Doctor, this is terrible, there is a ghost in my house...

This is the 2882nd article of Da Yi Xiao Hu

story

During the night shift, around 21:00, the crew received an order sheet: In a village on the outskirts of the city, the chief complaint was fainting.

After the ambulance started, I called the person who called the police to ask about the situation at the scene.

"Doctor, this is terrible, there is a ghost in my house!" the person who called the police shouted in a trembling voice.

"Don't be anxious, just tell me slowly what happened?" I asked soothingly.

"My wife was taking a shower on the second floor and somehow fell to the ground. My mother-in-law went in to check and saw her fall to the ground not long after. My father-in-law went in and saw her fall to the ground too. They were both unconscious. It really was a ghost!" said the person who called the police.

"What does your wife use to boil water for a bath? Does she use gas?" I asked quickly.

"Yes!"

"It's most likely gas poisoning! Turn off the main gas valve immediately, open the doors and windows for ventilation, and then find a way to move the patient to a place with good air circulation!" I ordered hurriedly.

"Doctor, there is no smell of gas in the house. How could it be gas poisoning?" the person who called the police asked in confusion.

"It's hard to say now, but you should just do as I say first!" I replied.

The ambulance arrived in more than ten minutes. The patient had been moved to the door. Many people gathered at the scene. I immediately went to check on the three patients. The wife of the person who called the police had no vital signs, and his mother-in-law was still unconscious. Fortunately, his father-in-law had woken up, but he had a headache, nausea and vomiting.

I went to the second floor of the patient's house to check. There was a faint pungent smell, but there was no obvious smell of gas.

We sent the father-in-law and mother-in-law of the person who called the police to a nearby hospital. We called the next day and learned that both patients had recovered and returned home after receiving hyperbaric oxygen.

Although there is no conclusive evidence, based on the hyperbaric oxygen treatment that the two patients received later, it is still considered that the patients were poisoned by gas.

The main component of coal gas is carbon monoxide, which is odorless. It is only during industrial production that a small amount of foul-smelling gases such as hydrogen sulfide and ethyl mercaptan are added to serve as a warning in case of leakage. Perhaps a small amount was added that day, so there was no "coal gas" smell.

Now that the story is over, let’s review what we talked about in the previous issue:

The basic routine of first aid is "six questions and three don'ts", that is, when a sudden injury or illness occurs, no matter what the situation is at the scene, ask yourself six questions and remind yourself not to do three things.

The six questions are:

1. Are there any safety issues?

2. Is the airway open?

3. Is there any active bleeding?

4. Is the condition serious?

5. Is the body position appropriate?

6.Do you want to call 120?

The mnemonic for the six questions is “Ammonia comes out, the body is healthy and well”, “ammonia” means safety, “air” refers to airway, “out” means bleeding, “disease” refers to the condition, “body” refers to body position, and “well” means 120.

The three are not

1. Don’t over-process.

2. Do not move the patient at will.

3. Do not feed or give medicine at will.

Those who are interested can search for the previous issue "At the first aid training site, a student suddenly fell ill..." to view the details.

So what are we going to talk about in this issue? The first of the “Six Questions”: safety issues.

Safety is always the most important issue, because first aid itself is related to whether the patient can survive, and safety issues sometimes are related to whether the rescuer and the patient can survive. Therefore, the first step of on-site first aid is always to confirm whether the scene is safe.

Common safety issues associated with first aid include environmental safety, infection risks, and legal issues.

01

Environmental safety

Ensuring a safe environment is the first principle of first aid. If the environment is unsafe, we must first try to eliminate the unsafe factors. If the dangerous factors cannot be eliminated, we cannot rush to rescue. Common dangerous factors are as follows:

1. Traffic Accidents

It is common for traffic accidents to cause secondary accidents. Therefore, after an accident, be sure to place warning signs far enough away from the direction of the oncoming vehicle. Even if warning signs are placed, it is best to have someone always observe the situation of the oncoming vehicles behind. If possible, retreat to a safe area as soon as possible and wait for rescue.

2. Accident sites such as earthquakes, landslides, explosions, etc.

The danger of this type of accident mainly comes from secondary accidents. Earthquakes may have aftershocks, landslides may have secondary collapses, and it is even more uncertain whether there is a possibility of another explosion at the explosion site. Before entering the rescue site, you must fully assess the possibility of secondary accidents, and you must not stay at the site for a long time. Try to ensure that the patient is evacuated quickly while ensuring the principle of first aid.

3. Murder or fight scene

The danger of a murder or fight scene mainly comes from the chaos at the scene. The scene is very dangerous before the police arrive to maintain order.

4. Electric shock, leakage of chemicals, radioactive substances or toxic gases

The danger at the scene of such incidents may persist and be difficult to detect. If you rush to rescue someone, it is easy to put the rescuer in danger. The story we are talking about in this issue belongs to this category.

02

Risk of infection

Regarding infection, there are two aspects that need to be paid attention to during on-site first aid:

1. When performing mouth-to-mouth artificial ventilation, it is best to do it under protective equipment.

If there is no professional protection such as breathing membrane, you should also use clothes or towels to isolate yourself.

2. When applying pressure to stop bleeding, try to wear gloves and protective glasses.

Even if you wear gloves, be careful of sharp objects such as glass fragments and barbs left in the wound to avoid scratching yourself. If you don't have gloves, try not to press the wound directly. You can cover the wound with clothes or towels before pressing, or use the patient's hands to isolate and press. If blood splashes into your eyes, rinse them immediately with running water. After the rescue, remember to wash your hands carefully.

03

Legal and ethical issues

Legal and ethical issues are a must when learning first aid, especially when rescuing strangers. We need to pay attention to the following points:

1. Identify yourself before providing rescue

It is the obligation of the rescuer to identify himself before rescuing, and it is also the basic right of the patient to accept or not accept first aid. You must identify yourself before rescuing to show your goodwill. You should also emphasize that you have learned first aid and ask the patient for his opinion. In principle, people who have not received formal first aid training are not qualified to rescue. Because if it were you, would you want to be rescued by a professional, or would you want to be helped by a kind person who does not know first aid?

2. Try to leave evidence or witnesses before rescuing strangers

It is necessary to take photos as evidence or have others testify. Saving lives requires skills and courage, and even more wisdom. In fact, as long as there are other witnesses at the scene, you are unlikely to be blackmailed. Disputes over saving lives mostly occur when there are no witnesses or strong evidence such as surveillance videos.

3. Keep the operation as standardized as possible

We can see in many news reports that enthusiastic citizens will use a variety of methods to save people. These non-standard first aid may be detrimental to the patients and may also bring hidden dangers to disputes.

4. Do not seek to achieve success, but to avoid mistakes

If you are not fully confident at the scene, it is a wise choice to call 120 and provide rescue under the guidance of the dispatcher. You should avoid rash rescue at the scene, which may cause harm to the patient and may also bring unnecessary trouble to yourself.

Author: PhD candidate in Internal Medicine, Kunming Medical University

Zhou Guozhong