Saving lives should not be this hard

Published: June 23, 2011

A little knowledge and its due application can make a difference in someone’s life.

I was enjoying a wonderful meal at the new food street on the pier with my family last week when I heard people gasp as two men carried another young man to the green sidewalk. They dropped him and disappeared. My first thought was this man had fallen into the water – but I was wrong.

I rushed to assess the casualty. Eager spectators had gathered around the young man – some of them instructing others to perform maneuvers which were extremely contraindicated in the given situation. I pushed through the crowd only to find the young man hyperventilating, followed by loss of consciousness. Before I knew it I was ‘in control.’

There seemed to be no one, out of the 200 plus people present, who knew how to handle an emergency situation – or they just did not act. Most just stood and watched what happened in the next 20 minutes – the longest 20 minutes of my life.

I shouted at someone to call an ambulance while I assessed the airway, breathing and circulation. Someone said the young man’s name was Wasim. He was a kebab maker at the restaurant, and had collapsed suddenly while cooking in the hot, humid night.

I called out to him but there was no response. Before I knew it, he had stopped breathing. My mind was racing at the protocol I have rigorously practiced on mannequins as a certified first responder. This was the moment to act. I checked the airway, it seemed clear but he was not breathing. The chin lift-head tilt did not help.

Next thing I knew, his pulse was rapidly falling. I had to make a decision within the next few seconds. Clearly, I could not deliver mouth-to-mouth since I was  and since about to start chest compressions and no one was accompanying him.

I asked one of the guys to raise Wasim’s legs to help the shock he might be in. Fortunately, and with quite a show of bravery, my uncle who was present at the scene offered to breathe him. Then followed a CPR, which went on till we had a response. Twice he gained consciousness and took a couple of breaths, but then again stopped breathing.

We did close to eight cycles of CPR till the Edhi Ambulance made its well pronounced loud entry in to the scene. Two workers came out with the stretcher and whisked him away before I could say a word.

The last I could see to my extreme disappointment was the lack of an oxygen cylinder in the ambulance. Furthermore only one person sat at the back with Wasim and I wondered how he would handle resuscitation.

As the ambulance left, everyone around me seemed to heave a sigh of relief. Some people came forward to ask me his chances of survival. Disappointed as I was, I just shook my head to most people and asked them to pray. I hoped that the closest ER of the hospital would give him the oxygen which I thought would reverse his symptoms.  My basic fears were carbon monoxide poisoning or a heat stroke. Both could be lethal if not managed properly in an ER.

How to react in emergency situations

This experience taught me a few things:

1. In an emergency situation, there is no use of bystanders, unless you are calling for help, or helping clear the way for traffic etcetera. If you are not useful, kindly continue to do what you were doing and do not clog and confuse the situation.

2. We have a terrible ambulance system. Our ambulances are mere taxis that help move the injured from one place to another (I mean Edhi, Chippa and KKF etc). The exception to these is the Aman Foundation Ambulances which are fully equipped including paramedics. There may be more, but not within my knowledge.

3. We lack a First Response center which uniformly co-ordinates emergency situations. For example in this case, someone called Edhi – the ambulance took 25 minutes to reach the site. This is not at all efficient. When I left the place I noticed a Chippa kiosk right around the corner – and I could not be more disappointed. Had we contacted Chippa, it would not have taken more than three minutes to reach the site. A simple helpline could designate the site of casualty and direct the closest ambulance service to reach over radio.

4. We need to train as many people as we can to deal with trauma. This incident is not the first of its kind in a public place. I am sure there has been loss of life before because of unavailability of medical care during the first few crucial minutes of trauma. As First Responders, we plan to teach the medical students of Karachi the basics of First Response and Primary Trauma Care. These Medical Students would be vectors to teach to a larger population of individuals, thus creating a safer place for the citizens.

5. Public entertainment places, like food streets, malls and dining restaurants should have first aid facilities – at least an artificial respiration material. Emergencies can take place anywhere. A common incident of choking could be life threatening if not managed properly.

Two day after the incident, a friend of mine visited the same food street. I had avoided thinking about the probable death of the young man by not reading the newspaper. But, I couldn’t resist asking her to find out his fate from the restaurant.

My heart leapt in delight when I heard the news. Wasim survived and was actually back to work, grilling kebabs at the famous eatery. I could not believe it.

I am glad a little knowledge and its due application saved someone’s life.

Jahanzeb Effendi

Dr Jahanzeb Effendi

A young doctor, First Responder and Co-founder of First Response Initiative of Pakistan, FRIP. Training the general public to become first responders. Aspires to be a Cardiac Transplant Surgeon and build Pakistan's first Organ Sharing Network. Believes in writing for change. He tweets as @Jahanzebeffendi (twitter.com/Jahanzebeffendi)

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Henna

    It doesn’t say why you were not able to breathe him?

    Thank you for saving his life.. Maybe you could offer a seminar or training for emergency situations.Recommend

  • Kinzah

    Great Piece…so proud of you! :-)Recommend

  • Asad

    Very nice..we still have humanity..way to go..!!Recommend

  • Fooz

    good job man..Recommend

  • http://waqasrasheed.page.tl Waqas Rasheed

    I really wish everyone in Pakistan behaves likewise for every other person.

    BTW, the pic on the tip shows CHHIPA while you mentioned EDHI :)

    I really admire your uncle’s and your values for a human life.Recommend

  • Jahanzeb Effendi

    @Henna:
    Its because if you do not know the person, its always a risk to provide mouth to mouth to a stranger, taking into consideration communicable diseases like TB, Hepatitis etc. According to the international basic life support protocols mouth to mouth has been removed from the management of victims because of the spread of diseases. However, if its a close relative and you know there are no communicable diseases, then you should go ahead. Recommend

  • Saad

    Bravo!

    Well done! you saved his life!Recommend

  • Samuel Niaz

    Good job Effandi but the assesment protocol for BLS and ACLS have changed. Now its no more ABC, but CAB.Recommend

  • The Critique

    Great job sir!Recommend

  • yasir effendi

    good work bro.. proud of you !Recommend

  • Rabbiya

    proud of you :)Recommend

  • nafisa

    Kudos to you.
    where did you take the first responder course? Aga Khan?
    The institute and the Course provider should be acknowledged as well.Recommend

  • Zeeshan H

    I can only imagine how frustrating it must have been to have so many people surrounding you but no one willing to help…Recommend

  • umaima

    Bravo! iam really proud of u atleast humanity still exists in Pakistan ! and i also believe that atleast two members of every family should learn the basic First aid i hope thats not asking for too much, cuz in the long run we might need it, Recommend

  • Asad

    Good work. Thanks for educating us about this. Informative and useful article for a change on ET keep it up.Recommend

  • Ammar

    Awesome!Recommend

  • Shajia

    Great job Jahanzaib! Proud of you!Recommend

  • Nisa Ghauri

    Well done Jahanzeb!…proud of you :)Recommend

  • Rafat Hussain farooqui

    Good work, proud of you, keep on working.Recommend

  • Rafat Hussain farooqui

    Humanity still exist. You have done a very good job. Recommend

  • Husain

    Kudos!Recommend

  • http://saidcanblog.blogspot.com Said Chaudhry

    @Jahanzeb: Nice article and I applaud your brave efforts at trying to save this young man. Surely, being a doctor and all we have attempted many successful and unsuccessful CPR’s. Also, the chances of hepatitis spreading to you are very low as you are not indulging in a french kiss with this man whereby exchanging large quantities of saliva. And since you’re becoming a doctor in Pakistan, I am sure you already “exposed” to TB or will be after your rotations at the hospital. Giving mouth to mouth in an attempt to save someone life will hardly activate the disease. My friend recently had a PPD done prior to starting his residency in Austin,TX and he had more than 15mm induration. American Heart Association has recommended mouth-to-mouth to be removed for average people who have not done BLS/ACLS but it still exists in training programs.Recommend

  • Ed

    Thank you, Jazak Allah, Merci…
    Good work bro… we really need a basic “civil defence” / “paramedical training” … not the official programme thats going on… but an effective one…Recommend

  • Jahanzeb

    @Said Chaudhry:
    I agree with your argument. My PPD was 9mm in Chicago this year so definitely if your’re a Pakistani not even in a hospital, you still have been exposed to TB. As for Hep, I mean its still debatable. However, I would do it with precautions if no other options seem to be available. I did think of using a small piece of cloth to cover the edges. There are instruments available for trauma personnel and we are trying to get those for all our First responders.They could carry the portable CPR protection mask which can fit in the back pocket. We are trying to change things. Slowly but definitely.

    Thank you for your comment. Recommend

  • Jahanzeb

    @Rafat Hussain farooqui:
    Thank you for your encouragement. Yes I do believe Humanity exists. Otherwise we would be disintegrated long time back. Recommend

  • http://rohailkhoso.wordpress.com/author/rohailkhoso/ Dr. Rohail A. Khoso

    Bravo Jahanzaib. Well done my friend – proud of you :) Recommend

  • http://lonepkliberal.wordpress.com LoneLiberal PK

    You could not deliver mouth-to-mouth because of what? Were you afraid of a scandal?

    The standard protocol is providing 2 breaths after every 30 chest compression. The compressions alone are usually enough, but it is always safer to give mouth-to-mouth with them.Recommend

  • Faraz Talat

    Great job, Jahanzeb..Recommend

  • sumaiya lakhani

    way to go effendi :)Recommend

  • StudentSecular

    Reminds me of a poem –

    “To be or not to be, that is the question…”
    That question has plagued us,
    Turned us into what once was humanity,
    For humanity has fallen from his high throne,
    He wallows in the mud with the lowest animal,
    Instead of, “Good will to all men.” as our quote,
    It is, “Survival of the fittest.”
    What has happened to our humanity?
    What happened to what once made us human?
    I’ll tell you what,
    We have lost touch with our beginning,
    What formed us and shaped us,
    And what had thrust us into this world,
    We can turn back,
    If its not too late.Recommend

  • Amin Baig

    @Jahanzeb Effendi:
    Health awareness book in Urdu on Care of patient during an emergency will be a solution to take care of patient in an emergency by a common man.I had published 6 books in Urdu on different diseases prevailing in our society…….We can publish a book on emergency care in Urdu.It will be a great service for common man.My support & assistance is always available for any book on health awareness in Urdu.Recommend

  • Amin Baig

    A book should be publish in Urdu for common man,how to handle an emergecy.Recommend

  • Jahanzeb Effendi

    @Amin Baig:
    I think it is a great idea. This would actually appeal to the people. Even if we can get a pamphlet made, or a brochure. We have been approached by a media channel to come demonstrate and teach skills on television. We are working on it. I will discuss the First Aid in Urdu. Thank you for all the support. Recommend