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A few days ago while driving, my grandson suddenly shouted, “Stop, stop! Look at all the blood on the road.” I pulled up to the side, and saw a dazed, 75-year-old man fast losing consciousness. A motorbike had knocked him down and sped away. There was a gaping hole in the side of his leg and he was exsanguinating rapidly from a cut artery.
We had no first aid equipment but we ripped off his shirt and applied sufficient pressure to reduce the bleeding till we got him to hospital. Most of the bystanders did nothing while a few clicked snaps on their cell phones.
India has only one per cent of the world’s motor vehicles but accounts for six per cent of global road traffic accident (RTA) deaths. Over 1,20,000 people die on the roads every year (one every two minutes), and a majority of them is pedestrians. Twenty per cent of the accidents are the result of alcohol consumption. The majority of the workforce in India is males under 45. This means that the greatest number of deaths also occur in this age group. Of those who survive, most are bedridden or confined to a wheel chair. Usually, they are the sole bread earners for their families.
Stop and take charge as people are looking for leadership.
Check if the person is bleeding. Apply pressure over the site to stop the bleeding.
Get the person to the nearest hospital.
Maintaining heartbeat and breathing is very important. If necessary, perform cardio-pulmonary resuscitation (CPR). Learn it as 15 per cent of people will have the opportunity to perform CPR sometime in their lives. Basic resuscitation can be remembered as ABC.
A. Clear the airway because if it is blocked with blood, mucous, a foreign body (bones, nuts) or water, air cannot enter. Then perform the Heimlich manoeuvre.
Stand behind the person and wrap your arms around the waist.
Make a fist and place the thumb side of your fist against the victim’s upper abdomen, below the ribcage and above the navel.
Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.
Repeat until the object is expelled.
If the victim is pregnant or obese, it is difficult to wrap the arms all the way around. Then stand behind the victim, move your arms up into the victims armpits, and make a fist in the centre of the chest, over the sternum, before proceeding with swift inward movements.
If the person is unconscious or unable to stand, place the victim on his or her back. Kneel astride the victim’s hips. Place one hand on top of the other. Place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the upper abdomen with a quick upward thrust. Repeat until the object is expelled
B. Once the airway is clear, listen and look for breathing by watching for the rise and fall of the abdomen. If the person is not breathing
Pinch the victim’s nostrils firmly
Place your mouth over the victim’s mouth
Blow air in forcefully at the rate of one breath per second.
If the mouth is full of vomited material or blood, administering chest compressions alone will help.
C. Circulation has to be maintained. If there is no heart beat:
Place the heel of one hand over the lower half of the sternum.
Place the heel of the second hand on top of the first.
Keep the arms straight.
Rhythmically depress the sternum 2-5cm at the rate of 100 compressions a minute.
In children use the thumbs one on top of the other and press down only 1-2 cm.
It is easier if two people work in tandem, with 15 chest compressions to two breaths (15:2) ratio.
There is a so called “golden hour,” the first hour after trauma, when the person has the best chance of survival provided he reaches the emergency department of a hospital geared to deal with accidents. By following these steps, you too might save a life.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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