Shantou is committed to perfecting the first aid system and improving the self-help and mutual aid ability of the whole people.
Sudden cardiac death refers to the natural death caused by various cardiac causes, with loss of consciousness as the forerunner. Sudden cardiac death is often very dangerous when it occurs, and the patient’s life hangs by a thread, and the effective rescue time is extremely short.
The relevant person in charge of Shantou Health and Health Bureau said that at present, all relevant departments in the city are working hard to improve the self-help and mutual rescue ability of the whole people, improve the treatment rate of sudden cardiac death and the level of social first aid in the city, improve the construction of social first aid system, reduce the casualty rate caused by natural disasters, production accidents and emergencies, and further protect people’s lives and physical health.
make a concerted/united effort
Race against time to beat "Death"
In the night, a rush of ambulance sirens sounded in front of a gymnasium in Shantou, and an unconscious patient was quickly taken to the ambulance. Before getting on the bus, the patient had received 3 times of AED defibrillation and continuous chest compressions. In Shantou Central Hospital, the first aid team has been in place, and the patients are ready to be rescued immediately after they arrive at the hospital.
This tense scene happened on the evening of November 20th. At about 21: 15 on the same day, a badminton friend suddenly fell unconscious, collapsed, convulsed and foamed at the mouth while chatting with others after playing. Fortunately, there happened to be several doctors in the crowd of the nearby stadium, and they responded quickly after hearing the staff calling for help.
"We heard it and immediately ran over and immediately started rescue." Wang Jiawei, deputy chief physician of the Department of Nephrology, Shantou Central Hospital, said that the patient had no pulse in the carotid artery at that time, and it was judged as cardiac arrest, so he and his fellow doctors and friends put the patient on a flat ground to take over chest compressions. Considering that the patient has malignant arrhythmia, they asked the venue staff for AED (Automatic External Defibrillator) to defibrillation the patient.
After receiving the alarm, Shantou 120 Emergency Command Center immediately assigned Shantou Central Hospital to drive. At 21: 16, the medical staff prepared all kinds of first-aid equipment within 1 minute and went out to the scene for treatment. Guo Shunqi, director of the emergency department of Shantou Central Hospital, said that 120 ambulances are equipped with mechanical cardiopulmonary resuscitation machines, which ensures that vehicles can also perform high-quality cardiopulmonary resuscitation during fast driving; The emergency intensive care unit (EICU) team has made sufficient preparations in the hospital, and the extracorporeal membrane oxygenation (ECMO) team that provides extracorporeal breathing and circulation for patients with severe cardiopulmonary failure has also been put in place, ready to participate in the rescue at any time.
Zhao Xianwu, deputy director of the fever clinic, who was admitted to the emergency department that night, said that the emergency team immediately started treatment and collected medical history for emergency assessment as soon as the patient was received. After circulating compression for nearly 10 minutes, the patient recovered sinus rhythm. According to the ECG results, the patient was diagnosed with acute myocardial infarction, so the emergency team immediately started the green channel of the chest pain center, and the cardiovascular intervention team immediately arrived to prepare for interventional surgery and get through the infarcted coronary artery. "The sooner the coronary artery is opened, the better. Time is the heart muscle, and one second earlier can save the patient more dying heart muscle! " Zhao Xianwu introduced that it took only about 30 minutes from the time when the patient was sent to the emergency door to the time when the interventional team first put the balloon to open the infarcted blood vessel, which was far faster than the internationally agreed golden "gateball time" of 90 minutes.
From the time when the patient was found abnormal in the venue in time, to the time when the doctor on the scene made accurate judgment and first aid, the staff took the AED for defibrillation; Then go to Shantou 120 to assign the police at the first time, Shantou Central Hospital will leave the car quickly, and all departments will cooperate tacitly after the patient arrives at the hospital. This emergency rescue perfectly explains the seamless connection between pre-hospital first aid and in-hospital first aid. Lu Senrong, deputy director of the Emergency Intensive Care Unit (EICU), said that through the concerted efforts of various departments, the patient’s condition is stable, his mind is awake, and his overall prognosis is good, and he is being further actively treated.
Strengthen training
Ordinary citizens can also be rescued after training.
Guo Shunqi introduced that in this race against time, the seamless connection of all parties is the reason why patients can save their lives in time and achieve a good prognosis. He introduced that after the cardiac arrest, the success rate of patient rescue dropped by about 10% every past minute, that is, the time window for rescue was only 10 minutes. More importantly, 4 minutes after cardiac arrest, brain cells will be irreversibly damaged due to ischemia, so timely rescue within 4 minutes is of great significance to the recovery of patients, which has the saying of "golden 4 minutes".
"We appeal to the public to actively participate in first-aid skills training and dare to rescue them in time in case of emergency." Guo Shunqi introduced that ordinary citizens can carry out cardiopulmonary resuscitation and use AED as long as they have received professional first-aid skills training, and can start rescue before professional medical staff arrive.
It is understood that at present, Shantou is stepping up the government-led efforts to co-ordinate people’s first aid training. Shantou Health and Wellness Bureau takes the lead in organizing emergency department experts and medical technical backbones from Shantou 120 Command Center, downtown hospital, the Second People’s Hospital, the First Affiliated Hospital of Shantou University Medical College and the Second Affiliated Hospital of Shantou University to form a training expert group and teaching team. According to the specific conditions of different training objects and units, the training content is set up, and the common sense of mass self-help and mutual aid and the basic skills of on-site first aid are highlighted. Through training in cardiopulmonary resuscitation, AED operation and emergency treatment of common family emergencies, it can effectively promote the improvement of citizens’ first aid technology and achieve a win-win effect of self-help or rescue. At the same time, the relevant departments continue to carry out first aid knowledge training, public welfare publicity and theme publicity activities to enhance pre-hospital first aid awareness and public participation rate, and effectively contribute to protecting people’s lives, health and safety.
In addition, Shantou Red Cross Society has also established a team of professional ambulance training teachers with professional trainer qualifications certified by the Red Cross Society. With the theme of "Red Cross’ rescue’ at hand", it has continuously carried out the "five-entry" activities of emergency rescue training in communities, enterprises, institutions, schools and rural areas to carry out emergency training for the public, enhance the public’s awareness of safety prevention and improve the people’s emergency rescue ability.
Guo Shunqi appealed that citizens and friends should actively participate in first aid training and master first aid skills. He encouraged every citizen with first-aid skills to lend an emergency hand and dare to give first aid in time when someone else’s heart stops. He reminded that Article 184 of the Civil Code of People’s Republic of China (PRC) stipulates that "the rescuer shall not bear civil liability for damage caused by voluntary emergency rescue", which confirms that emergency rescue can be used as an exemption. Therefore, citizens and friends who have received standardized first aid training need not worry too much about emergency rescue.
Perfect construction
Accelerate the configuration of AED in public places
Looking back at the scene of this first aid, when the patient was unconscious, it was Wang Jiawei and his fellow doctors and friends who relayed chest compressions for the patient. All citizens who have received first aid training know that chest compressions are "physical activities": the frequency is about 100 to 120 times per minute. At this critical juncture, the staff of stadiums and gymnasiums took the AED in time, which greatly improved the quality of this tense pre-hospital first aid.
Guo Danfeng, deputy director of Shantou 120 Emergency Command Center, said that this is also the first case in which AED was successfully used to save sudden death patients since Shantou was equipped with AED in crowded and influential public places in 2020.
At present, Shantou has installed 163 AED163 units in schools, institutions, large commercial complexes, industrial parks, tourist attractions, stadiums, stations and other public places. When the citizens find that the people around them have cardiac arrest, they can use the "Shantou AED" WeChat applet or map navigation software to navigate and access the AED at the first time. Before the arrival of 120 ambulance professional emergency personnel, early cardiopulmonary resuscitation, calling 120 for help and timely use of AED defibrillation are very important to improve the survival rate and clinical prognosis of patients with cardiac arrest outside the hospital.
According to Shantou Health and Wellness Bureau, based on the existing 163 AEDs, the bureau will allocate 400 AEDs in crowded public places in the city by the end of 2025 according to the population density, personnel turnover and other factors and the principle of step by step. Among them, in 2023, it is planned to complete the deployment of 100 AEDs in middle and high schools, institutions, communities, large commercial complexes, tourist attractions, farmers’ markets and other public places, and 150 AEDs in 2024 and 2025 respectively.
Shantou Health and Wellness Bureau also led the 120 Emergency Command Center to connect AEDs in public places in the city to a unified AED cloud management platform, unified logo identification, unified setting norms and unified management processes, and realized online management of AED location information, configuration units, functional status, daily inspection, maintenance and usage records. With the remote management of "internet plus AED" technology, once someone takes the AED, the chassis will automatically give an audible and visual alarm. When the AED is turned on and used, the management personnel of the AED cloud management platform can inform the on-the-job personnel of the configuration unit to go to the scene for first aid after receiving the alarm information, so as to realize the intelligent and life-cycle remote management of AED equipment.
In addition, Shantou Housing and Urban-Rural Development Bureau will also implement the installation of AEDs in new buildings and new residential quarters, and regard the installation of AEDs and the rescue training of property personnel as the basic construction standards for new buildings and new residential quarters, so as to create a safe community integrating first-aid equipment, first-aid skills certification of property personnel and popular science of first-aid knowledge.