This is the 5137th article of Da Yi Xiao Nu
In June 2023, the National Center for Cardiovascular Diseases released the latest "China Cardiovascular Health and Disease Report 2022", which pointed out that there are 330 million patients with cardiovascular disease (CVD) in mainland China, and the morbidity and mortality are still increasing, with 2 out of every 5 deaths due to cardiovascular diseases, and CVD ranks first in the proportion of disease deaths among urban and rural residents. The article "Life Rescue: Mastering Pre-hospital First Care and Collaboration Skills in Cardiovascular Disease Emergencies" is the author's own opinion as a pre-hospital emergency physician based on practical work experience and reference to a large number of literature, aiming to provide necessary knowledge and skills for medical professionals and the general public. This article details the first aid steps in cardiovascular emergencies and emphasizes the importance of collaboration and communication. It is hoped that readers will understand the correct emergency response methods, master the key skills from basic cardiopulmonary resuscitation to advanced first aid measures, and carry out timely and effective first aid in emergency situations to improve the overall health of society.
1. Rapid identification of emergencies
In the event of a cardiovascular emergency, such as cardiac arrest or myocardial infarction, every 1 second counts, and it is truly "time is myocardium, time is life". In the face of such a crisis, preliminary judgment is crucial. For example, when people around you suddenly develop persistent chest tightness, chest pain, or difficulty breathing or loss of consciousness, the possibility of a cardiovascular emergency should be considered first; In addition, some atypical symptoms of sudden cardiovascular disease should not be ignored, such as sudden unexplained radiating pain in the left shoulder or toothache in patients with a history of heart disease, hypertension or hyperlipidemia. These judgments require not only observation of the patient's symptoms, but also understanding and evaluation of environmental factors and personal health history. For example, find out if the patient has a history of heart disease, whether they are taking relevant medications, etc. This step is the basis for follow-up first aid measures and is key to ensuring that first aid is effective.
2. Call the emergency number correctly
Once a cardiovascular emergency is diagnosed, the emergency number "120" should be called immediately. When the emergency call is connected, quickly and clearly describe the patient's current situation to the dispatcher, including consciousness, breathing, and any major discomforts, etc., answer the dispatcher's questions concisely and provide the information required by the dispatcher, which is essential for the dispatcher to dispatch a car and the emergency doctor to develop a treatment plan. At the same time, it is necessary to tell the dispatcher the detailed address of the patient or nearby markers, so that the ambulance can quickly find the patient after arrival, and the dispatcher can be consulted according to the actual situation of the patient how to carry out self-rescue before the ambulance arrives, but do not take up too long to affect the rapid arrangement of the ambulance. In addition, it is necessary to wait for the dispatcher to hang up the phone first to avoid the dispatcher still having important information not collected, and keep the call for help unobstructed after the call, because the dispatcher or ambulance doctor will return to visit the patient at any time or guide self-rescue, call for help, and confirm the address.
3. Do your best to carry out self-help and mutual rescue
If there is a standby ambulance near the call location, the ambulance may be able to arrive at the scene in a few minutes, but in most cases it takes about 12 minutes or even longer, so it is important to quickly carry out self-rescue and mutual rescue before the ambulance arrives. First of all, ensure the safety of the patient's environment, if there is a gas leak or other unsafe factors, quickly transfer the patient to a safe location, if it occurs in a public place, to avoid unrelated people watching the air and affect the rescue; In addition, to put the patient in a suitable position, the vast majority of sudden cardiovascular diseases, need to lie down and rest, do not move the patient at will unless special circumstances, if the patient has dyspnea, judged to be heart failure, should take a semi-recumbent position, both lower limbs droop, oxygen as soon as possible; If it is judged to be an acute angina attack, let the patient immediately squat or lie down to avoid falling, take deep breaths in time, relax the mood, and then take nitroglycerin, salvia dripping pills, fast-acting Xingxin pills, etc.; Cardiac arrest is indicated if the patient is unconscious, the pulse of the large arteries (carotid or femoral) is absent, and breathing stops or sighs, and CPR should be started immediately. Before the ambulance arrives, the patient must be closely observed for changes, and if necessary, you can call "120" for telephone guidance and help.
Fourth, try to master cardiopulmonary resuscitation
Sudden cardiac death is the most common and most serious case of cardiovascular disease, there is a sudden cardiac death event almost every minute in the mainland, but the rescue success rate is less than 1%, time is life, the earlier you start cardiopulmonary resuscitation, the higher the success rate, if you start cardiopulmonary resuscitation within 1 minute of sudden death, the success rate can reach 80% to 90%, the success rate within 4 minutes is about 50%, if the success rate is almost zero after 10 minutes, so it is very important to be proficient in cardiopulmonary resuscitation technology and carry out first aid in the first time. Key points of cardiopulmonary resuscitation: once it is confirmed that breathing and heartbeat have stopped, immediately place the patient supine on a solid plane, expose the patient's chest, the rescuer's palm is close to the middle of the patient's chest (the midpoint of the two nipple lines, the lower half of the sternum), the ten fingers of both hands are interlocked, the palms are overlapped, the palms are cocked, the upper limbs are straightened, the upper body is leaned forward, the joints are the axis, and the strength of the upper body is used to press vertically downwards to ensure that the compression depth is 5~6 cm, and the chest cage is completely restored to its original state after each compression, and each compression is 30 times (about 15~18 seconds) after 2 mouth-to-mouth artificial respirations (hold the jaw with one hand, pinch the nostrils with the other, aim at the patient's mouth and blow inward, then release the nostrils, and then use the same method to blow a second time, the two blows should be completed within 10 seconds, if there is a foreign body in the mouth before blowing, it should be removed before blowing), chest compressions and artificial respiration are carried out in a 30:2 ratio until the first aid personnel arrive or or the heartbeat breathing is restored. If you can get an AED (automated external defibrillator) before the ambulance arrives, the AED is easy to operate, just "listen to it, follow it", and follow the voice prompts and screen display.
5. Be prepared to seek medical treatment as soon as possible
Before the ambulance arrives, prepare the medical insurance card, medical record book (book), determine the escort, and some necessary daily medicines and daily necessities to the hospital, so as to avoid delaying the time of sending to the hospital by rushing to find things after the ambulance arrives; In addition, it is estimated that the ambulance will arrive at the approximate arrival time, and wait for the ambulance at the entrance of the community or the place agreed with the driver of the ambulance in advance, so that the emergency personnel can reach the patient for first aid faster. At the same time, it is extremely important for emergency physicians and in-hospital physicians to understand the patient's condition by collecting and sorting out as much critical information as possible before first responders arrive. This information includes the patient's name, age, known health problems, medications being taken, and any known allergic reactions. If possible, ask the person or their relatives about recent events, such as whether there has been a recent history of strenuous exercise, angina, or recent health changes.
6. Cooperate with first responders wholeheartedly
After the first responders arrive at the scene, the patient needs to be transferred to the hospital quickly after the necessary examinations and treatments have been quickly administered. During this process, it is important to cooperate with first responders in carrying work. Ensure that the handling path is clear, remove obstacles that may hinder the handling, and ensure that the path from the scene to the ambulance is clear. All critical and serious diseases, ambulances are sent to the hospital are to follow the principle of "nearby, urgent, and capable", family members should fully believe in them, follow their suggestions and arrangements, many people often think about sending them to a big hospital for the first time, rather than the nearest hospital, in fact, the first thing to consider is the rescue time, to ensure that the first life, the nearest treatment is the most important, the ambulance on the road delay of a minute will be more uncertain factors and dangers.
In conclusion, timely, effective first aid and close collaboration with pre-hospital first responders are key to saving lives in cardiovascular emergencies. Every step counts, from initial judgment and timely emergency calls to the implementation of basic first aid measures. At the same time, maintaining the safety and stability of the emergency scene, as well as effective communication with medical professionals, are important factors to ensure the success of first aid. Through learning and training, everyone can become a lifesaver in cardiovascular emergencies.
Unit: Shanghai Minhang District Medical Emergency Center
Author: Chen Diping
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All names and place names have been changed and any similarities are purely coincidental.