Dare to help!

If a person needs medical help, first aiders are needed. It takes courage and the will to provide help as quickly as possible. Immediate measures can save lives. First aiders provide bridging care until the EMS arrives.

The rescue chain describes the phases of care in emergencies:

1. awareness - recognize helping as necessary and human
2. enable - learning first aid
3. recognize and alarm- to organize professional help
4. spontaneous first aid - by those present
5. organized first aid - by first responders, company paramedics etc.
6. professionalized rescue - by the rescue service
7. clinical treatment - in the nearest suitable hospital
8. impact assessment - to improve the system

The so-called "traffic light scheme" helps to keep a clear head during first aid:

1.    looking (red as in "Stop!")
2.    thinking (yellow)
3.    acting (green)

Everyone should be able to provide help without becoming a victim.

1.    looking: Grasp what has happened in the first place. Here it is particularly important to recognize dangers for the patient and / or bystanders (e.g. fire, explosion, crash or rolling traffic) as well as the possible situation of the affected person, the course of the accident, the injuries or the signs of an acute illness.

2.    thinking: possible dangers are assessed and appropriate self-protection measures are taken before the first patient contact. The most important self-protection measures include:

• Wearing protection gloves – if possible from the beginning, but certainly before the first contact with body fluids.
• Cordoning off or signaling in case of accidents (especially in road traffic), caution in flowing traffic.
• Restraint in aggressive confrontations.
• Keep your distance in case of fire, explosion or fall hazard.
• Attention to electricity and poisoning.

After that, it is a matter of what help the affected person needs.

3.    action: The more threatening the situation for the affected person, the more urgent the first aid. It is essential to alert and request assistance at an early stage. According to Art. 128 of the Swiss Criminal Code, every person is obligated to render assistance within the bounds of what is reasonable if a person's life is in immediate danger.
 

Information
If there are still injured people in a vehicle after an accident and they cannot free themselves independently, all rescue attempts by first responders are to be refrained from, because such maneuvers can endanger the rescuer as well as the victims equally.
Very rare exception: if a vehicle threatens to catch fire, attempts may be made to pull the injured out of the car. First responders should also intervene in other cases where life is in immediate danger or death is imminent without immediate rescue – for example because a collapse is imminent or the patient is unconscious and no longer breathing normally.

However, this should only be done if the rescuer does not expect to be seriously injured himself during such actions. Self-protection takes precedence over all measures!
 

Anyone requesting help from EMS, police or fire department is guided systematically through the query. Usually, the first question asked is the location of the emergency. This is followed by questions about the emergency: What happened? What is the callback number? How old is the patient? Is the patient responsive, is the patient breathing?
The answers make it easier for EMS to find the emergency location quickly and respond appropriately. If necessary, dispatchers already direct immediate measures and support the caller by telephone until the arrival of EMS.

The following emergency numbers apply throughout Switzerland:

• Emergency Medical Service (EMS) 144
• Fire department 118
• Police 117
• Air rescue (Rega) 1414
• Poisoning 145
• Offered hand 143

In addition, the European emergency number 112 is active in most cantons and makes it easier for tourists to alert in emergency situations. 

Information
During first aid, injuries and infections can be dangerous for first aiders. The first priority is always your own safety. First aiders should not come to harm themselves.

Recognition

• Caution: not every threat is recognizable at first glance. 
• Consider the traffic light scheme. If necessary, call in experts (e.g. safety officers, fire department, etc.). 
• Warn other people and rescuers if, for example, there is a risk of slipping or if there is broken glass, drug syringes, etc. lying around.

Action

• Wearing gloves reduces the risk of transmitting diseases, as does hygienic hand disinfection. 
• In case of threatening violence, always immediately alert the police via 117.
• Keep escape routes open.
• Never turn your back on the victim / perpetrator.
• Appear calm, speak calmly.

Special features in road traffic:

• Take traffic into account (before getting out of the car, crossing the road, etc.)
• On the highway, seek shelter behind the guardrail.
• Wear high-visibility vest.
• Use own vehicle as a bugger to secure the accident site.
• Switch on flashing warning lights and dipped headlights, set up a warning triangle (in built-up areas at least 50 meters from the scene of the accident, on country roads with increased speed at least 100 meters, on highways at least 200 meters).

Information
Better than having to give first aid is to prevent emergencies. A large part of emergencies is predictable and therefore preventable! Prevention includes recognizing, evaluating and reducing risks. Many diseases can be influenced by lifestyle. For example, many risk factors for cardiac arrest (elevated cholesterol, smoking, high blood pressure, obesity, diabetes and lack of exercise) can be influenced by conscious lifestyle or medical measures. With regard to accidents, there is a whole range of prevention options:

• No alcohol behind the wheel or when operating machinery.
• Adapted speeds in road traffic and on the slopes.
• Protective measures and equipment such as helmets, harnesses and much more.

Information
Stress is the body's natural response to pressure, tension or change. In the context of first aid, helpers often experience negative stress from feeling overwhelmed. Typical signs of stress include increased heart rate and blood pressure, acceleration and deepening of breathing, restlessness and difficulty concentrating, sweating, etc.
Emergencies with children, suicide attempts, confrontation with death, helping friends or relatives, own endangerment, overtaxing of helpers, etc. are considered particularly stressful.
Since stress is a subjective phenomenon, similar situations are experienced as stressful in different ways by different people.

Recognition
The signs of a post-traumatic stress reaction are the normal reaction to extraordinary events. They usually disappear spontaneously after 10 to 14 days. 
However, if the symptoms last longer than four weeks, post-traumatic stress disorder should be considered and help should be sought. This is especially true if the following signs are present:

• Repeated stressful recollections (dreams, sounds, smells, physical reaction, confrontation with event symbols, etc.).
• Increased level of arousal with sleep disturbances, irritability, difficulty concentrating, etc.).
• When symptoms cause significant impairment in private and professional spheres.

Information
First aid can alleviate suffering and save live. First aid should be a matter of course for those in need of help. Nevertheless, Art. 128 of the Swiss Penal Code makes it a punishable offense to fail to provide first aid in cases of imminent danger to life.
Conversely, it can be assumed that in the context of first aid to the best of one's knowledge and belief, legal consequences are unlikely. Especially in the cases of life-threatening cardiac arrest, the following applies: Without resuscitation measures, the patient dies! The duty to provide emergency aid applied to all those who are able to do so. If several people are present, the duty to help applies to each of them. The reasonableness of the assistance is evaluated restrictively. This includes the degree of personal danger or impairment, personal abilities, the availability of aids, as well as training and experience.
At least the alerting of EMS is reasonable for everyone.

Information
The emergency call is usually made by the Emergency Medical Dispatch Center on the basis of key words, because partner organizations can call on each other (for example, in the event of a fire alarm, the police will automatically come). High-visibility vests / gilets can provide information about the organization and functions of the people. The instructions of the professional rescuers must be strictly followed.

Cooperation with EMS

• Usually the EMS is on scene within 10 to 15 minutes.
• Briefing makes it easier for EMS to find the scene of the incident.
• EMS often enlists help from first responders and passers.
• EMS takes information from bystanders, especially if the victim is unresponsive.

Cooperation with the police

• Police have solid basic first aid training.
• Police is usually called automatically in case of work and traffic accidents with injured victims.
• First aid has priority over investigations and securing evidence.
• The police secure accident sites, keep the way clear for fire department and EMS and direct the rescue helicopter if necessary.

Cooperation with the fire department

• Volunteer fire departments usually need a few minutes to move out (starting points are often places of work or residence).
• Special units such as helicopters or railroad rescue trains can have longer travel times.
• Firefighting units are strictly hierarchical and each responder has a clearly defined role.
• The fire department decides on the danger area and its access.

Cooperation with Air Rescue

• Air rescue (mainly Rega, but also Air Zermatt or AAA) takes over transports to hospitals that can be reached more quickly by air (e.g. special clinic, center hospital).
• It reaches remote locations (mountains, forest areas, etc.).
• Is usually briefed by the police, fire department or slope rescue services.
• Caution: There is danger from rotor blades and downdrafts: Approach the helicopter only from the front with eye contact to the pilot and only when the rotor blades are stationary! 

Information
The Swiss law links the dispensing of medical products to appropriate training. The aim of this regulation is to ensure the safe use of medicines by ensuring that they are dispensed with the necessary expertise. First aiders without the appropriate professional qualification are therefore prohibited by law from dispensing medicines in dispensing categories A, B and D.

The Swiss law defines four different dispensing categories:

• A: One-time dispensing on medical or veterinary prescription;
• B: Dispensing on medical or veterinary prescription after professional consultation;
• D: Dispensing after professional consultation;
• E: Dispensing without professional consultation.
• Category C was abolished as of 01.01.19.
• Drugs in dispensing categories D and E are not subject to prescription.
• Under "professional advice" (Category D), the legislature lists "people authorized to dispense prescription drugs and certified druggists". 
• Neither package inserts nor specialist information are required for medicines in dispensing category E.

Various international guidelines state that it is medically appropriate to administer 150 to 300 mg of aspirin orally for chest pain of suspected cardiac origin, as long as no known allergy or current bleeding (the most common dosage in Switzerland is 500 mg tablets).  A corresponding recommendation for use can also be found for the use of adrenaline (e.g. Epipen ®, or Epipen junior®) in severe anaphylactic reactions. The contradiction between medical appropriateness and legal restriction by the Swiss law cannot be resolved by SIRMED.