[2023 "Science Popularization China Youth Star Creation Competition"] Use your hands to ignite the hope of life - Single-person BLS first aid technique

The author of the winning works of the 2023 "China Science Popularization Star Creation Competition": Feng Zhiliang

One spring day a few years ago, a young woman suddenly collapsed at a bus stop. Several passengers and passersby found her and called the police, but no one knew how to perform cardiopulmonary resuscitation (CPR) or use an automated external defibrillator (AED). By the time the 120 ambulance arrived at the scene, the woman had already lost precious time for rescue.

Despite the medical staff's full efforts to rescue her, she still did not recover her spontaneous breathing and heartbeat, and eventually bid farewell to this world forever in that beautiful spring scenery.

This is a regrettable case, but it also sends us a warning signal - if someone at the scene could perform CPR and use AED in time, perhaps the speed retardation button could have been pressed when the woman's life was about to end.

But life is only once, and there is no way to rewind and replay it...

According to statistics from the American Heart Association (AHA), more than 350,000 people suffer cardiac arrest outside of hospitals each year, but only about 10% survive. Cardiac arrest is one of the most common causes of sudden death. There are more than 500,000 sudden deaths in my country each year, and 70% of cardiac arrests occur outside of hospitals, but less than 1% of on-site witnesses are able to provide first aid.

If CPR and AED are performed within a few minutes after cardiac arrest, the patient's survival rate can be increased several times. Therefore, it is very important to master this first aid skill, which can save a life and continue the happiness of a family at a critical moment.

Chest compressions Source: pixabay

Basic life support (BLS) is a technique that uses manual resuscitation to rescue people in emergency situations such as cardiac arrest or respiratory arrest.

BLS includes two main parts: CPR and AED. CPR maintains the patient's blood circulation and oxygen supply by compressing the chest with hands and performing artificial respiration. AED is a portable electronic defibrillator that can detect and correct arrhythmias. It restores the patient's heart to normal beating through electric shock, thereby restoring blood circulation and oxygen supply to the heart and brain.

The purpose of BLS is to provide the most basic life support to patients within the golden time (4 to 6 minutes) after cardiac arrest, to prevent the brain and other important organs from being damaged due to lack of oxygen, leading to death or permanent disability. In most cases, pre-hospital emergency personnel are often unable to arrive at the scene within the golden time, so BLS can buy precious time for patients to wait for the arrival of emergency personnel.

So how to perform BLS first aid correctly and effectively? (Take a single rescuer and an adult patient without professional training as an example)

CPR:

Confirm safety: Before approaching the patient, first confirm whether the scene is safe to avoid putting yourself in danger.

Check for identification: Tap the patient's shoulder and call out loudly, "Are you okay?" Observe if the patient has any response.

Call for help: If the patient is unresponsive, call 911 or have someone else call 120 immediately and look for a nearby AED.

Check breathing and pulse: Kneel on the side of the patient's torso, use the index and middle fingers to touch the patient's carotid artery pulse (2 cm next to the Adam's apple) for 5 to 10 seconds, put your ear close to the patient's mouth and nose to feel the breathing airflow, and observe the chest to observe the rise and fall. If there is no breathing and pulse, CPR needs to be performed immediately.

Chest compression: Place the base of one hand on the center of the patient's sternum (midpoint of the line connecting the two nipples), and cover the back of the first hand with the other hand, and cross the fingers. Use the weight of the body to press down 5 to 6 cm at a speed of 100 to 120 times per minute. When pressing, the arm should be straight (perpendicular to the patient's chest), and the elbow should not be bent. After each compression, the chest should be allowed to fully rebound without the palm leaving the chest wall, and the compression should not be interrupted.

Artificial respiration: Before performing artificial respiration, you need to clear the respiratory tract of foreign matter or secretions and fully open the airway. For rescuers who have not received professional training, they can only perform compressions without artificial respiration. If they are performed alternately or by two people, first aid should be performed in a cycle of 30 chest compressions and 2 artificial respirations.

AED:

After obtaining the AED, turn it on immediately and follow the voice prompts. First, connect the electrode patch wire to the AED, and stick the two electrode patches on the patient's chest skin as shown in the figure, one on the upper right and one on the lower left.

Analyze heart rhythm: After the electrodes are attached, the AED will automatically start analyzing the heart rhythm. Do not touch the patient during this period to avoid interfering with the analysis results. The AED will give corresponding voice prompts based on the analysis results.

Electric shock defibrillation: Before pressing the defibrillator button, make sure everyone is away from the patient and shout out warnings such as "get out of the way". After the shock, the AED will analyze the patient's heart rhythm again and decide whether to repeat the shock based on the situation.

Continue CPR: Regardless of whether another shock is needed, the AED will prompt the rescuer to continue CPR and provide countdown and rhythm guidance until vital signs are restored or emergency personnel arrive.

Automatic external defibrillator Image source: pixabay

These operational steps are the most core and critical links in the basic life support treatment process. Only high-quality implementation can effectively improve the success rate of resuscitation.

hint:

No matter when, safety should be the primary principle to avoid secondary injuries, such as car accidents, explosions, falling objects, and defibrillation scenes.

Laying the patient flat on a hard surface can help improve the quality of chest compressions.

When there is water flowing or rescuing a drowning patient, ensure the environment is safe and wipe the patient's chest wall skin dry before using the AED.

Whether artificial respiration is needed depends on whether the patient has spontaneous breathing; whether chest compression is needed depends on whether the patient has a pulse; whether defibrillation is needed depends on the results of AED analysis of heart rhythm. If any of the three indicators is restored, the corresponding measures do not need to be taken, because it means success.

Some people can't help but ask: How do I know where the AED is near me?

If there are relevant staff or signposts nearby, it is naturally the quickest way to get it. If you are outdoors in an open space, you can try this method: open the mini program → search for "AED", and you can usually find the AED map of the corresponding local location.

BLS is the first line of defense for treating cardiac arrest patients, and is also a key factor in improving the survival rate of patients and reducing sequelae. This simple and effective first aid technique can be learned and put into practice by everyone. As long as you have a pair of hands and a little courage, you can become a guardian of life, light up the flowers of hope in others' hearts, and let them enjoy the joy and prosperity of spring!