आपदा प्रतिक्रिया – अवलोकन
(Chapter – 5)
DISASTER RESPONSE – OVERVIEW
1.Golden Hour :
If a critical trauma patient is not given definite medical care within one hour from the time of accident, chances of his ultimate recovery reduces drastically, even with the best of Medical attention thereafter. This one hour period is generally known as The Golden Hour.
During this Golden Hour period every effort should be made to :
(i)Render definite medical care to the extent possible preferably by qualified medical practitioners.
(ii)Stop bleeding and restore Blood Pressure.
(iii)Persons under shock should be relieved of shock immediately.
(iv)Transport casualties to the nearest hospital so as to reach within this Golden Hour period.
For being effective, any Disaster Management system should aim at recovering as many critical patients as possible and rushing them to hospital within this period.
2.Disaster Syndrome :
A victim’s initial response following a Disaster is in three stages, viz. Shock stage, Suggestible stage and Recovery stage. These initial responses are called Disaster Syndrome.
(i)Shock stage : In which victims are stunned, dazed and apathetic.
(ii)Suggestible stage : In which victims tend to be passive but open to suggestions and willing to take directions from rescue workers and others.
(iii)Recovery stage : In which individuals may be tense and apprehensive and may show generalized anxiety.
3.Different phases of Disaster Response :
Disaster Response in case of a railway accident constitutes of 3 phases. These 3 phases are determined both by the time factor, as also by the extent of specialized assistance available. Firstly,it begins with the spontaneous reaction of men available on the train at the time of the accident. Thereafter the second phase continues with contributions made in rescue and relief work by men and material available locally in nearby areas of the accident site. The third and longestphase consists of meticulously planned action by trained DM teams who arrive at the accident site to carry out rescue and relief operations.
With the above scenario in mind, it is necessary to take firm and quick decisions to save lives and property. To achieve these objectives Railways have a well-defined action plan that is successfully executed by the coordinated efforts of different disciplines, all of whom function as a team. The three groups which are active during the above mentioned 3 phases of Disaster Response may be classified as follows:
(i)Instant Action Team (IAT)
(ii)First Responders (FR)
(iv)Disaster Management Team (DMT)
4.First Aid in Emergency :
(a)Order of priority for dealing with and helping injured passengers should be as follows :
-having breathing problems,
-in a state of shock,
(b)For assessing and handling injuries, acronym DR ABC is to be followed.
(i)D – DANGER :
Look for danger. Make sure that no further danger exists either for the patient or for the First Aider.
(ii)R – RESPONSE :
Check for consciousness. Call by his/her name, slap, pinch and shake gently. If there is no response, then it means that the patient is unconscious.
(iii)A – AIR WAY :
Clear the airway (Trachea). If patient is unconscious, then the airway may be narrowed or blocked making breathing impossible. This occurs due to several reasons. Mass food particles or foreign body in the air passage; or the tongue may have sagged back and blocked the air passage.
To open the airway lift the chin forward with the fingers of one hand while pressing the forehead backwards with the other hand, now the tongue comes forward and the airway is cleared. To clear the other objects in the mouth press the Jaw, open the mouth put your fingers or a clean cloth in the mouth and clear the things. Now the air passage is clear.
(iv)B – BREATHING :
Check for Breathing. Keep the back of your fingers near the nose of the patient. You can feel the warm air (or) keep your ear near the nose and look for the movement of chest, listen to the sound from the throat and feel the warm air from the nose.
(v)C – CIRCULATION :
Check the pulse. Normally we check the pulse at the wrist; however, sometimes it is not felt because of severe bleeding. So, it is better to check the pulse at neck. (Carotid Pulse).
After checking DR ABC, there may be two possibilities.
(i)If patient is breathing, has circulation but is unconsciousness, immediately turn him to Recovery position and transport to hospital.
(ii)If the patient has failure of breathing and circulation, then immediately start CPR (CARDIO PULMONARY RESUSCITATION) the important life saving technique in First Aid.
To revive the lungs you have to give artificial respiration by mouth to mouth (Kiss of Life) method. Lift the chin forward and press the jaw open the mouth with one hand and close the nose with other hand keep your mouth on the casualty’s mouth and blow.
To revive the heart you have to give external chest compression. The casualty should be made to lie down on a hard surface. Keep heel of the palm on the chest (Pit of stomach) of the casualty and keep the other palm overthathand and compress.
Mouth to mouth ventilation and external chest compression should be given in the ratio of 2:15. This should be continued up to the revival of life or till reaching the hospital. Once life starts, immediately turn the casualty into recovery position and transport to hospital. (Recovery position or three quarter prone position means turn to one side, better to right side)
Recovery position :
Recovery position is the safest position for unconscious patients. Normally we keep the patient in a supine position. However, in case of unconscious patients, it is a very dangerous position because the tongue can fall back and close the airway or saliva and other secretions may get into windpipe. To avoid that, turn the casualty into recovery position and transport to hospital.
Sometimes, you may not be in a position to do First Aid due to tense situation. In such circumstances at least turn the casualty to Recovery Position, which would help to save many precious lives.