By CHIOMA OBINNA

The death of 29-year-old Jonathan, a graduate of Mass Communication from one the nation’s universities will forever remain in the minds of his parents.  Jonathan, had bid farewell to his mother that fateful morning after he had boarded a commercial bus from Owerri to Lagos but little did he know it would be the last time he would talk to her.

The fully loaded 18-seater bus departed Owerri with all passengers hale and hearty without any inclination of what lay ahead. Shortly after Ijebu-Ode, the unexpected happened.

According to eye witness account, the bus was on top speed when it collided with an oncoming truck.  Many died at the spot.  Jonathan along with two others sustained injuries, but all attempts to seek help immediately yielded no results as sympathisers around the accident scene could not get through to any emergency ambulance to transport the injured to a nearby hospital.  Before assistance could come, Jonathan and the other young men bled to death.

The victims mentioned above are among the 4,000 Nigerians who die due to poor emergency response in the country every year.Ahmed was just as unlucky when he slumped and died after a heart attack.

The middle aged man suddenly slumped on hearing news of the death of his three children in one of the recent explosions in Bauchi.

According to experts, with an eight-minute Cardiopulmonary Resuscitation (CPR), Ahmed could have survived.  Unfortunately, most of the people around him on that fateful day had no idea what CPR is all about. Painfully, Ahmed died like hundreds of thousands of Nigerians who have lost their lives to preventable deaths.

However, Janet was lucky to have cheated death once in her life. It was a narrow escape. Janet almost lost her life when she fell into labour and it was discovered that she had eclampsia. Unfortunately, her hospital could not handle such emergency situation.  She lapsed into a coma after she was operated. After 72 hours, the hospital management told the shocked husband his wife could not be resuscitated

and advised him to take her to the teaching hospital. But transporting the comatose woman to another hospital became a big problem because there was no ambulance on ground. The hospital’s medical director’s old mini van was quickly brought in, and Janet was bundled to a tertiary institution where she was resuscitated.

Despite commendable improvements in health since 1950, there are still so much challenges, which should have been easy to solve in the country. In Nigeria, it is pathetic that most hospitals have no standby ambulances to commute unconscious patients to the hospital. However, with the outcome of the recent spate of bombings and floodings in the country, it is obvious Nigeria has an emergency management problem and this has been amply demonstrated on several occasions.

While several  nations of the world are seeking to develop commitment to the health and safety of all citizens by addressing issues of First Aid as part of its overall disaster preparedness and emergency response responsibilities, Nigeria is still more or less at ground zero.

Undoubtedly, in today’s world, different kinds of accidents do happen, either natural or man-made in origin and Nigeria is no exception.Statistics have revealed a sharp rise in the number of accident victims who die annually due to poor emergency management.

Just last year, no fewer than 4,000 accident victims died last year due to poor emergency rescue and management. The country has lost uncountable lives, including some of its best brains to avoidable emergencies. In several cases, healthy men, just slump and died without records of prior illness.

According to reports, within 20 years, road accidents are likely to be the third biggest killer. Globally, it is said that road accidents claimed 30 million lives worldwide in the last century. In one year alone, road accidents now account for 700,000 deaths, 10 million injuries and cost the global economy $500 million.  Certainly, there is already a perception that our roads are unsafe and young people, including child pedestrians, are at risk.

However, experts say all these can be change through delivery of effective First Aid.  First Aid is a crucial determinant of the severity of injury eventually received and the chance of survival and it has been proven invaluable beyond reasonable doubt in times of emergencies and disasters. Unfortunately, a lack of it has had negative, even fatal consequences in emergency response in Nigeria.

In the view of Prof. Villis Marshall, the Sub Prior, St John Ambulance International, First Aid is the act of helping people out of dangerous situations and making them more comfortable until definitive treatment can be accessed.  According to him, First Aid is very simple and good

potentially lifesaving practices when performed correctly.  “First Aid is required for situations such as fractures, bleeding, cardiac arrest, fire burn amongst others and these vary in degree thus requiring a variation in the response mechanism.

According Marshall, people should not wait for emergencies to occur before taking precautionary measures. Again, basic First Aid should be incorporated at one point or the other in the curricular of schools along with periodic drills. Observers have blamed the death of Nigerians through traffic accidents on the long neglect of emergency management and safety in the country.

To them, there is need for an improved and efficient emergency management system in the country. Chairman, St John Ambulance, Nigeria,  Mr. Folarin Mabadeje says there is need for Nigerians to embark on skill acquisition on safety, rescue and emergency management. Nigerians should be educated on how to get help in times of distress and how to assist victims.

Further more, medical evidence shows indisputable findings that although pre-hospital deaths from injury are not inevitable but some can be prevented by simple First Aid measures.

Another study  on pre-hospital deaths “showed that at least 39 per cent and up to 85 per cent of preventable pre-hospital deaths may be due to airway obstruction and all the pre-hospital deaths reported occurred before the arrival of medical help or a paramedic/ambulance crew. The report says with simple First Aid tips many of these lives would have been saved.

Mabedeje, in a chat with Sunday Vanguard explained that Nigeria is currently on the infant level of health and safety emergency response. He noted that before the ambulance crews and paramedics arrived to the scene of an accident, having a First Aider among sympathisers already on the scene can make a significant difference.

“Of utmost importance when tending to a casualty is the ability to ascertain some understanding of the history of the incident and the casualty’s condition. If a first aider is able to provide details such as any changes in conditions/levels of consciousness and ulse rates, this can prove vital.

It is important for paramedics to have an accurate history for the casualty if they can. The information first aiders can give is essential: on arrival at the hospital, assessment is vital and the details provided help give the doctors a true record.

This is especially important when it comes to the matter of consciousness levels”. Lamenting the dearth of First Aid in Nigeria, he called for practical First Aid skills and knowledge amongst the general public saying it has always proved to be an important way in which communities can play a part in emergency preparedness and response in much the same way St John and the Red Cross and its volunteers do every day.  He added that the capacity for community members to help each other at these times is invaluable.

He called on the government to encouraged wider First Aid awareness and training. The Commissioner St John Ambulance, Lagos University Teaching Hospital (LUTH), Dr. Patrick Orumbe pointed out the need for every Nigerian to attend First Aid training as this will be necessary some day.

Continuing, Orumbe noted who the poor Ambulance Services in the country said there should be  improvement.  “When there is an accident, the first thing that needs to be done is not to panic, but to access the situation.”

Tips on attending to a casualty

If the casualty is not responding or unconscious, place your hand on the casualty’s forehead and gently tilt the head back, try to place the finger of your hand under the point of the casualty’s chin, lift the chin and look for chest movement, listen to the sound of breathing. If the casualty is not breathing, or has agonal breathing, call for help and ambulance or begin chest compression.

Chest compression:  Place the heel of your hand on top of the first hand and interlock your fingers. Keep your fingers off casualty’s ribs, but on the centre of the casualty’s chest, this is the point at

which you will apply pressure, learn over the casualty, with your arms straight. Press down vertically on the chest depress about 4 -5cm (11/2 – 2 in). Release pressure and let chest recoil. Following the above procedure, compress the chest 30 times, at the rate of 100 compressions per minutes. Then you need to Tilt the head, lift the chin and give two rescue breaths. You need to keep alternating 30

chest compressions with two rescue breath. Continue the compression until emergency help arrives and take over or until casualty starts breathing normally. Once the casualty becomes responsive, place in

recovery position and awaits emergency services.

How to stop Nosebleeding:

Bloody noses (epistaxis) are uncomfortable and scary-looking, but usually not dangerous. Kids get nosebleeds more often than adults, typically either from irritating the nasal membrane (picking their

noses) or from trauma (like a soccer ball in the face). The victim’s bloody nose may be from trauma. Make sure you are not going to be hurt while helping the victim. Lean forward, not back. Don’t try to protect a favourite shirt by leaning back.

The blood needs to go somewhere and will most likely go down the throat. If the victim leans back, blood could get in the windpipe causing a blocked airway, or go into the stomach. Blood may irritate the stomach lining and cause the victim to vomit. Pinch the victim’s nose just below the bony bridge.

Your fingers should be on the soft tissue as well as the bone. If there is still blood flowing, adjust your grip. There should not be visible bleeding while you are holding the nose. Blood vessels that supply the nasal membrane can be pinched against the bony bridge (the hard part) to slow blood flow and create a clot. Hold the nose for at least five minutes. Do not let go to check bleeding until the five minutes is up.

After five minutes, release the pressure to see if the bleeding has stopped. If not, repeat Step 3 for 10 minutes this time. Remember: don’t let go to check bleeding until the 10 minutes is up.

Repeat for

another 10 minutes if necessary. If a nosebleed doesn’t stop after the second or third tries, it’s time

to see a doctor. First Aid common ‘core’ training includes:

•(How to) Protect the scene – to prevent further accidents and minimise the risk for those rendering assistance;

• (How to) Summon help – report the accident to the emergency services, and give relevant information;

• (How to) Make an emergency removal – from the scene, of an injured person – when necessary and possible;

• (How to) Assess the physical state (check vital functions -consciousness,circulation, breathing) as well as the physiological needs of those affected;

• (How to) Respond to visible bleeding, unconsciousness, breathing problems, and shock, and offer psychological support, to enable the injured person to survive whilst awaiting the arrival of the emergency services.