The relationship between poisoning and accidental first aid

Poisoning is one of the top three types of accidental emergencies with the highest fatality rate worldwide. Poisoning first aid is the branch with the highest requirements for timeliness and accuracy in the entire accidental first aid system, and the treatment logic is the most different from conventional trauma first aid. The two are "special vertical fields under a common framework".

I went through three months of on-the-job training with Captain Zhang from the Municipal Emergency Center. My deepest feeling is that in other accidental first aids, even if you step into a small hole, there is usually room for improvement. However, with poisoning, if you make one wrong step, the person may be dead. Last year, we picked up an uncle who was poisoned by drinking self-brewed medicinal wine. His lips were numb and speechless after just 15 minutes of drinking. The family members were still sober. They stuffed the remaining half bottle of wine into their bag when they went out. The emergency doctor glanced at the Aconite in the bottle and immediately knew that it was aconitine poisoning. He immediately prescribed anti-arrhythmic drugs and the patient recovered within half an hour. Later, we chatted with colleagues in other districts and said that they also received an identical case on the same day. The family members poured the rest of the wine first to avoid being blamed. It took the doctor 20 minutes to figure out the source of the poisoning. When the patient was delivered, the patient had heart failure and could not be saved.

It's interesting to say that there are actually differences in the logic of handling poisoning first aid in the emergency circle, and no one is completely convinced. The old school of doctors emphasizes "detoxification first". As long as the patient is conscious, they should induce vomiting, gastric lavage, and catharsis first to remove unabsorbed toxins. After all, less absorption means less danger. But now more and more young emergency doctors are more inclined to "prioritize vital signs" - I once met an old man who ate poisonous mushrooms. His family members blindly induced vomiting on the road, and the vomit was sucked into the lungs and he suffocated. When he was delivered, the patient was already dead, and tests showed that the toxins had not had time to take effect. Another time, we picked up a little girl who had swallowed half a bottle of sleeping pills. When she was brought to her, she had almost stopped breathing. We put the trachea on a ventilator first, and then performed gastric lavage half an hour later. She was fine in the end. If we had tried gastric lavage first, she might have stopped breathing. There is no absolute right or wrong between these two ideas. It all depends on the situation on site. There is really no standard answer.

Of course, poisoning first aid is still a branch of accident first aid in the final analysis, and general principles must still be adhered to. For example, if you encounter someone suffering from carbon monoxide poisoning, you must first open doors and windows and drag the person to a ventilated place. You cannot rush in without any protection. Otherwise, you will be trapped in the person without any protection. This is completely consistent with the logic of first aid for accidents such as fires and electric shocks. It is also necessary to first determine the patient's basic signs of consciousness, breathing, and pulse. This is also the first step in all accidental first aid. There is nothing special about it.

When I usually do community first aid science popularization, the most common question I get asked is "If you are poisoned, should you just fill it with milk/soap water first?" ”It's really not the case. If you drink corrosive things like strong acids and alkalis, and you feed people something to induce vomiting, it will burn through the already injured esophagus and stomach, and it may even cause direct perforation. The safest thing to do when encountering poisoning is always to call 120 first, tell clearly what you ate, how much you ate, and how long you ate, and follow the dispatcher's instructions for the rest, which is a hundred times better than just messing around.

To put it bluntly, accidental first aid is the first line of defense for all sudden health problems, and poisoning is the most dangerous step in this line of defense. If you know some general first aid knowledge, you may not be able to deal with emergencies of poisoning, but if you understand the basic logic of poisoning first aid, at least you will not be of any help when something happens - this is the most real connection between the two.