Monday, January 21, 2019

This is good news: PCR teams to be first doctors on spot in Delhi

PCR vans are usually the first to respond to a road emergency, and now the police control room personnel are set to turn paramedics to manage accident trauma, reported the TOI (Jan.17, 2019). The Delhi PCR vans will now carry cervical collars and fracture braces, among other medical accessories, to provide proper care within the crucial first five minutes of an accident. The van will now also carry ice packs and eye shades to ensure that the victim is in comfort and the pain from the injuries is managed before they are shifted. Additional training will also help the police personnel to judge and deal with the medical condition of the victims.

Doctors from AIIMS and NGOs, who already teach the cops how to provide cardio-pulmonary resuscitations and undertake basic procedures, will instruct them in life-saving measures.

This is good news indeed.

Any delay in treatment in acute emergencies can mean a difference of life and death for the victim. Most acute emergencies will require emergent evaluation and treatment without any delay. The large majority of deaths occurs either at the scene or within the first four hours after the patient reaches a trauma center.

The concept of “golden hour” emphasizes the need for rapid intervention during the first hour of care following major trauma. Prompt medical treatment during the golden hour has the highest likelihood of preventing death.

“Platinum 10 minutes” refers to first ten minutes after trauma and refers to the importance of starting first aid within 10 minutes to reduce the chances of death.

Heart Care Foundation of India (HCFI) is actively engaged in training people from all walks of life, including school children, in the life-saving technique of hands-only CPR (CPR 10).

There is substantial evidence to suggest that CPR is effective in the first 10 minutes of cardiac arrest. After 10 minutes of death, there is practically no chance of recovery unless patient is in hypothermia. So, we created a formula of 10 which is “within 10 minutes of death (earlier the better), at least for the next 10 minutes (longer the better, up to 25 minutes), compress the centre of the chest of the victim with a speed of 10×10 i.e. 100 per minute”.

This way the public can remember the technique of CPR after sudden cardiac death. It is easy to learn and easy to do and one does not need to be a doctor or be certified in this technique to do CPR.

Numerologically also, the CPR equates to number 10. In English alphabets, ‘C’ comes at number ‘3’, ‘P’ comes at number ‘16’ and ‘R’ comes at number ‘18’. If we add the three i.e. C=3, P=16, R=18 (3 + 16 + 18 = 37) and, if we further add the two digits in ‘3 + 7’, the total we get is ‘10’. So, numerologically also, ‘CPR 10’ should be an effective way to remember.

HCFI had also provided training on CPR for 100% PCR vans (over 8000) in Delhi in 2014 along with the Indian Medical Association (IMA) and Delhi Red Cross Society. 

The PCR vans should also be equipped with Automated External Defibrillator (AED) machine and personnel should be trained in the use of the AED. Defibrillation within 3 to 5 min of collapse can result in survival rates as high as 50-70%.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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