“Let us Save Lives” by Dr. Saeed Minhas


Book Review

“Let us Save Lives”
by Dr. Saeed Minhas

An informative useful book on First Aid for every one

KARACHI: Health education of the community with particular reference to First Aid in case of emergency can save many precious lives if the victims are able to get First Aid in time during the golden hours and they are safely transferred to the nearest healthcare facility. However, there is a paucity of literature on health education in Urdu that is why the recent book “Let us Save Lives “by Dr. Saeed Minhas consultant orthopaedic surgeon at Jinnah Postgraduate Medical Center is a welcome addition to the scarce literature available. He has special interest in trauma management and has been conducting workshop training healthcare professionals and other support staff in primary trauma care now for many years. He must have felt the need for such a book and based on his personal experience, he has tried to collect all the relevant information which could be useful in managing emergencies thus saving lives.
This 166-page book has been divided into four sections i.e. First Aid and ABC of Trauma Management, Industrial, Occupational and other emergencies and Disaster management while the last section deals with safety and recommendations. Writing in the foreword Dr. Sher Shah Syed has referred to the haphazard industrialization without following the safety rules and regulations which results in lot of industrial accidents. Most of the head injuries that take place on our roads and some of them are fatal involves the motorcycle riders who do not use helmet. This little carelessness accounts for many precious lives which are lost on the roads every month.

Dr. Saeed Minhas

In the first section, the items which a First Aid Box must contain have been mentioned in detail. The importance of maintaining Airways and Breathing, Cardiopulmonary Resuscitation, preventing bleeding and ensuring blood circulation have been highlighted. It also gives useful information on how to safely transport the patient with head, neck and spinal injuries. How to manage the bone and joint fractures, what should be done if the patient is in a Shock, what to do in case of burns and what not to do, managing patients suffering from smoke inhalation, those who suffer from electric shock, how to manage drowning patients, doing Triage i.e. separating the patients with mild to moderate and severe injuries have all been discussed in detail.
Management of occupational and industrial emergencies has also been covered. Poisoning is quite common and this book provides lot of useful information on how to handle such patients. This chapter also deals with ammonia gas poisoning, methane gas poisoning, treatment of snake and animal bite, heat stroke management, effects of extreme cold i.e. Hypothermia, Frostbite, choking and heart attacks, stroke, hypoglycemia and epilepsy have been covered. However, I was greatly disappointed while going through the chapter dealing with Heart Attacks as life saving properties of miracle drug Aspirin has not been mentioned at all. The author is a senior orthopaedic surgeon and a faculty member in a premier postgraduate medical education; hence his ignorance with the life saving properties of this drug is surprising. It may be mentioned here that it was in 1974 when a Scottish physician Peter Elwood for the first time proved that a single tablet of Aspirin taken immediately after heart attack proves life saving. It reduces mortality in myocardial infarction patients by almost 32% if taken within six hours of heart attack which is similar to the most expensive streptokinase injection which also saved similar number of lives if taken within six hours. Secondly most of these heart attacks occur late in midnight or early in the morning when no doctor is available and taking the patient to the nearest hospital can also take some time. Hence, if one tablet of soluble Aspirin 325mg is taken immediately, it might save the patients life. Active ulcer and patients having history of bleeding disorders are the only contraindications for the use of Aspirin in such conditions. It is recommended that one must have Aspirin at office, clinic, home or even while travelling because it may be needed any time .
Same is true in case of stroke. Most of the strokes are ischaemic and if one tablet of Aspirin if taken immediately, it might dissolve the clot and the damage can be minimized. Even in case of hemorrhagic stroke, it is said; just one tablet of Aspirin won’t do much harm as regards bleeding but could be very beneficial. Despite thousands of papers published and many being published every month highlighting the safety and efficacy of Aspirin, its use is still not optimal and the healthcare professionals deprive their patients of the benefits of this life saving miracle drug. Apart from its antiplatelet activities, new and emerging indications for low dose Aspirin therapy are being reported in the medical literature regularly. Aspirin Foundations all over the world are trying to promote the use of Aspirin in its well established indications and Pakistan Aspirin Foundation also since 1998 have been organizing CME programmes for creating awareness about the use of Aspirin. Omission of the mention of Aspirin to save lives in case of heart attack in this book also highlights the fact that Pakistan Aspirin Foundation still has to do a lot to educate the healthcare professionals in this regard.
Disaster management, dealing with emergencies due to earthquake, managing blast injuries and road safety also contain useful information. Another problem that we face is affluence without education with the result that people keep on using mobiles while driving leading to increased road traffic accidents some of which also prove fatal. Management of communicable diseases, vaccination schedule, immunization during pregnancy, expanded programme of immunization with details when to go for various injections, safe delivery, safety in old age and healthy living are also discussed. In addition the book also contains important telephone numbers of Emergency, Hospitals, Ambulance Service and Blood Banks in Karachi.
On the whole it is an extremely useful informative book which should be an essential reading not for fresh medical graduates, technicians, paramedics, ambulance, Fire brigade staff and nurses. As suggested by Dr.Sher Shah Syed in his Foreword, it should be included in the curriculum of students in higher secondary schools so that they are familiar with dealing such emergencies. It is an excellent effort by Dr.Saeed Minhas for which he deserves to be commended. Printed on art paper it is very reasonably priced at Rs. 250/- and is available from Dept. of Orthopaedics Ward-7, at JPMC Karachi besides SK Surgicals opp Jinnah Sindh University and Khalid Book Depot Lahore. SAJ

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