A stampede in Seoul, South Korea has left many dead and injured. In the event of a stampede, how can we protect ourselves?

I hope that the injured can recover quickly. The following two issues are mainly discussed.

1. Causes of stampede incidents and self-rescue

Stampede accident is a serious mass disaster. Usually occurs when a large number of people gather and the crowd is crowded and moving, triggered by accidents such as individual falls, falls, etc., the crowd panics and flees, aggravating crowding and causing more people to fall, forming a vicious circle, which eventually leads to a large number of casualties . Such accidents often have the characteristics of suddenness, publicity, event diversity and group hazard.

According to research and analysis, stampede accidents are often caused by the following two reasons:

From a psychological point of view, the causes of stampede events can be divided into two modes: “frightful escape” and “fanatical tendency”: the former is when the crowd is affected by negative factors and panics and escapes (commonly known as escape); the latter is when the crowd is affected by positive factors. And crowded in a certain direction (commonly known as watching the fun).

Therefore, when participating in large group activities that are prone to stampede incidents, we should pay attention to the following points:

1. Don’t stop and fight in the narrow aisle, let alone make a fuss, to create a tense atmosphere;

2. When there is a large flow of people, remember not to stop suddenly, do not bend over to tie your shoelaces;

3. Try to walk to the edge of crowded people;

4. If you find someone falling in front of the crowd, you should call for help and tell people around you not to approach;

5. If you are unfortunately overwhelmed by the crowd, you should take the following measures to protect yourself:

Cross your hands and fingers to protect the back of your head and neck, and your elbows forward to protect your head. When accidentally falling to the ground, push your knees forward as much as possible to protect your chest and abdomen organs, and lie on your side.

Second, the rescue measures in the event of cardiac arrest

The definition of cardiac arrest

Cardiac arrest is when the mechanical activity of the heart stops and signs of circulation disappear. If the patient is treated in time by measures such as cardiopulmonary resuscitation, it is possible to restore spontaneous circulation, and the probability of survival is high. Otherwise, biological death is likely to occur, and spontaneous reversal is extremely rare.

The epidemiology of cardiac arrest

The epidemiological survey data of cardiac arrest in my country is still lacking, especially the understanding of the occurrence and development of out-of-hospital cardiac arrest is still insufficient. The overall prognosis for out-of-hospital cardiac arrest patients in the world is currently poor. There are approximately 150,000 to 450,000 cardiac arrest patients in the United States each year, and the survival rate to hospital discharge is only 10.6% [2]. Due to the lack of awareness of out-of-hospital cardiac arrest and the popularization of emergency measures among ordinary people in my country, the overall level of patients’ discharge survival rate is not high, which is far from the international level. A 2012 study from Beijing showed that of 1693 out-of-hospital cardiac arrest patients with heart disease, only 85 (5.0%) recovered spontaneous circulation, 71 (4.2%) survived to hospital, and 22 (1.3%) Survived to discharge, 17 patients (1%) had good neurological function.

For patients in cardiac arrest, the most important rescue measure is to perform high-quality cardiopulmonary resuscitation (CPR) within the golden four minutes after cardiac arrest, and immediately for patients with ventricular tachycardia or fibrillation Defibrillation.

3. Cardiopulmonary resuscitation process

1) Assess whether the site environment is safe.

2) Judgment of consciousness: Tap the patient’s shoulders with both hands and ask: “Hello! What’s the matter with you?” Observe the patient’s response.

3) Determine whether there is carotid artery pulse and spontaneous breathing: Use the middle finger and index finger of the right hand to draw from the cricoid cartilage in the middle of the trachea to the proximal carotid artery pulse to feel the pulse. Observe whether the chest and abdomen are up and down. If there is no ups and downs within 5 to 10 seconds, it is judged as “no breathing”. If you can’t judge accurately, don’t waste time in this step.

4) Call for help: Someone! Dial 120! Get an automated cardioverter-defibrillator from a public place.

5) Cardiopulmonary resuscitation and electrical defibrillation: Immediately perform chest compressions, the compression site is the intersection of the two nipples and the sternum, the depth is 5-6cm, the rate is 100-120 times per minute, and the head tilting method is used after 30 compressions. Open the patient’s airway, pay attention to the need to remove foreign bodies such as secretions and dentures in the patient’s airway, and then perform 2 artificial breaths alternately. The interruption time should not exceed 10s until the automatic cardioverter-defibrillator arrives.

After the automated cardioverter-defibrillator arrives, use it as soon as possible to see if defibrillation is required. If defibrillated, the AED will automatically deliver the defibrillation. Do not turn off the power after the first defibrillation, immediately follow with high-quality CPR for 2 minutes, then use an AED for a second defibrillation, and then perform high-quality CPR, and so on, until the arrival of professional ambulance personnel or the patient’s pulse recovers and breathing.