The relationship between first aid and emergency health

First aid is essentially the "first piece of the puzzle" of the emergency health system - it is neither the whole of emergency health, nor is it a separate skill independent of the system. It is the core pre-link that directly determines the final success rate of emergency health intervention. It is the key connection point between sudden accident scenarios, standardized treatment in the hospital, and subsequent long-term health recovery.

Don't tell me, when I was doing first aid science popularization in the community last week, I met Uncle Zhang who was rescued last year. He came over with the vegetables he just bought and gave us a bottle of water. Last summer, he suffered a cardiac arrest while playing chess downstairs in the community. Lao Zhou, who was playing chess with him next to him, was dragged by the street to participate in free first aid training last month. A person who is usually afraid of injections knelt down to do chest compressions without saying anything that day. The young man next to him ran to the property to get an AED, which he used in less than 3 minutes. By the time 120 arrived, Uncle Zhang had resumed breathing on his own. Later, I went to the hospital to have a stent placed, and now I still go downstairs to walk and play chess every day without any sequelae. Another old man in the same community suffered a heart attack last winter. No one around him dared to touch him. He only dared to squat next to him and call 120. By the time the ambulance arrived, it had already been 12 minutes. Even if his life was saved later, the brain was deprived of oxygen for too long and half of his body could not move. He even had to be fed by his family to eat.

Because this kind of comparison is so eye-catching, many people now directly equate "first aid level" with "emergency health capabilities." This is also the core view of the "pre-emergency first aid school" in the academic circle: Most of the people who hold this view are front-line practitioners of pre-hospital first aid, and their logic is particularly practical - the golden window for dealing with health emergencies is often In those few minutes, for every 1 minute of delay in implementing effective first aid after cardiac arrest, the survival rate drops by 10%. If standard CPR is carried out with AED defibrillation within the golden 4 minutes, the survival rate can be increased to more than 50%. If the national average waiting time for ambulance arrival is more than 10 minutes, most people will not be able to wait for follow-up treatment at all. Many cities now promote "full AED coverage in public places" and "first aid skills into communities and campuses", which essentially follow this logic.

But when I attended an industry seminar last month, the director of the emergency department of a tertiary hospital slapped the table and refuted this statement: "What's the use of just pushing emergency care to ordinary people? After being rescued and sent to the hospital, the emergency passage was blocked for half an hour, and it was useless to get into the cath lab. ”This is the view of another school of "system synergy theory": they believe that first aid is only the first link in the emergency health system. If the green channel in the hospital is not opened, the post-operative rehabilitation resources cannot keep up, and the daily screening of high-risk groups is not in place, even if a life is saved in the pre-hospital, either the person will suffer severe disability later or relapse after a few months, it cannot be regarded as a "successful emergency health intervention" at all.

This is actually quite poignant. When I went to teach in the western mountainous area last year, the village doctor there had never even touched an AED. Last time, a primary school student was poisoned after eating undercooked kidney beans. The village doctor only gave the child soapy water to induce vomiting. Fortunately, the county ambulance arrived in more than half an hour on the newly built winding mountain road. If it had been half an hour later, the child might have suffered from kidney failure. Do you think this is a problem that the village doctor doesn’t know how to provide first aid to? That's not entirely true. There is only one village doctor in the whole township, and he doesn't even have a first aid kit with oxygen equipment. There are only three doctors in the county's emergency department. Even if the village doctor knows first aid, he may not be able to receive follow-up treatment after he is rescued and sent to the county. This is a shortcoming of the entire emergency health system, and it cannot be made up by just popularizing a few first aid courses.

I have been doing first aid training for three years, and the most common questions I encounter are not "how hard to press CPR" or "how to turn on the AED", but "I am not a doctor, do I have to pay compensation if the compression force breaks?" ”. There was a young man who saved an aunt who fainted on the subway, and was chased by her family members and asked, "Did you break my mother's ribs?" Although he later adopted the good person clause of the Civil Code and did not take responsibility, it also upset many people's hearts. You see, this is neither a problem of first aid skills nor a problem of the hospital. It is a failure of the security mechanism at the social level to keep up. This is still an unavoidable part of the emergency health system.

In the final analysis, the relationship between first aid and emergency health has never been as flat as "part and whole". If you compare emergency health to a big net that covers everyone's health risks, then first aid is the load-bearing rope at the front of the net - the rope is strong enough to catch people who fall and send them into the net, but if the net itself is tattered at the back, people will still fall through even if they are caught. There is no need to argue whether first aid is more important or the subsequent system is more important. When it comes down to it, saving people, suffering less, and living a good life in the future is better than anything else.