an ER. "It can be due to a serious problem such as a heart attack," he points out. Powerful abdominal pain is also very serious--it can signal an appendix attack or an abdominal aneurysm. Women with terrible stomach pain could be having a miscarriage or an ectopic pregnancy. They may not even know they're pregnant, but these conditions--which often come with vaginal bleeding--need urgent care.
Again, the question is: what would you do in case of an emergency? Cardiopulmonary resuscitation (CPR) is considered the cornerstone of emergency medicine. "The universal final step to dying is when the heart stops to beat or pump so that circulation of blood and distribution of oxygen to every part of the body cease," explains Dr Roberto Raymundo, CPR council chairman of the Philippine Heart Association.
There are lots of reasons why someone's breathing or heartbeat might stop--heart attack, stroke, drowning, electrocution, vehicular accidents, overdose and many others. Whatever the cause, the required action is the same: Put oxygen into the victim's lungs by performing rescue breathing, and circulate it through the body by doing chest compressions.
"When a person breathes air into victim's lungs, oxygen is provided into the blood," Dr. Raymundo says. "And when a rescuer compresses on the chest, oxygen-carrying blood is moved or circulated through the body of the victim."
He points out that many untimely deaths can be prevented if only bystanders know and can do CPR until the emergency response team in ambulances arrives. A warning though: If you are not trained in CPR, do not attempt to resuscitate.
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