The difference and connection between poisoning and accidental first aid

The core difference between first aid for poisoning and ordinary first aid for accidents is that the first priority of the former is always to cut off the intrusion of the poison source and use the corresponding antidote as soon as conditions permit, while the first priority of the latter is to control immediate fatal obvious injuries (such as massive bleeding, suffocation, cardiac arrest)； The essence of the two is completely the same - they both help patients regain the golden treatment time as much as possible before professional medical care arrives, and follow the general principle of "saving lives first, treating injuries later, and avoiding secondary injuries" throughout the process.

Last month I took two 120 trips to the same community, less than two hours apart, which was enough to explain the difference between the two. The first one was Aunt Zhang on the first floor. She thought there were fleas in the house, so she sprayed the whole house with undiluted dichlorvos. She closed the door and let it simmer for half an hour before going in to clean up. She fell to the ground two minutes after entering. When the family members called for help, they were so panicked that they first said, "My old man fell." As soon as we opened the door, After smelling the pungent smell of pesticides, I understood everything. First, open all the windows, carry the person to a ventilated area in the corridor, and give atropine as soon as possible. If this was a normal first aid procedure for a fall, first check whether there are fractures and brain hemorrhage. If there is a delay of three to five minutes, the person may be dead. The second trip was when the young man on the fifth floor was installing the air conditioner. His foot slipped and he fell off the ladder. He suffered a big cut on his forehead and started bleeding. The first thing we did when we arrived was to apply pressure to stop the bleeding and test our consciousness to see if there was any cervical spine injury. At this time, it would be a waste of time to look for some "source of poison".

What's interesting is that there are two factions in the first aid training circle who are constantly arguing about the relationship between the two. One group is the "split group", which advocates that poisoning first aid be completely separated from general accident first aid and be taught separately. The reason is that poisoning is too specific - different poisons have different invasion routes (ingestion, inhalation, contact, injection), and the treatment methods are very different. For example, there is no specific antidote for tetrodotoxin poisoning. Inducing vomiting + maintaining oxygen saturation are the core treatment. For organophosphorus poisoning, atropine and pralidoxime chloride are required. If you follow the ordinary accident process, it will be easy to get into trouble. The other faction is the "merger faction", which believes that there is no need to separate the antidote. Ordinary people simply cannot remember the use of so many antidotes, and it is easy to get confused. It is better to add a "poison source investigation" link to the pre-steps of general first aid: when someone is fainted and injured, first scan the surroundings for pesticide bottles, unpacked unknown drugs, and strange pungent smells. After eliminating the possibility of poisoning, deal with it as an ordinary accident. The error tolerance rate is much higher for ordinary people. When I teach myself, I actually prefer the merger school. When things really happen, ordinary people can't tell the difference so clearly. If you can call 120 first to explain the situation clearly, you have already done 80% of the right things.

Don't just think that the two are different, in fact there are really too many things in common. Take the most basic airway opening as an example. Whether a person is unconscious after drinking pesticides or has a concussion after falling, the first thing to do is to tilt his head to one side and clean up the vomit and foreign matter in his mouth to prevent him from choking. This is the first rule of all first aid. There is also the prevention of secondary injuries. If you encounter chemical burns (actually considered a combination of poisoning + accident), you should not pull the clothes that are stuck to the skin. If you encounter someone who falls and suspects a fracture, you should not shake the person's neck. The essence is to avoid causing additional harm to the patient. There are also common requirements for calling 120: Don't say "Someone is coming, someone is going to die." Please state the address clearly, whether the patient is conscious now, and the approximate cause. If you are poisoned, say "I drank half a bottle of dichlorvos, and it has been 20 minutes." If someone is accidentally called, say "I fell from a two-meter-high ladder, my forehead is bleeding, and I can speak now." This gives the medical staff time to prepare in advance, which is much more useful than crying on the phone.

Oh, by the way, there are many times when you can’t tell the difference between the two. I ran past the police in a chemical park last year. A pipeline exploded. There were three workers. One was pricked in the leg by a flying piece of iron (pure accidental injury), one breathed in chlorine gas and coughed and couldn’t breathe (pure poisoning), and another one suffered both burns and poisonous gas. At this time, you have no idea We can't follow the rigid rule of "treat poisoning or accident first", we have to decide which one will kill first: the one with a leg pricked in the leg is bleeding so much that his pants are soaked, so stop bleeding first, the one with chlorine gas is already cyanotic, give oxygen first, the one with mixed injuries is moved to a safe area first, and the burns and airway are treated at the same time. They are very flexible and there is no standard procedure.

In fact, for ordinary people, there is really no need to be obsessed with the definition of "poisoning" and "accident". Just remember the two principles: first, ensure your own safety first, and don't save others from getting in. For example, if someone is poisoned by gas, open the door to ventilate it before going in. Don't rush in and faint yourself.； Second, save your life first and then worry about other things. No matter what the situation is, if the patient is not breathing, perform cardiopulmonary resuscitation. If there is severe bleeding, stop the bleeding first. Wait for 120 to do the rest. If you are really interested, go to the Red Cross near your home and sign up for free first aid training. You can get started in two hours, which is more useful than reading ten popular science articles.