Doctor's advice on rescuing flood victims: What to do if injured?

 Doctor's advice on rescuing flood victims: What to do if injured?

Families at risk should follow the instructions given by the administration and security personnel. Special priority should be given to moving children, the elderly, the disabled and the sick to a safe place.

The floods from Tibet have damaged settlements, roads, bridges and other structures in Rasuwa, Nuwakot and surrounding areas.

Dr. Shreeram Tiwari urged people to check the site of the disaster before going for rescue and to put their safety first.

Dr. Nabin Poudel and Dr. Bipin Nepal suggested not to move broken limbs, apply pressure if there is a lot of bleeding and to quickly take the injured to a health facility.

Kathmandu. Due to the floods from Tibet, there is loss of life and property in the areas around the rivers including Rasuwa and Nuwakot.

The increase in the flow of the Bhotekoshi and Trishuli rivers has damaged settlements, roads, bridges and other structures. The work of rescuing those at risk and moving the displaced to a safe place is ongoing.

Due to the flood, some people may be drowned, swept away, or buried in collapsed structures. In such cases, security personnel and trained rescue teams are deployed to rescue. However, ordinary people at the scene may also try to rescue someone on their own if they see someone in distress.

In such a situation, the first thing to pay attention to is whether the person going to rescue is safe or not. It may be necessary to know.

According to experts, while rescuing from floods, rushing into the water, trying to pull a person who is being swept away, or pulling the injured by the hands and feet can make the condition of the rescuer and the injured more serious.

According to Dr. Shreeram Tiwari, former head of the emergency room at Bir Hospital, it is most important to assess the risk of the scene before going to rescue.

“Before going to help others, your own safety comes first. You should check whether the scene is safe. You should only go to rescue by checking whether the water flow has decreased, whether the ground is in a state of collapse, and whether the house or structure is in a state of collapse,” he says.

According to him, if the rescuer himself gets into an accident while trying to save someone, the problem can get worse. Therefore, the policy should be to first secure the scene and only then rescue.

‘Do not immediately enter the water after seeing someone trapped in a flood’

Even if the floodwaters appear shallow from the outside, if the water flow is still strong, houses or structures are in danger of collapsing, the ground may sink, or electric wires may be in the water, the general public should not go to the scene to rescue them.

As much as possible, security personnel and trained rescue teams should be informed.

According to Dr. Tiwari, the current disaster situation is different from a normal accident. Since a large area has been affected in a short time, there is great pressure on the available rescue and health teams.

‘The current disaster has come at a terrible time on short notice. Health workers are on standby in the hospital. However, there may be problems in bringing the injured to the hospital as roads and bridges have also been damaged,’ he says.

‘When rescuing a drowning person, your own safety comes first’

After seeing a drowning person, you should think about your own safety before approaching him.

If a trained diver or rescue team is available, it is safer to entrust the task to them. People who do not have the necessary equipment and training to go into the water and rescue should not attempt such an attempt.

However, if it is possible to help from a safe place, they can help by informing the rescue team, informing them of the incident, and arranging for the injured to be taken to the hospital.

According to Dr. Nabin Poudel, a consultant neurologist and orthopedic specialist working at a civil hospital, there are many things that need immediate attention even after a drowning person is pulled out of the water.

‘First, you should check whether the patient has a pulse and whether he is having difficulty breathing. If there is something stuck in the mouth, it can be removed,’ he says. ‘You should not treat the patient carelessly or move the body unnecessarily if you are not trained in this.’

If you suspect a broken bone, do not try to fix it yourself

A limb can be broken by falling, being swept away, or bumping into something in a flood. In some cases, the bone may even be dislocated. In such a situation, one should not try to push or pull it inwards to straighten it, says consultant Dr. Poudel.

According to Dr. Poudel, if a limb is suspected to be broken, the injured person should not be taken to the hospital by walking or moving the injured limb. The injured limb should be immobilized using available materials and safely transported to the health facility.

‘In the case of a broken limb, splinting, that is, to keep the broken limb stable, the limb should be placed on available materials such as cardboard, sheets or boards and tied so that it does not move,’ he says.

The purpose of this is not to fix the bone, but to prevent the injured part from moving further while being taken to the hospital and to prevent internal damage.

What should you do if you see a head injury?

If the person has a head injury, is unconscious, is behaving abnormally, or is having trouble moving any part of the body, do not lift or move them unnecessarily.

According to Dr. Poudel, if there is a suspicion of an injury to the head and neck, the body should be kept as straight and stable as possible and taken to a place where there are health workers.

"If there is a head injury, you should lie down and take the person to a health facility without moving their head. If there is a neck injury, if the person's limbs are immobile, they should be placed on a board."

"They should be carried in the same position," he says.

If there is a suspicion of a neck or back injury, do not lift the limbs

Many people who have been injured in an accident lift them by holding their limbs or by two or three people from different directions. But in cases of spinal injury, doing so can be very risky.

According to Dr. Poudel, a person suspected of having a spinal injury should not be carried by pulling, swinging or lifting their limbs.

"Our habit is that if we see a person, we lift them by pulling their limbs. But in cases of spinal injury, we should not carry them that way. It can further aggravate the injury," he says. "If there is any doubt, the body should be moved in the same position on a board or hard flat surface as much as possible."

What should you do immediately if you see a patient bleeding profusely?

When swept away in a flood or falling into a collapsed structure, various parts of the body can be injured and bleed profusely. According to Dr. Bipin Nepal, a specialist in blood transfusion medicine, the first priority in cases of heavy bleeding is to reduce bleeding and take the patient to the nearest health facility or hospital as soon as possible. Applying continuous pressure by placing a cloth or gauze on the wound can reduce bleeding.

“If the cloth gets wet, it is better to apply pressure by adding another clean cloth on top rather than removing it repeatedly and looking at the wound. If there is an object embedded in the wound, do not remove it yourself,” says Nepal.

Similarly, do not move the injured limb unnecessarily or bandage it tightly. Even if a bandage is needed, it should be done as per the advice of the health worker so as not to affect blood circulation, says Dr. Nepal.

Transporting the injured to the nearest health facility

After providing first aid at the scene, the injured should be taken to the nearest health facility as soon as possible. However, since the current flood has also damaged roads and bridges, it may be difficult to bring the injured to the hospital by ambulance.

Dr. According to Tiwari, coordination between local health institutions, hospitals, administration and rescue teams is necessary in such situations.

‘Currently, it may be difficult to bring an ambulance by road because the roads and bridges are damaged. In some cases, we may have to rely on helicopters,’ he says.

According to him, there may be a situation where rescue and air routes need to be coordinated with the Chief District Officer and administration of the concerned district.

‘Rescue’ is not just about pulling people out of the water

When we think of rescue in a flood, we think of the scene of wading into the water and pulling people out. But from a medical point of view, rescue work cannot be done just like that.

Moving the person at risk to a safe place, preventing the condition of the injured from worsening, controlling bleeding, stabilizing the broken limb, not moving the body in case of spinal injury, and getting them to a place where there are health workers as soon as possible are also important parts of rescue.

More importantly, he says, the person who goes to rescue should not risk his own life.

Dr. Tiwari says, ‘From a humanitarian perspective, we all try to go to save another person. But it is not good to go that way if the person going is not safe. When one person is in trouble, another person is also at risk.’

Therefore, if you see a person trapped in floodwaters, the safest way is to first inform the rescue team from a safe distance, understand the situation at the scene, and help them when the trained team arrives.

Hospitals are also on standby

Keeping in mind the possibility of a large number of injured people from the flood, hospitals are on standby for emergency treatment.

According to Dr. Tiwari, health workers have been kept on standby in Trishuli, Rasuwa, Kathmandu and other areas.

But since the disaster area is large, coordination is necessary in all aspects from rescue to treatment.

‘When a patient arrives at the hospital, treatment priorities are determined based on severity. Patients with excessive bleeding, difficulty breathing, unconsciousness, and serious injuries to the head, chest, or abdomen may require immediate treatment. We are on standby,’ he says.

What should the general public remember in the current situation?

Citizens in flood-prone areas should not go to risky places to watch the flow of the river or make videos. Even if the water appears to have receded, the flow may suddenly increase.

Families at risk should follow the instructions given by the administration and security personnel. Special priority should be given to moving children, the elderly, the disabled and the sick to a safe place.

If someone is found injured, first ensure their safety, then check their breathing and level of consciousness, apply pressure if there is a lot of bleeding, stabilize broken limbs and limbs, and if there is a suspicion of an injury to the head, neck or back, take them to a place where there are health workers in a way that does not bend the body.