Sudden Collapse- How to Handle in Public places

It’s not everyday you watch a sudden collapse live on TV. Earlier this week, the senate screening for ministerial candidates almost turned into a funeral. The candidate from Kaduna state, Mr Balarabe Abbas Lawal, after making his submission suddenly slumped. This led to a flurry of activity with people scampering to either see what was going on or assist. The senate President, concerned, urged them to ‘Give him water,… water and sugar!’.

Prior to this, a journalist Tijani Adeyemi who was to cover the screening wasn’t so fortunate. He had a cardiac arrest on the way to the event and was pronounced dead at the nearest clinic.

Situations like these are not new, and happen everyday and everywhere. However, happening in the full glare of National and international cameras brings to the fore our level of emergency awareness and preparedness as a people.

Years ago in the Uk, I noticed people around an elderly man who had slumped. While I contemplated whether my Nigerian medical licence allowed me to intervene and take charge of the situation, paramedics were called in. In the blink of an eye they were on the scene. I introduced myself to a paramedic and asked whether I could help. He politely declined that he had everything under control..

There are general principles and several ways to approach public emergencies like a sudden collapse. It depends on several factors like the environment, the possible cause and help/facilities available.

Possible Causes of Sudden Collapse in Public

Possible causes are endless and include hypertensive emergencies, diabetic/ hypoglycaemic emergencies, cardiac emergencies, exhaustion, dehydration, high fever, shock etc. However, the initial management is quite standard.

The role of first responder

If you’re the only one or first at the scene of such an event, you want to make sure that the environment is safe for you before you help. For example, the person could have been electrocuted, you don’t want to be electrocuted while trying to save them,

When you approach the person, there are things you should look out for, these include evidence of breathing and a pulse.

You can call out the person’s name and shake to elicit a response. The next step depends on what the response is. Shout for help and assess the person. Check the airways (mouth and nose) is there anything obstructing breathing? Look for signs of breathing like chest movement or listen at the person’s mouth. , Check the neck for a pulse.

If there is no response it may be a cardiac arrest. Commence immediate CPR

What is CPR?

Cardio- pulmonary Resuscitation. This involves giving 100 chest compressions per minute. Depending on the situation, rescue breaths can also be given in the ratio of 15 compressions to 2 breaths.

If the person is responsive, place the person in a recovery position where he can receive further care.

What is the Recovery Position?

This is a method used in first aid of placing an unresponsive but breathing patient in such a way that prevents the person choking. It involves placing the person on their side, with bent limbs and their airways open.

The Case for Water and Sugar

There are certain cultural activities that we do that could further worsen and maybe lead to death of an unconscious person. One is crowding over the person, this limits oxygen supply to the person.

The next one is where we spray or drown a fainted individual with water. This should be discouraged. This can cause more harm than good e.g a person who already has a breathing difficulty.

However, a glass of water may be justified in a person who is already conscious and observed to be dehydrated. Under no circumstances should water be forced down the throat of an unconscious person.

Sugar is useful in the case of a person who has lost consciousness due to a condition called hypoglycaemia or low blood sugar. However, this is given via an intravenous drip. The only situation sugar is given orally is when the person is conscious and his blood sugar has been checked and certified to be low. The risk of giving sugar to a random unconscious person could well be catastrophic if the cause of his unconsciousness was high blood sugar.

It is necessary that all public places should have at minimum a First-Aid Box and Automated External Defibrillator (AED). Ambulance points should be nearby.

Large workplaces and factories should have an onsite clinic.

People should know emergency numbers and emergency drills should be undertaken at workplaces.