There are small incidents in life which, although seemingly insignificant then, shape the person you become.
In today morning’s sleep-inducing lecture on ‘Managing a Case of Head Trauma‘, my mind couldn’t help but wander back to the day when ‘Head Trauma’ was more than just a gory picture in my textbook.
It was evening. The cold sun was setting on the horizon. I was sitting at this new ice-cream parlor near my college, taking a well-deserved short break from the truckload of case histories that I had to submit as a part of my Clinical Surgery exam. The parlor was off a busy road, almost impassable at that time of the day, as the traffic jostled to snake its way through. In the din of the traffic, I was so engrossed in my triple scoop sundae that pending assignments were momentarily forgotten.
Just then, I heard a loud blare of horn, a squeal of brakes, and I saw a car ram into a motorcycle. The biker flipped head over heals and hit the concrete.
My first thought was that it was nothing too serious. But as I saw swarms of people gathering on the site, a rush of adrenaline swept through my body. And in a mix of fear and concern, I started walking towards them.
The sight was enough to leave an indelible imprint in my mind.The traffic on the road came to a grinding halt. The biker had received head injuries and was lying unconscious.The fall had cracked his skull into pieces, and a gush of blood from his torn arteries was painting the dusty road into a gruesome red. There were unintelligible shouts from here and there; some shouting frantically at the frightened car driver. Most were content to just stand by the writhing biker, surrounding him in a circle. Nobody dared going close. I saw that his eyes were closed, respiration faster than normal, and shallow, like someone trying to fetch scarce air in a closed room.
As I knelt beside him, my thoughts were muddled, and before I could even sympathize, I mechanically took his head into my lap, and started looking for the source of the leak. I checked his carotids. His heart was still beating, the pulse getting faster and fainter with each passing second. It was in that inopportune moment that I realized that not one person in that hysterical crowd had offered to help. A feeling of disgust and frustration welled up inside me, but I knew this was not the time.
In a flash of reminiscence, I recalled the text box titled ‘Things To Do’ from my textbooks. In big, bold letters, the phrase ‘DO NOT PANIC’ stood out. Calming myself, I signaled a man standing close to ask the crowd to step away and make the place less suffocating. To another, I bawled out orders about making a call for an ambulance. As the crowd pulled back, I focused on the boy. I tried putting pressure on the sites from where he was bleeding. All the while, I kept talking to him, reassuring him. He was drowsy from all the blood loss, but I knew that my words were getting registered in his cortex. Although we didn’t know each other, I could tell that he found my touch and my words very comforting. It didn’t seem too long (a couple of minutes, at best) before the ambulance arrived and parked right in front of us. The back door flew open and two men jumped out, one caring a mask bag, the other a stretcher. In a flurry of motion they had the boy on the stretcher, and the doors slammed shut before I was on my feet. As I watched the ambulance speed away, the crowd dispersed in a matter of seconds. Normal traffic resumed. It was like nothing had happened. But that spot of red on the black tarmac told a different story.
Suddenly, I felt a strong jolt on my shoulder, a push that took me away from the red gore that lay on the road. I was in my Surgery lecture again, and the only words I remember hearing from the professor were, “Roll no 71?”
People often fail to respond correctly at the time of emergency. Their panic and non timely support often lead to a catastrophic result. To avoid this there are some basic rules that we need to keep in mind. We all need to know it because an emergency can happen anywhere may it be at home, a shopping mall, a swimming pool, a city street or a grocery store.
1. DO NOT PANIC
It gets worse before it gets better. Never panic. It eats your brain deranging the cognitive skills. Relax. Take a few deep breaths and get back to work!
2. CHECK FOR RESPONSE
See if they are alert or able to talk. Ask questions like ‘Are you okay?’ If they respond, ask ‘What is happening to you?’. Sometimes it is easily determined with their posture. A patient with myocardial infarction (heart attack) would be found clenching his fist over the front of the chest. It’s called a Levine sign. Check for their level of consciousness. If they become unresponsive in the middle, check for respiration and pulse.
3. CALL FOR HELP
This is the most important step. People often forget this and jump to step 4. If you don’t activate a help team, all your efforts would go wasted and you would only be left helpless and exhausted.
4. LOOK FOR RESPIRATION
The fundamental management of an emergency case is ABC ie, airway, breathing and circulation. See if the chest expands. Put your hand around the nose to look for exhaled air.
5. LOOK FOR PULSE
Pulse is a reflection of your heart activity. For every beat of your heart, there is a wave felt at the peripheral arteries. A failing heart will have a thready pulse. Often irregular. Look for the pulse at the neck(carotids) for 5 secs.
6. START THE CPR
CPR stands for cardiopulmonary resuscitation. People often believe only a medical professional can give CPR, well, anybody can provide this. It is the most life saving maneuver.
Brain can survive without oxygen for only 3 mins. Even before the ambulance arrives the brain can permanently go into a vegetative state of coma due to lack of oxygen. To avoid this, heart is mechanically caused to pump the blood with manual compression. The procedure is: Give a chin lift head low position to open up the airway. Start giving compression in the center of the chest right at the lower end of sternum.(it’s a long flat bone placed in the midline) The compression should be rapid almost at the speed of 100/min. It should be deep and equal, giving the same time for recoil. (This ensures proper filling of blood)
Hope this piece of information helps you all. Always strive to help the needy in a case of emergency, because it is only a coward, who in a perilous emergency, thinks with his legs. Have a great weekend!