Throughout the duration of the COVID-19 pandemic, we’ve been constantly reminded of the safety precautionary measures we should always practise – and although the challenges of the pandemic have hit the pause button on many things – there are certain unfortunate incidents that continue to occur. Time and again, health practitioners have raised concerns of the burdened trauma units and emergency cases they need to attend to – but prior to that, when an emergency occurs, the first people on the scene of that particular incident are forced to take measures to save the lives in danger. 

The question is, how should we handle emergencies, as first responders within our spaces or in a situation we may encounter with someone who may be harmed – whether they are family or a stranger while treading carefully to avoid getting infected by COVID-19? 

Emergency Physician, Dr Thabiso Pitso takes us through life-saving information we need should we be first on the scene of an emergency while treading carefully around COVID-19.

Common Emergency Scenarios 

Dr Pitso indicates that on weekends, the emergency room commonly attends to cases of assault due to blunt force trauma, stabbing, gunshots, and motor vehicle accidents. “Common injuries at home include falling from stairs, falling from height, burn injuries from simple to complex, gender-based violence, choking, drowning and drug overdose/ suicidal attempts. Other common medical emergency scenarios include diabetic and hypertensive complications such as heart attacks, heart failures, strokes and diabetic ketoacidosis, and extreme allergic reactions,” he highlights.

Identifying Someone Who Is In Danger 

Emergencies are unfortunately regular occurrences that could happen to anyone, anywhere. Chances are, at some point, you will witness or be involved in a situation that requires you to be proactive when someone’s life is in danger. When it comes to identifying whether someone is in real danger, Dr Pitso says it boils down to two fundamental things you need to pay attention to – firstly, whether the life of the person in that situation is under threat and secondly, whether is there is a possible permanent disability of that person – “If the answer is yes, then the person is in real danger and needs assistance.” 

Protecting Yourself First

In a time where personal contact is a health hazard, as someone who is first on the scene of an emergency, navigating through the rules of engagement can be quite complex. “As much as we love to help others and preserve life, it is extremely important to prioritise yourself first,” says Dr Pitso. “Although I understand that if it is a very close family member, you are most likely going to think out of emotions, however, try as much as you possibly can to protect yourselves first – you can never know what type of infections the next person is carrying.  Always make sure, without any exception, that you are protected and ensure that you wear the available personal protective gear – wear your mask and a shield if available as well as gloves. Never handle bodily fluids with your bare hands. Only when you are protected and the scene is safe, can you then attempt to help the next person,” he warns. 

The Do’s And Don’ts of Assisting Someone As The First Personal On The Scene

“Mouth to mouth CPR is no longer an option as it will compromise the life of the rescuer. It is now recommended to do hands-only CPR (only good chest compressions) while covering the face of the patient with a cloth or towel, to reduce further exposure to covid.” Dr Pitso lists the following do’s and don’ts when assisting someone during an emergency:

Do’s
  1. PPE should take priority (even if it means to delay starting CPR). 
  2. Make sure the scene is safe and remove any potential hazards or move away from hazards if there are any.
  3. Have a towel to cover the patient’s face and mouth. 
  4. Check if the person is responding by tapping on the chest. Speak to them gently to check if they can hear you. 
  5. To check for breathing – look at the rise and fall of the chest.
  6. Feel for a pulse on the neck.
  7. Do hands only CPR if the person is not breathing and has no pulse.
  8. Get help and have someone activate the emergency medical services.

Don’ts
  1. Don’t try to be a superhero – make sure you always wear your PPE.
  2. Do not put your face or hand next to the person’s mouth. 
  3. During this time of Covid, avoid mouth-to-mouth rescue breaths. 
  4. Do not forget to properly wash your hands after a resuscitation.

Dr Pisto warns that even if you have been vaccinated, you still need to protect yourself and not behave in an emergency like you ordinarily would. “There are many covid vaccine efficacy trials, which range between 70% to 90%. None of the trials have shown 100% efficacy, which means even if you had a vaccine jab, you still stand a chance of getting Covid-19. Therefore, the basic principles of wearing PPE and proper hand hygiene should remain mandatory,” he explains.

What Should Be In Your Emergency First Aid Kit

Dr Pitso explains that first aid kits always come pre-packed depending on the supplier. “It always includes basic items like band aids, steri-strips, scissors, gausses, thermometers, and basic medications such as paracetamol and aspirin, antiseptics, and sterile gloves. For someone with life threatening allergic reactions, there should always be an EpiPen. It can also be personalised according to need,” he adds. 

“The extreme importance of PPE’s during this pandemic cannot be emphasised enough. Wearing PPE and hand hygiene has helped me and many of my colleagues throughout the covid waves, and to this day, after thousands of covid-19 contacts, I have never contracted the virus,” says Dr Pitso. He emphasises that if your first aid kit does not have disposable gloves, then it is not complete and suggests that surgical masks be included, just in case. 

Wrapping Up

“Covid made me realise that nothing is more important than life itself and is something that we should never take for granted. We are fighting an invisible enemy and we all know how to protect ourselves and our loved ones, and as heartbreaking as it is, we are not putting enough effort,” says Dr Pisto. “As a consequence, we have lost our friends, our loved ones, community leaders and our colleagues. If you forget everything about this article, please remember this one thing, never underestimate the importance of social distancing, proper hand hygiene, wearing your face masks, wearing PPE and avoiding any gatherings. Let us all commit to choose our lives over our lifestyles,” he concludes. 

Dr Pitso’s practice is a 24/7 emergency centre located at Mediclinic Medforum Hospital in Pretoria Central. Address: 412 Francis Baard Street, Sunnyside, Pretoria, 0002