What I Saw At The 6th National First Aid Conference (Part 2)

In the last article, I shared what I learned from the Advanced Cardiovascular Life Support (ACLS) training workshop at the National First Aid Conference. Today, I’m going to share my experiences at another workshop, as well as what I saw at the conference’s exhibition booths and the National First Aid Skills Competition.

VA-ECMO

In this workshop, a physician from Peking Union Medical College Hospital walked me through Veno-arterial Extracorporeal Membrane Oxygenation (also known as VA-ECMO) using real equipment. To be honest, my first impression was that the machine looked nothing like an advanced medical contraption; it was such a messy jumble of wires and tubes (professionally known as cannulae) that I could easily have taken it for a failed attempt at cable management. But I was clearly mistaken, as ECMO is the most advanced form of life support that currently exists.

In a healthy human body, the heart and lungs provide oxygenated blood to organs and tissues while simultaneously disposing of waste products such as carbon dioxide. However, in cases of life-threatening organ failure, the lungs can no longer perform efficient gas exchange, and the heart is unable to pump blood effectively.

ECMO provides immediate medical intervention required to maintain body functionality. Here I should point out a difference between venovenous (VV) and veno-arterial (VA) ECMO; the former can only support respiratory failure, while the latter can also support heart failure. Both of these processes utilize external circulation; deoxygenated blood is drawn from a vein (like the femoral vein in the groin), oxygenated by an oxygenator within the ECMO machine, and then pumped back into the body. In VA-ECMO, the oxygenated blood is pumped directly into a large artery, while in VV-ECMO, it is instead pumped back into the venous system. The procedures support respective functions, giving the organs time to potentially recover.

Typical VA-ECMO duration can, on average, last 5 to 10 days, while some patients require extended periods up to several months. Once the lungs and heart show improvement, the support can be gradually reduced, and in a stable condition, taken off. In unfortunate cases where recovery isn’t enough, additional measures would then be considered, such as a heart transplant.

Although VA-ECMO is portrayed as a life-saving measure (and it indeed has saved countless lives), it is an extremely risky procedure with an in-hospital mortality rate of roughly 40% to 75%, which is why it is generally considered a last-resort treatment only used in otherwise deadly situations. Considering its nature, VA-ECMO is a relatively challenging procedure for medical teams. It requires immense precision, constant care, and extensive labour to surgically plant, monitor, and maintain the machine’s cannula.

The specialist talked about a particular case – the inherent danger of accidental ECMO decannulation, a rare but serious scenario where the cannula partially or fully dislodges. This can cause immense bleeding, loss of life support, and air entrainment (which can further cause massive air embolism, the sudden entry of massive amounts of air into the bloodstream), circumstances likely to be fatal. Although the risk of accidental decannulation cannot be fully avoided, the specialist did recommend practices such as stitching the cannula in place. When I heard this, I was genuinely surprised by how a seemingly insignificant action could prevent major accidents from occurring – it served as a great reminder of the importance of paying attention to detail.

Exhibition Booths

In addition to the workshops held at the National First Aid Conference, there was also a section dedicated to exhibition booths, each showcasing different medical devices and equipment.

There was a booth from a company dedicated to making first aid training manikins that simulated various medical situations. They had anatomical models designed for medical students to perform surgery on, which used textured rubber to simulate the feel of different organs, featured ‘blood’ when you cut the organs, and even had breathable lungs and a pumping heart that could be controlled via computer. There were also different manikins for specific exercises, including one used to train medical students in intubation, another with detailed skin burns of different degrees, and a transparent model used to provide clear visual cues for ultrasound training. Finally, there was a manikin with electrodes and receptors that enabled extensive training exercises, where defibrillators, monitors, CPR, BVM, and even intubation were used. This last manikin was the one used in the ACLS drill. The major advantage of this manikin is that it can provide detailed feedback and analysis of first aid performance, including CPR quality, air intake, defibrillator accuracy, etc.

Another exhibition booth was dedicated to CPR compression practice models. As you performed CPR on their model, a computer synced to a TV screen displayed your performance status, including compression rate, depth, placement, and breath data. The first time I tried CPR using the machine, it showed I had done hundreds of wrong compressions! Fortunately, my poor performance quickly improved over my next few attempts. In addition to their CPR manikins, they had a variety of reference samples of external injuries, including different levels of skin abrasions, burns, and fractures. Some of them could be worn like ‘armbands’ and used in practicing bandaging and fixation, crucial skills used to prevent the injury from worsening. One of these armbands simulated a compound fracture, complete with protruding bone fragments. When worn, the effect was so realistic it appeared authentic. In my opinion, it would be the perfect addition to a Halloween costume.

The National First Aid Skills Competition

Although I still need far more professional training to qualify for this competition, it was fascinating to see real paramedic teams from across China compete using many of the same techniques I learned in the workshops.

There was a comprehensive first aid category, where the judges provided ‘assignments’ to each competing team, involving case-specific circumstances such as cardiac arrest or cerebral infarction. The team would then have to evaluate what to do based on factors such as the simulated patient’s age, allergic history, medical history, etc. For example, I got to see three paramedics perform a full ACLS procedure on a manikin (the same one with electrodes that I saw at the booth), including defibrillator shocks, BVM, and using something called an automated CPR machine (also known as mechanical CPR or mCPR). I began wondering why the mCPR device wasn’t deployed earlier. Luckily, I had the opportunity to ask the deputy head referee, and he explained that first aid teams prioritize initiating compressions immediately, and the device requires a setup period, which would have wasted valuable time.

Another category was on external injuries. Here, they didn’t use a manikin; instead, a person cooperated as the patient. This poor guy had to sit on a chair and be bandaged, then unbandaged, every single round.

Interestingly, there was a specific category called ‘rural brawls’. It simulated a patient being heavily injured after a fight, and had to be transported from the ‘scene’ onto an ‘ambulance’ to conduct first aid. The manikin used here even featured a severed leg, with additional details such as a split bone, further contributing to the convincing look.

My Takeaway

Overall, I learned an unbelievable amount from the 6th National First Aid Conference and 8th National First Aid Skills Competition, which is why I would like to thank the organizers of this wonderful event for making my weekend so enjoyable and teaching me so much.

However, a rather disappointing fact I noticed throughout my time at the event was that there were no other teenagers or children there. To be honest, I think that first aid techniques and skills should be spread to more people, especially today’s younger generation. Although children nowadays are more interested in the internet and digital entertainment, these potentially life-saving skills are definitely worth learning and appreciated within society. More efforts should be made to teach minors the importance of first aid. Perhaps some of these children will discover a newfound passion for helping and saving others and grow up to become paramedics themselves. Who knows?

Conclusion

I hope that you learned a lot from this article. If you liked today’s article, please help spread awareness of first aid by liking and sharing. Thank you for reading.