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New Delhi, May 13, 2019 :
In all times of flood, fire, famine, war (air raids), tsunami, earthquake, epidemics and even in day-to-day medical emergencies, one needs to know what to do. The recent unnatural calamity in Uttrakhand and such sporadic episodes of different magnitudes in India and abroad are not uncommon.
Besides, injuries, fractures, starvation, dehydration, gastrointestinal disturbances by polluted water/food, snake/rabid dog -bite, scorpion-sting, tetanus, plague epidemic, etc., add to the problems. Untimely heart attacks, fits, unconsciousness due to various reasons call for immediate attention.
Life may be saved by immediate aid by someone who has the knowledge in urgent medical tips, till the patient gets proper treatment. For this, one needs to carry, especially while travelling, some necessary medicines and other appliances besides his/her drugs of daily usage.
Some guidelines are given below:
Wounds/burns/fractures
Wounds: These are required to be cleaned with any antiseptic lotion and trial should be made to remove any foreign matter. In severe bleeding, raise the part in case of limbs, and tie the limb with a strong bandage or anything available (tourniquet). It should not be tied for more than half an hour, it may be repeated. Prophylactic anti-tetanus injection need to be given. Antibiotics and pain-killers are also required.
Injury to head, chest and abdomen require immediate attention. There may be fracture of skull bones, of ribs or of the spine. The wound should be cleaned as mentioned above. In case of abdomen, if intestines have come out, put sterilized gauze or cotton over the protruded viscera and apply loose bandage across the abdomen. Never try to force viscera into the abdominal cavity, outside the operation theatre.
Burns: Wrap the patient in a clean cloth. Mild cases may be treated like wounds.
Fractures: If there is a wound, treat it as described above. For fracture of collar bone (clavicle) tie any bandage or even cloth over the shoulder crossing the armpit (axilla), repeat the same on the other side, and then tie the two together over the back with the help of another bandage.
In case of fracture of upper arm (humerus), tie the lower limb, tie the fractured limb to the normal limb with the help of bandage. Available pain-killers shall be required.
Reviving heart :
The heart is revived by external massage. It is required when the heart stops working. There is no pulse, or it is so feeble that it can be hardly felt. The patient is gasping for breath or the breathing too has stopped. This usually occurs in an already ailing patient or the one who has had a sudden massive heart attack. The heart has to be revived within 3-4 minutes.
Put the patient on the floor with the back touching the ground. The neck of the patient is to be pulled backward and legs are raised. No pillow or any other thing is required to be kept under the head. One person places his palm on the lower part of the sternum, and immediately puts the other palm upon the palm already placed on the sternum. Now, with the help of two palms, the sternum bone is pressed backward for about 80 times a minute, and this pressure should not exceed 4-5 cm. Mouth-to-mouth breathing should be given by another attendant. In this process, the person forces his expiration into the mouth of the patient. During this time, the nose of the patient should be closed, otherwise the air forced into the mouth of the patient will come out through the nose. One breath after every five times of chest pressure/cardiac massage is required. If no other person is available, two breaths should be given after every 15 times of cardiac massage, by the same person giving cardiac massage.
Artificial respiration :
It may be required when the patient cannot breathe properly as for instance in cases of drowning, etc., or in cases of heart attack.
The patient be made to lie on the floor with no pillow. Gently pull the neck backward and hold the jaw. Then start mouth-to-mouth breathing as mentioned above. In case of children, expire both into the mouth and nose at the same time, while in the case of adults the nose is closed with the help of fingers.
If possible, artificial respiration may be given by prone-pressure method. In this case, put the patient on the floor, in a prone position so that the chest and abdomen are in touch with the floor. In this way, the tongue cannot fall back and obstruct the air ways. The attendant is to kneel with the thighs of the patient in between his knees and is required to place the palms on the lower part of the chest. The attendant is to press the chest with the weight of the body keeping the arms straight. This pressure is to be kept for 2 seconds, and the attendant swings backward. This is to be done 12-15 times per minute.
Snake/rabid dog-bite, scorpion-sting :
In all these cases, care of the wound shall be required. In case of snake-bite, tourniquet may be tied for a limited period. It may be noted that anti-snake venom, vaccine against rabies and scorpion antivenin are easily available. However, all snakes/scorpions may not be poisonous. Scorpionsting is most dangerous and one can die within few minutes to 24 hours. Hence the need for caution.
Plague epidemic :
A word about plague epidemic may be mentioned here. People die en masse during this epidemic. It can be forecast as well. The occurrence of seismic activity or an earthquake or the alike circumstances is an important warning signal.
Common but fatal diseases: Diabetes, hypertension, high blood cholesterol/uric acid and thyroid gland disorders are some of the common but fatal diseases. These need to be controlled adequately. Uncontrolled/undetected cases may lead to heart attacks, strokes and kidney failure requiring emergency medical aid mentioned above. Untimely deaths are not uncommon.
The above directions, though not exhaustive, are recommended for saving a life as and when the situation warrants. Above all, one needs to be emotionally balanced during and after the crisis.
Author :
Jaswant Singh Puri, Journalist
Member Dewan Family, Erstwhile Princely State of Patiala
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