Coming to Rescue
There is a near total absence of a support system for medical emergencies outside the hospital in Kashmir
Last summer, following a Golf Tournament at the good old Kashmir Golf Club, participants were busy having their lunch. Suddenly, there was an unusual activity about a dozen yards away from me. A young golfer was giving Abdominal Thrusts (Heimlich Maneuver) to one of the senior most golfers who had apparently chocked on a piece of meat. Out came the piece of meat, the gentleman was relieved; a big disaster averted. Not many people around at that particular spot would have known as to what was happening. But possibly the gentleman could have gone to develop a complete airway obstruction and the resultant consequences; he could have even died of respiratory failure. Thank God nothing like that happened. I felt so proud of the young man for I exactly understood what a commendable job he had done. It reminded me of the training, the drill and examinations that I had gone through every second year of my past 25 years. What that young man did, was to provide Basic Life Support to a victim of choking.
There have been two famous catastrophes, on the course, in Kashmir Golf club. Who knows, they could have been saved with a timely help? Not too long ago, one of the most esteemed professors of Medicine from Srinagar expressed his great anxiety to me about the near total absence of a support system for medical emergencies outside the Hospital. He was truly worried, “What, if I collapse while walking down a road, does anyone know how to help?” was his question. Perhaps he was gripped by a recent comment in a tabloid saying that an individual having a heart attack in a McDonald outlet in USA has a better chance of survival than a Hospital Ward in Kashmir. “I have not trained any of my students in providing Basic Life Support during my time”, the professor admitted with sadness. “There is no indication that it is being done presently, either.” he added.
BLS or basic life support is a skill, an expertise, that any individual, medical or non medical, learns so that he or she can provide the initial help to a victim faced with a medical emergency. There by, the risk of death from the initial episode, inside or outside the hospital is reduced and some lives saved. BLS is a step further up the ladder of ‘first aid’ as we know the term from older times. This skill may need utilising for several conditions like sudden cardiac arrest (heart attack), brain stroke, choking, drowning, poisoning, electric shock etc. It is indeed a common practice in developed and many developing countries to train, senior students, teachers, security personal and surface and air transportation staff as basic life support givers. Cardiopulmonary resuscitation (CPR) is a part of this support system. There are separate protocols for adults, children and infants. For the past several years Automated External Defibrillator (AED), a device used to revive a dying heart, has been a common sight at airports, railway stations, schools and colleges, restaurants and offices. Present day AED’s are made to be user friendly, even voice prompting the user, step by step, with what to do. Manufacturers provide these at much subsidised prices as a good will to their societies. Two hours of teaching and training, half an hour of video demonstration and an hour of practice is all that is required for any fit and averagely educated person to learn being a BLS provider.
Applied to hospital staff, it is an essential requirement for all the medical and paramedical staff to be qualified in BLS training. License to practice and therefore the renewal of employment contract is subject to updating BLS certification every two years. In the West and even in Middle Eastern and Far East states, no doctor or nurse will be allowed to work without a certification of BLS. In recent years it has been made compulsory for anesthesiology, radiology and laboratory technicians as well as pharmacists and physiotherapists. Ambulance drivers and disaster management workers are in fact a step ahead in such training. Medical personnel may need to provide this type of support as a part of their job or simply as a bystander within or outside the hospital.
Kashmir must be the only place in the whole World where an approval for imparting life support training to the doctors must come from the state Chief Minister (……also approved training of Cardio- Pulmonary Resuscitation to Residents and staff of SKIMS; Greater Kashmir 17 May 2012). It is so incredible! Does it mean that no such training has been given to the Residents and other staff up till now? And where does the approval of the Chief Minister come into this. BLS and CPR is a pure and simple teaching activity, organised by the clinical tutor that needs to be left at that. It is a routine hospital practice, forms a vital component of modern day medical training that needs no permission or approval from the apex body. One would like to think that the honourable CM himself would have exclaimed, finding such a point on the agenda of the apex body. BLS and CPR training needs to be made mandatory for every Medic and Paramedic working at the SKIMS and indeed in all medical institution of the state. No Medicine or Nursing student should be allowed to take the final qualifying examination without a certification of BLS. State Medical council needs to monitor the compliance and not register any doctor or a nurse without completing such a requirement. There is every chance that different medical councils around the world will not recognise our degrees if we do not change the present system of training. Unfortunately, SKIMS cannot claim to be a premier, super speciality centre of excellence if their staff is not trained in CPR. There is no reason why this programme cannot be carried to colleges, universities, teachers and police training schools. It will cost no money, only a day’s time from an individual who cares for a fellow citizen.
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Lastupdate on : Mon, 11 Jun 2012 21:30:00 Makkah time
Lastupdate on : Mon, 11 Jun 2012 18:30:00 GMT
Lastupdate on : Tue, 12 Jun 2012 00:00:00 IST
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