You’re shopping, and as you wait for your turn to pay for the goods you bought, someone in front of you in the queue suddenly collapses. He appears to be unresponsive.

You’re eating in a restaurant, and the girl at the next table who’s eating while playing with her kid brother suddenly gasps for breath.

You’re trekking in a forested area with friends, when someone in your group gets bitten by a snake.

What do you do during such situations and other emergencies if there is no medical doctor around?

What if there is no hospital or medical clinic nearby?

What if there are no drugstores in the area and no available medicines?

What if you are in a remote area in the middle of the night and there is no means of transportation to get you to the nearest hospital or medical facility?

What if—even in the presence of a doctor, a hospital, a drugstore and transportation—you don’t have enough funds?

Third edition

These are the questions noted surgeon Dr. Juan “Jim” Sanchez and emergency medicine specialist Dr. Emelie Santamaria tried to answer when they came out with the third edition of their book, “First Aid for Every Juan.” They included various emergency and non-emergency situations in this edition, as well as some pointers on what to do if you suspect that you might have COVID-19.

Among the emergencies tackled in the book are: difficulty of breathing (dyspnea), asthmatic attack, severe allergic reaction (anaphylaxis), gunshot or stab wounds, arm or leg injuries, burns, drowning, heatstroke, snake bite, bee sting, jellyfish sting, acute stroke, heart attack and cardiac arrest. In the book, the authors also give practical pointers for nonemergency but common problematic situations like uncontrolled hypertension, diabetes, palpitations, colds and coughs, flu or COVID-19, diarrhea, constipation, heartburn, skeleto-muscular pains, mouth sores, sore eyes, menstrual problems, difficulty in urination, motion sickness, nausea and vomiting.

During an emergency, time is gold, and every second counts. Waiting for a doctor or a paramedic to come could lose precious time that can spell the difference between life and death, or preventing brain death and surviving but being in a vegetative coma indefinitely.

Lack of physicians

Dr. Sanchez says that what prompted them to come up with the book is the lack of physicians to attend to the needs of all Filipinos, especially those in the rural areas. He adds that as of Oct. 2021, there were less than 30,000 actively practicing physicians to serve more than 110 million Filipinos all over the country.

“Based on this statistics, if equally distributed, one doctor takes care of 4,000 people. However, because of the maldistribution of doctors, this ratio varies a lot especially outside the urban areas where we see one doctor covering 30,000 people,” laments Dr. Sanchez.

What’s compounding the problem is that many young doctors are inclined to go abroad to seek greener pastures. Dr. Sanchez hopes that the book can provide immediate life-saving pointers for emergency situations until expert help and facilities are available. For nonemergency but common situations, when one cannot seek medical care yet or buy the prescribed medicines, the book offers some pointers how to alleviate the medical condition temporarily. However, the authors caution against self-medication and advise “every Juan” to see a doctor once possible.

A dire situation one may rarely encounter is when someone—relative, friend or stranger—goes into cardiac arrest. The book teaches, with detailed illustrations, how to do cardiopulmonary resuscitation (CPR) or the basic life support intervention. Of course, someone should call for emergency help immediately to bring the victim to the hospital but the few minutes after the heart stops beating are critical to make sure brain death does not set in.

Frequently, the cardiac arrest victim may be resuscitated once they reach the emergency room or when the paramedics arrive, but since the brain tissues die within minutes after the heart stops beating, the victim has become brain dead already and may be doomed to a vegetative state should they recover.

Hands-on CPR

Sudden cardiac arrest is defined as the abrupt stopping of the heartbeat, usually due to a fatal arrhythmia or irregular heartbeat. It may be related to an acute heart attack, but it may not be so all the time. The arrhythmia may be due to a problem in the heart’s “electrical wiring,” which disrupts the heartbeat, and causes the blood circulation to stop. Breathing also stops and the victim loses consciousness.

There are now cardiac defibrillators in some malls and crowded areas, and one should use them when available. Most portable models use easy-to-follow step-by-step voice instructions. With the defibrillator paddle on top of the chest, it delivers an electric shock to the heart to stop the serious arrhythmia and restore the circulation. But even if there’s no defibrillator around, one can administer basic CPR or hands-only CPR by just giving compressions to the chest properly until emergency help arrives.

If the person who collapses is really unresponsive and has stopped breathing, one can begin CPR by pushing hard and fast on the person’s chest (depth of around two inches)—at the rate of 100 to 120 compressions a minute. One may do it to the tune of the song “Staying Alive” as a guide. For those trained in CPR, they should check the person’s airway and deliver rescue breaths after every 30 compressions. But for the ordinary Juan who’s not trained, just continue the chest compressions, allowing the chest to rise completely between compressions. One may alternate doing the chest compressions with another person since it can be quite exhausting after a few minutes. The chest compressions must be maintained until a portable defibrillator is available or the paramedics arrive.

This and other initial measures for emergency and non-emergency situations are available in this highly recommended book, “First Aid for Every Juan.” All proceeds go to the medical missions of Dr. Sanchez’s Hospital on Wheels (HOW), a state-of-the-art operating room in a bus, which travels nationwide to perform surgeries for indigent Filipinos for free.

For those who wish to order the book or know more how they can help the HOW medical missions, you may call tel. nos. (0930) 818-1467 or 8990-9190.