The relationship between first aid and emergency health

The core relationship between first aid and emergency health is that the former serves as the end-to-end link for the latter, forming a full-chain health protection network covering "prevention, handling during the event, and recovery after the event." The two are neither substitutes for each other, nor are they independent of each other. The two common misunderstandings currently common among the public are that "first aid is equal to emergency health" and "emergency health does not require mastering first aid skills", which are precisely caused by misunderstandings of the relationship between the two.

Last summer, I encountered a very typical incident when I was doing free health clinics in the community: Uncle Zhang, who lived in Building 3, suddenly fainted while playing chess downstairs. His face was red and his whole body was hot. People gathered around him and pinched him and poured Huoxiang Zhengqi water into his mouth. He didn't stop until the doctor from the community health service center ran over. This was the early stage of heat stroke. When you are unconscious, taking medicine can easily choke the airway and cause suffocation. You have to move to a cool place to physically cool down. Later, this matter was quarreling among the owners for almost a week. Some people said, "Is it wrong for me to provide first aid?" ”Someone said, "I have already reminded him not to sit in the sun all afternoon if he has high blood pressure. If he doesn't pay attention, what's the use of first aid?" ”The essence of the quarrel between the two parties is actually a point of contention that has not been completely unified in the public health field and emergency clinical circles.

Most scholars in the field of public health prefer the "pre-emergency theory", and the data they have is indeed hard: a report released by the National Cardiovascular Center in 2023 shows that the success rate of out-of-hospital cardiac arrest rescue in my country is less than 1%, and more than 90% of the incident witnesses did not dare to perform cardiopulmonary resuscitation, let alone use an automated external defibrillator (AED) correctly. The view of this school is very clear: the core of emergency health is to move the disposal window forward. After all, the golden rescue time for most health emergencies is within 10 minutes. When 120 arrives, the best opportunity is often missed. First aid skills are the "window of opportunity" that ordinary people can seize. I went to an industrial park in Shenzhen for research. Every floor of the factory there is equipped with an AED, and each team has at least two people with first aid certificates. Last year, we rescued three workers who had suffered a myocardial infarction. They probably wouldn't have been able to save them elsewhere.

However, many front-line doctors in the emergency department do not agree with this statement. When I chatted with Brother Li from the emergency department at the municipal hospital, he also complained that last month I picked up three young men who died suddenly while running a half-marathon. The youngest was only 22 years old. He had never done a cardiopulmonary function screening. He had no idea about the congenital coronary stenosis. He had to finish the whole race. Even if someone at the scene performed cardiopulmonary resuscitation and was sent to the ICU for three days, he still didn't survive. He always said, "First aid is just to make up for it. When it comes to cardiopulmonary resuscitation, it's already the last step." This group prefers "prevention first" and believes that the core of emergency health should be risk screening beforehand: patients with high blood pressure regularly measure blood pressure, people with allergies carry anti-allergic drugs, and people with high workloads undergo regular cardiopulmonary function tests to eliminate sudden risks from the source, which is more effective than any first aid.

Don't tell me, in reality many people really look at the two separately. I was doing emergency training for an Internet company a while ago. When the boss came up, he patted his chest and said, "We have installed AEDs on every floor, and all employees have taken the first aid certificate exam. We have absolutely no problem with emergency health." I asked him back then: Do you have statistics on how many people in the company have high blood pressure in the backend? How many people stay up past 12 o'clock for a month? Last month, the young man in your operation and maintenance department worked overtime until he had a nosebleed. Did you force him to take a rest? The boss was stuck at that time. To put it bluntly, emergency health in the eyes of many people means "buying good equipment and learning first aid", but no one cares about the risks hidden in daily life. Just like if you install the best airbags in your car, but never perform brake maintenance, or drive a sick car on the road every day, the airbags will not be able to save you in the event of an accident.

Oh, yes, there is another typical counter-example. Last year, an employee in an office building in Shanghai suffered a cardiac arrest. The whole building was equipped with three AEDs, but they were all locked in the fire cabinet at the end of the corridor. Everyone searched for the key for 10 minutes, but in the end, the employee could not be rescued. Are you saying that everyone has no first aid skills? There were several people on site who had taken first aid classes, but the emergency health system had not kept up. It was useless no matter how well equipped the equipment was or how well they learned the skills.

I have been doing first aid training for 5 years, and I never tell students that "everything will be fine if you learn first aid", nor that "if you take precautions well, you don't need to learn first aid." The relationship between the two is actually like when you drive on the road: do regular maintenance, wear seat belts when driving, don't speed or drink and drive. This is the pre-prevention of emergency health.； When you encounter an accident, the airbag pops up and the seat belt pulls you down, that means you have first aid at your fingertips. You can't say that if you have a seat belt, you don't need to install an airbag, and you can't say that if you install an airbag, you can run a red light, right?

Some students have asked before, “I’m not a doctor, so what’s the use of learning this? ”I told her about Aunt Wang in our community. Last year, Aunt Wang learned the Heimlich maneuver from the community. When her grandson got stuck in his throat after eating jelly, she took out the foreign object in 30 seconds. If she had to wait for 120 to come, it would have taken at least 10 minutes. The child might have suffered a lack of oxygen and brain damage. Would you say this is first aid or health emergency? In fact, they are inseparable at all: only if you have emergency health awareness, you will take the initiative to learn first aid skills, and you can use them as soon as possible when something really happens. Otherwise, even if you know the Heimlich maneuver, if you don't care when you see a child stuffing the whole jelly into his mouth, if you try to save him if he is really stuck, the risk will have already become greater.

Now many cities are already piloting the integration of the two. I went to Hangzhou for inspection a while ago. The community emergency service station there provides free blood pressure and blood glucose testing and follow-up for chronic diseases to the elderly. It also has first aid kits and AEDs and offers free first aid classes twice a month. To put it bluntly, it is to weave a tighter safety net. The emergency health network seems useless at ordinary times. Only when you actually fall will you know that the tests you did in advance and the skills you learned in advance are the rope that will hold you in the end.