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Journalism of Courage
You see the man lying on the road, bleeding profusely. Within minutes a crowd gathers to stare with morbid fascination at the agony that the accident victim is going through. But how many actually do something to help the victim? Even if one wishes to help, how many actually know what to do and where to begin. Says Dr. C.P.Bajpayee, medical director, Ruby Hall Clinic, 8220;The first 45 minutes after an accident are the most crucial to save the victim8217;s life or avoid permanent disabilities.8221;
But if it rushing to a hospital is not possible, the least a passerby can do is administer first aid 8211; an act that can make the difference between life and death.
When you come across an accident victim there are three basic things to look for. This is, of course, assuming that the person will be moved to a hospital as soon as possible. In the meantime lookout for the A,B and C of first aid.
A would be the airways. Is the accident victim breathing properly or is he gasping for breath, or not breathing at all? Difficulties in breathing could be due to a blockage in the mouth such as loose dentures, or fluids such as blood or the tongue has rolled back.
In case of a blockage, one should wrap one8217;s fingers in a handkerchief and remove the obstructing object or wipe off the fluids. This should be done after turning the person8217;s head sideways, for gravity will then pull out any fluid trapped inside the mouth. If the person is unconscious and the tongue has rolled back preventing the breathing, one should use a handkerchief to hold the tongue. It is important to re-establish breathing quickly. Says Bajpayee 8220;The brain can function without oxygen for only two to three minutes.8221; Breathing is fairly simple to determine. Place a ear over the patient8217;s mouth while watching to see if the chest and abdomen rise and fall. If you fail to hear and feel expired air, mouth-to-mouth ventilation must be done.
So, how does one do this? 8220;First of all the larynx, trachea and the naso- pharynx should be in a straight line. If not, then chances are that the air you pump in will not reach the lungs. Translated this means that you put the person8217;s head back straight and extend the neck. Like the position you would use to smell a rose,8221; says Bajpayee. Once the person is lying on his back in the correct position, artificial respiration can begin. From the right side of the victim, hold his nose shut with your left hand for left handed people the reverse will work With the index and middle fingers of your right hand, keep the chin up of the victim. Then exhale deeply into the open mouth of the victim.
Says Dr Swaroop Bharadi, 8220;Using a kerchief will help minimise the risk of getting infected from the patient.8221; Four quick ventilations are given without allowing for the complete lung deflation of the victim between breaths. Thereafter the rate of 12 ventilations per minute needs to be maintained till you reach a hospital.
But the doctor cautions, 8220;If there is a wound on your hand or an ulcer in your mouth, contact with body fluids can expose you to HIV infections if the victim is positive himself.8221;
After clearing the airway and checking the breathing, the blood circulation is the next thing to look for. This is determined by feeling any major pulse point in the body. Feeling for the pulse at the wrist may not be correct because if the blood pressure is low, the pulse will not be felt there. The best place to look for presence of blood circulation is the carotid artery situated in the neck. Says Dr. Sanjeev Gupta an ICU consultant at Ruby Hall Clinic, 8220;This can be done by sliding the thumb on the windpipe which lies bang in the middle of the neck to the right or left till you can feel the pulse.8221;
If after 10 seconds of careful searching, no pulse is felt, it means that the heart has stopped functioning and the person will need a cardiac massage. Says Dr. Kapil Zirpe, also an ICU consultant, 8220;This is best done by a para-medic as it requires some training. If the hands are placed too high or too low it can cause organ lacerations or break the ribs. But if the hospital is far which is the case many times, a layman can learn the technique with some help. Get onto the right side of the patient and kneel down. Then run your fingers down the middle bone between the ribs this is the sternum. The place to put pressure is one inch above the end of the sternum.8221;
After locating the spot, place the lower end of your right palm over the left for left handed, the opposite at the point identified before. Then lock the elbows and keep the arms straight, with the shoulders directly over the patient8217;s sternum. The sternum should be depressed one and a half to two inches at a rate of 60 times per minute. Each compression and release should take half a second.
If the heart is not beating, obviously the person won8217;t be breathing. So the chest compression to ventilation ratio in case of one rescuer would be 15:1. In case of two rescuers one ventilation is to be done after every five chest compressions. Says Zirpe 8220;One must wait for one and a half seconds before doing the ventilation. After the first minute, you should stop for five seconds.8221; Sometimes the heart begins beating, but the person may still not breathe. In that case the ventilation must continue. Once the ABC has been restored, other problems such as bleeding, broken bones and so on should be looked into. 8217;In case of bleeding ly from any limb, putting pressure above the bleeding site will help.8221; says Bajpayee.
Broken bones, neck injury are also common during accidents, and in such cases it is best to have as little movement as possible, till the person is taken to a hospital. Meanwhile getting empowered to help the accident victim will go a long way in saving people8217;s lives instead of letting them waste away on the streets.
