Emergency Medicine Away From Home

As an Expatriate, living away from your home is daunting enough without having to worry about how your family’s health will be taken care of. This is especially the case for an emergency.

No one expects an emergency to happen but when they do it is good to be prepared. In fact, being prepared for and knowing how to respond to an emergency is your best defense to combating an emergency situation, no matter where you are living in the world. This is particularly the case for expatriates who are living in a foreign country, such as China, where the emergency response network is often very different than what they would encounter at home. So, in China, what can you expect?

A very common cause of Emergencies in China relate to trauma, usually caused by car or bike accidents. According to the WHO, the death rate on China’s roads is the highest in the world per car with 680 dying and 45,000 being injured every day. In addition to trauma, it is important to realize that while living in China, you and your family are not immune to other common emergencies such as heart attack or cardiac arrest, severe allergic reaction, drowning, choking, poisoning, and stroke. It is important, therefore, to be prepared for all types of
emergencies and take preventive measures where possible. Prevention and preparation, in fact, go hand in hand.

Prevention

Prevention is critical to avoid emergencies – An ounce of Prevention is worth a pound of cure. Living in China you are more likely to be exposed to vaccine preventable diseases than in your home country. Make sure you and your family is up to date with such vaccines as Hepatitis A and B, Influenza, Japanese Encephalitis, and Typhoid. Even your pets are at greater risk as Rabies is relatively common here. Another preventive step you can take is to simply wear seat belts in cars and taxis, and a helmet when riding a bike. Also be aware that safety regulations are often very different to those you would encounter at home. Childproofing, for example, is not regulated in China so keep all medications and other risks to children away from their exploring hands and mouths. Look under the kitchen sink and in your bathroom for poisons that might be easily accessed and think about easily ‘explored’ electrical sockets and cords. Also, don’t forget that swimming pools and open bodies of water are one of the greatest hazards worldwide to children. Make sure children are watched at all times when they might be at risk.

Preparation

While it is important to take preventive measures to avoid emergency situations, it is just as important to be prepared if one does happen to arise. In being prepared for an emergency it is important to consider the chain of survival, (as shown in the diagram). Although the chain is important in any emergency, it is particularly critical in cardiac arrest, foreign body aspiration and drowning.

The first link in the chain is early access; that is early contacting of emergency services which involves knowing exactly where and how to contact help. In Beijing and Shanghai an ambulance can be reached by calling the 24 hour Emergency numbers at United Family Hospitals – Beijing +86 (10) 5927-7120 and Shanghai +86 (021) 2216 3999 – where you can speak to English speaking staff that will get an ambulance dispatched to you. To be prepared keep important phone numbers, contact information, and addresses in Chinese, in your phone. Other important emergency numbers in China include: Ambulances for all of China 120, Ambulances in Beijing only 999, Police 110, Fire 119, and Car Accident 122. It is important to note however at most of these numbers they may not speak English.

The next link to improving survival, especially in cardiac arrest, is CPR. Learning First Aid and CPR are great ways in which you can be prepared for an emergency. A trained bystander knowing correct First Aid and CPR is the key to the best recovery rates. Proper CPR can double or triple the time available for successful defibrillation and makes all the difference in drowning related emergencies.

The next link, especially in cardiac arrest, is early defibrillation. Successful recoveries from such emergencies are reduced 7-10% each minute a person does not have defibrillation. If a defibrillator is required quickly to the scene of the emergency then make sure this is successfully communicated to the emergency services. If there is not one in your compound and business perhaps you should advocate getting one. Having quick access to AEDs (Automatic External Defibrillators) can mean the difference between life and death.

The next link in the chain of survival, especially crucial for trauma related injuries, is early advanced care. This goes back to knowing exactly where and how to access emergency transport help. For severe trauma (say a car accident) the most important factor is rapid transport (while protecting any possible spinal injuries) to a facility where surgical treatment is immediately available. You should keep in mind that many local hospitals may require cash payment before any surgical intervention is carried out. You will, therefore, need to be prepared and solve this problem in advance.

Taking preventive measures and making preparations will mean you have the tools to cope with an emergency if one ever does arise.

In the event of an emergency what should you do?

Ambulance services can be sent to you through the United Family Hospitals ‘999 or 120 Ambulance Services’ partnership. First, call the ER (Beijing +86 (10) 5927-7120 and Shanghai +86 (021) 2216 3999). You will then speak with the ER Physician to determine your situation’s needs and get emergency advice such as a reminder of how to do CPR. If an ambulance is needed, the ER Nurse will obtain your details and location then call 999 or 120 for dispatch giving them directions to your location.

If appropriate, it might be faster to take your own transport and come directly to the Beijing or Shanghai hospital’s Emergency Room. It is often quicker to drive directly to the hospital than to call for transport.

If you are unsure of whether or not your situation warrants a hospital visit, it is recommended that you first call the Emergency Room and speak with the doctor

If you are coming to the hospital, call the ER (Beijing +86 (10) 5927-7120 and Shanghai +86 (021) 2216 3999) to notify them of your emergency and estimated arrival time.

UFH First Aid and CPR Training

United Family Hospitals teach First Aid and CPR Courses for you, your driver and your Ayi. The courses are given in Chinese and English and focus on the Emergency care of infants, children and adults, what constitutes a true emergency and what to do if one arises.