Dr M.K. Mam
Basic Life Support skill training of people- The need of hour Bone and Joint day is celebrated all over India by the Indian Orthopaedic Association (IOA) and all its state chapters on 4th of August every year since 2012. The primary aim is to create awareness among people about the bone health and various orthopaedic illnesses which can be prevented or treated .We have public awareness programs at state chapters to sensitize the society about the increasing impact of bone and joint disorders, how to prevent and treat them. People are educated about the importance of maintaining a sound bone health and what all can be done for keeping the bones healthy and strong. The activities that are usually organised include health education programmes for general public highlighting bone health- having stronger bones, free surgeries for deserving patients by the members etc. Bone and Joint day is not a mere celebration, the day gives orthopaedic fraternity an opportunity to reassess and evaluate their performance and usefulness to the society. It gives an opportunity to introspect and think about their role in the society in improving bone health of the people, in prevention and / treatment of bone and joint disorders that is cost effective and within the reach of a common man. It gives us an opportunity to honestly look into ourselves to find how far we are fulfilling the social obligations and what all can be done to make it better.
Every year we have a theme for observing the day and this year the theme of observing the day is “Save Self Save One”. Aim is to save self and someone who could be a friend, relative or an unknown person who is in a ” Life Threatening Situation” because of accident- trauma. Deaths and injuries resulting from road traffic accidents certainly is a major and growing public health problem in our country. As reported by Ministry of Road and Transport and Highways in 2019 a total of 4,49,002 road accidents were reportedin India killing 151,113 persons and causing injury to 4,51, 361persons. This means that on an average there were 1230 accidents and 414 deaths every day. These figures are much higher than that of many of the countries.India in fact ranks first in the number of road accident deaths across 199 countries reported in the World Road Statistics, 2018 followed by China,US.It has been observed that it is the young adults in the age group of 18-45 years that are mostly ( nearly 69.3 percent) involved in the road accidents and males are most often (86 %) involved in comparison to females.Good thing is that road traffic fatalities can be prevented , yes they can be prevented to a large extent. We can certainly reduce number of fatalities and injuries in the road accidents by giving an appropriate first aid at the accident site. It has been reported that a third of prehospital deaths may be preventable, so the general public should be trained to provide excellent first aid at road accident site.First aid has to start with”Basic Life Support” which consists of emergency care to restore or sustain vital functions i.e. airway, breathing respiration and circulation. Initial assessment, airway maintenance, expired air ventilation (mouth to mouth breathing) and chest compressionare the main elements of basic life support ( BLS). Main purpose is to maintain an airway, support breathing and the circulation without specialized medical equipment and thus try to limit further damage in the period till the victim reaches to a specialized emergency medical care centre. There is no doubt that early- immediate proper BLS can sustain- save the life of the injured person till the proper medical help arrives. BLS helps to maintain circulation of oxygenated blood to brain during the “Golden Minutes”, thus preventing irreversible damage to brain cells before actual medical help arrives.What do we mean by golden minutes ?Golden minutes are immediate 3-5 minutes of time following an injury. It is a fact that biological death where victim’s brain is irreversibly damaged and cells in brain are dead from lack of oxygen occurs 3-5 minutes after clinical death where heart stops pumping blood , if oxygen does not reach brain during this time.These 3-5 minutes time following an injury is the most critical period and these are the real “Golden Minutes” during which proper first aid -BLS can save an injured person till proper medical aid arrives. Having discussed about golden minutes, it is also pertinent to talk about “The Golden Hour” that is the one hour time following an injury during which prompt medical and surgical treatment prevents death and morbidity. Morbidity and mortality increases significantly after that time.Chances of survival of a person are certainly greatest if the person receives care within a short period of time after a severe injury.
BLS skill training is mandatory for doctors and paramedics. As a matter of fact, BLS skill training should not be must only for healthcare professional, but should be an essential skill for every person as it is the common man who is the first to be present at the accident site. We need to train people especially teachers, students, police, drivers etc, This can help a lot in reducing the mortality and morbidity following road accidents. As such, IOA this year is focussing on first aid and /basic lifesaving after road accidents and accordingly various public awareness programs are being arranged by various state chapters and orthopaedic fraternity all over the country for education of public about importance of golden hour and golden minutes. There shall be a weeklong activities from 1st. to 7th August– Bone and Joint week to increase the awareness of first aid and basic life saving amongst the general public.
Online teaching and training on first aid/ basic lifesaving- BLS are going be held for the school children of class 9 and above, teachers, police etc. during this week. Other activities include distribution of pamphlets and putting of posters on first aid and basic lifesaving. It is not uncommon in our country to see an injured person lying on road and immediate medical help very often not available. It is not uncommon to see people collect around at accident site, just watch and or walk away without being of any help because of the fear of police enquiry etc. It is important to remove the fear the people have of helping the injured and more than that of police enquires about which people in general are very much scared.People need to be good Samaritan- help the patients ,get educated and trained in immediate first aid- BLS skills. Early and immediate care of trauma victim by using BLS skills during the golden minutes helps the patients – sustain life until appropriate medical treatment begins. In fact, it can make the difference between life and death for some people as such imparting BLS training among the general public is the need of the hour.
(The author is former Vice Principal, Professor & Head of Orthopaedics , Christian Medical College, Ludhiana, Punjab)
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