First aid might have saved Do­minic

Jamaica Gleaner - - SATURDAY TALK - Klive Walker Guest Colum­nist

THE EDITOR, Sir: AM a Level Four paramedic/emer­gency med­i­cal ser­vices (EMS) in­struc­tor em­ployed to the Univer­sity of the West Indies. My job is to train EMS pro­fes­sion­als at the ba­sic to ad­vanced lev­els. I have been teach­ing and work­ing in the field of EMS for more than 14 years.

First, there are mul­ti­ple lev­els of EMS prac­ti­tion­ers. The skill pro­vided at each level is way above or be­yond first aid.

The pre-hos­pi­tal man­age­ment given to Do­minic James, the schoolboy who col­lapsed on a foot­ball field re­cently, should have been first aid. I can­not say if this would be enough to save the young man’s life, but it does leave

IWHAT IF you were asked to name only three of your favourite reg­gae books? How would you select just three from 50 years of writ­ing about reg­gae? That’s ex­actly the chal­lenge Toronto lit­er­ary critic Donna Bai­ley Nurse asked me to con­sider. It forced me to think about the cri­te­ria I would use to ar­rive at my choices for a short­list.

First, I de­cided to dis­re­gard all those large, exquisitely de­signed cof­fee-ta­ble books. If you are at all fa­mil­iar with reg­gae books, you know the ones. They roughly fall into two cat­e­gories: The Bob Mar­ley bi­og­ra­phy told through at­trac­tive im­ages sur­rounded with un­sub­stan­tial text; and books, us­ing the same ap­proach, that fea­ture an as­sort­ment of reg­gae mu­si­cians, singers and pro­duc­ers. I’m not against the glossy pho­to­graphs in those books, but typ­i­cally the writ­ing in many of them doesn’t pos­sess the craft or an­a­lyt­i­cal depth to po­si­tion them as more than just av­er­age.

While I re­main a huge fan of Bob Mar­ley, I had to ex­clude all those bi­ogra­phies of him that re­cy­cle the same in­for­ma­tion with­out of­fer­ing any new in­sights or per­spec­tives. I also steered clear of books with a one-track vinyl-col­lec­tor’s per­spec­tive. They of­ten trade in dis­em­bod­ied anec­dotes di­vorced from any so­cial or his­tor­i­cal con­text. They fit Amiri Baraka’s de­scrip­tion, in his book, Blues Peo­ple, of cer­tain jazz writers as ‘gee whiz hob­by­ists’.

Af­ter all that whit­tling down, what’s left? Well, some of the most al­lur­ing and pow­er­ful reg­gae writ­ing can be found in po­etry and fic­tion. Lorna Good­i­son, Ka­mau Braith­waite, An­thony McNeill, Bongo Jerry,

Mervyn Mor­ris, Kwame Dawes, Colin Chan­ner, Chris­tian Camp­bell, Nalo Hop­kin­son, Mar­lon James, Kei Miller and Ish­ion Hutchin­son are just some of the gifted Caribbean po­ets and nov­el­ists whose work has en­gaged the mu­sic. Whether they ex­plic­itly dis­cuss reg­gae or not, their writ­ings are of­ten steeped in its rhythms, themes, and over­all aes­thet­ics. De­spite the lit­er­ary qual­ity of those works, I de­cided to fo­cus on non-fic­tion.

When no one out­side the Caribbean thought to write about the mu­sic, Gor­don Rohlehr, Garth White, Ver­ena unan­swered ques­tions.

I am very cer­tain that if he fell and was seiz­ing and gasp­ing, oxy­gen could not stop that. He would re­quire med­i­ca­tion to stop his seizure, then ag­gres­sive air­way and car­diac man­age­ment. Fi­nally, the car­diac mon­i­tor, when placed in de­fib­ril­la­tion mode, does not start back the heart. It kills the weak im­pulses caused by ven­tric­u­lar fib­ril­la­tion and pulse­less ven­tric­u­lar tachy­car­dia, which are the only two rhythms that can be de­frib­ril­lated.

This, with the use of ACLS drugs, is what al­lows the pri­mary elec­tri­cal stim­u­lus of the heart to re­turn. Do­minic might have been in a rhythm for which no shock was re­quired.

I do not be­lieve that am­bu­lances with trained med­i­cal per­son­nel can be at ev­ery Man­ning Cup event, be­cause Ja­maica’s EMS sys­tem is nowhere near the First World level. This is be­cause of poor reg­u­la­tions, poor pub­lic aware­ness, poor stan­dard of care and scope of prac­tice.

CHAIN LINK TO SUR­VIVAL

Now if there is no first aider, the EMT does what the first aider should have done. If there is no EMT care, the paramedic does what the EMT should have done. If there is no paramedic care pro­vided, the nurses and doc­tors must do what the paramedic should have done. This is the chain link to sur­vival, and if there is a break in that chain, the pa­tient’s chances of sur­vival are greatly di­min­ished.

My sug­ges­tion would be to have the coaches and teach­ers trained and equipped with jump bags un­til our Ja­maican EMS sys­tem, by some mir­a­cle, reaches where it needs to be. I also rec­om­mend that you re­view the cur­ricu­lum for train­ing EMS prac­ti­tion­ers at all lev­els men­tioned above to get a bet­ter un­der­stand­ing of the level of train­ing, skills, med­i­ca­tion and knowl­edge re­quired for these pro­fes­sion­als to be cer­ti­fied or li­censed.

There is a say­ing that emer­gency per­son­nel are like a spare tyre; they do not be­come im­por­tant un­til they are needed. Sadly, in Ja­maica, they are not seen as im­por­tant at any time. Do­minic de­served a First World re­sponse, whether he would have sur­vived or not. RYAN O. RU­FUS oneil_ru­fus­ryan@hot­mail.com

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