Things YOU Can Do To Increase The Chances of Survival

11:04 PM

WHAT_TO_DO_WHILE_WAITING_FOR_AN_AMBULANCE


When the time comes for you to call for an ambulance, it is most likely due to a medical emergency. be it at home, at the office or by the roadside. Some would be calling due to a life and death situation whereby somebody around them may be in a life threatening condition.

However, one need to consider that an ambulance might take some time to arrive at the reported location. The key performance indicator for an ambulance to arrive at the scene is 15 minutes from the time of dispatch within a 10km radius. Furthermore, have you ever seen how Malaysian drivers respond to an ambulance with sirens blazing on the road? On top of that there are drivers who blatantly abuse the emergency lanes on a regular (maybe habitual basis).

Here is how it is in Malaysia:

Meanwhile in Germany:


Here is a piece I wrote previously You Are The Reason Why Ambulances Are Late

WHAT TO DO IN A MEDICAL EMERGENCY

Remember this 999...NINE - NINE - NINE. Malaysia utilizes a centralized system called Malaysian Emergency Response Service (MERS)


All calls will be attended by a trained staff to determine the nature of emergency. Once the nature of emergency is established, the staff will direct the call to the relevant departments. However, this process may take time and requires feedback from the caller.

What you can do is:
1. Stay calm and speak as clearly and concise as possible.
2. Answer the questions as precise as possible.
3. Wait for further instructions from the staff.

The standard questions are:
1. What is the nature of your call - is there a fire or is there a medical condition?
2. Is the victim conscious?
3. Can the victim breath?
4. Does the victim have any underlying medical conditions?
5. Where are you calling from?

In the event that the victim is unconscious, the staff will first guide you on what to do. Attending staff may speak to you in a slow and clear voice. PLEASE DO NOT GET MAD. The staff wants YOU to get each word he or she is saying.

DO NOT PUT DOWN THE PHONE until the call center tells you to.
The staff at MERS may then pass you to the call center at the nearest health facility near you. AGAIN, answer the questions asked as clearly as possible.

Why is it important to be asked SO MANY QUESTIONS?
The call center need to assess the severity and nature of the condition. If it is a motor vehicle accident, they would ensure that the relevant spinal boards and cervical collars are in place. If there is a possible need for intubation, the paramedics will be mentally prepared for it.
So please, cooperate with them.

At the end of the call, the call center will verify on the location. If you are not sure, provide a landmark that is clear. Some examples: 

"Northbound highway between Tapah and Trolak exit. There is a TNB substation nearby." 

"My address is XYZ, Jalan Harimau. The house with a blue coloured fence and blue roof tiles."

The paramedics would most likely call you up again if they can't find your location. Please keep your phones on standby.

WHAT ELSE CAN I DO?

1. Fits or seizures

If the victim is having fits or seizures; 

DO NOT PUT ANYTHING IN THE VICTIM'S MOUTH. 

DO NOT RESTRAIN THE VICTIM

CLEAR THE SURROUNDING OF ANY POTENTIAL DANGERS

Wait for it to resolve by itself. After the fit settles, put the victim in a recovery position to prevent any vomitus or saliva to obstruct the airway.


Recovery position (from epilepsy.org.uk)

2. Severe Asthma or Chronic Obstructive Airway Disease (COPD)

Victim may be rapidly breathing and restless. If this happens to be your relative, try and find out where the victim keeps his or her inhalers. Attempt to give the inhaler to the victim. The use of a spacer device may be useful. If you can't find the inhaler, calm the victim and sit him or her upright. Try and find a place where there is good ventilation and away from the causative agent (allergen) such as dust and pets.

**The rescue doses (salbutamol) are usually in a blue coloured device.

Metered Dose Inhaler

3. Heart attack

Usually, a heat attack victim would have multiple underlying diseases and risk factors (THEY DO OCCUR WITHOUT ANY RISK AS WELL), such as:

1. History of Diabetes Mellitus, Hypertension and Dyslipidemia
2. History of cigarette smoke
3. Elderly
4. History of previous heart attacks

If this is your relative, you most likely already know the history. Try and give sublingual (below the tongue) GTN (glyceryl trinitrate) if it is available. Make the patient calm and sit up straight. Provide plenty of space for ventilation.

4. Unconcious or cardiac arrest

This requires the application of Basic Life Support algorithms.
The key is D-R-S-A-B-C. I have written about this (albeit for drowning victims) here. 

Chain of Survival (from resus.org.uk)

FEEDBACKS

The health care scene in Malaysia is constantly changing at a rapid pace. The Ministry of Health (MOH) strives to provide the best care possible for every Malaysians, with finite resources made available to them, which is complemented by the private health system. Our system is still far from perfect. Therefore, if you happen to be in that unfortunate circumstances whereby you encounter unfavourable health services, do contact the MOH with the details of your encounter in order for it to be assessed and rectified accordingly. Constant (detailed) feedbacks and constructive criticisms are surely welcomed. Without these feedbacks, it will be difficukt for MOH to assess what is happening on the ground.

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