The word "emergency" has two key aspects: "urgent," meaning a race against time, and "rescue," meaning doing everything possible to save a life. Emergency care is a battle with death itself, pulling those on the brink of life and death back from the edge. Sudden cardiac arrest is that threshold, and those who survive resuscitation have essentially "visited death's door" and returned. Those who cannot be revived remain beyond that threshold forever.
Modern emergency care is mainly composed of three parts: pre-hospital emergency response, continued treatment in the emergency department, and more specialized care in intensive care units (such as ICU, CCU, etc.).
Pre-hospital emergency care, also known as out-of-hospital or on-site emergency care, refers to assistance provided outside of the hospital before the patient arrives. It involves assessing, rescuing, and transporting patients with acute or critical conditions or those involved in sudden accidents, ensuring their safe removal from danger. This quick response buys time for in-hospital treatment, increasing the chances of survival.
In a narrow sense, pre-hospital emergency care is handled by emergency centers. More broadly, it includes community health centers, clinics, and even public self-help and mutual aid efforts. Pre-hospital emergency care is an essential part of modern emergency medicine, the frontline in the fight to save lives, and often the last line of defense.
What constitutes a critical emergency? For instance, if someone suddenly develops a fever, is that urgent? Yes, but it's not severe, and it's unlikely to be life-threatening. The patient can go to the hospital's emergency department with the help of family. On the other hand, if a liver cancer patient suddenly suffers severe bleeding due to ruptured esophageal varices, that's both urgent and critical, potentially life-threatening, and requires immediate emergency assistance. That's when we, the emergency doctors, step in.
Who do we rely on when sudden cardiac arrest occurs? In my opinion, we cannot rely solely on doctors and emergency centers. Why do I say this?
From the moment of onset to realizing the need to call emergency services, to the call being connected, describing the situation, providing the address, and then dispatching the doctors and ambulances-each of these steps takes time. If everything goes smoothly, a doctor may arrive within 15 minutes. But if there are delays-such as a call not going through, or a lack of available ambulances, or even heavy traffic-then the situation becomes dire.
Many times, we've arrived at the scene as quickly as possible, only to find that the patient has already stopped breathing, while those around are at a loss, unsure how to help. This shows that the public lacks not only the knowledge of emergency procedures but also the skills and awareness necessary to act promptly.
The level of public awareness and success rates for emergency procedures, including CPR, are indicators of a country's medical advancement, economic development, urban management, social coordination, and the overall quality of its citizens. It has become a symbol of a nation's or community's level of civilization and harmony.
When sudden cardiac arrest occurs, the most important factor is the immediate actions of those around the patient. Acting quickly, correctly, and consistently is crucial! Don't assume that calling emergency services is enough. Before the emergency doctors arrive, timely self-help or mutual aid on the spot can make all the difference. This is the true value of learning emergency care!
