On the difference between poisoning and accidental first aid

The core difference between poisoning and accidental first aid is thatThe first aid logic caused by different sources of injury is completely opposite-the former should give priority to blocking toxins from continuing to enter the human body, and the latter should give priority to avoiding secondary injuries to aggravate the injury.All operational differences extend from this point.

In the summer when I was working in the emergency center of the city, I met a family of three who called 120 and said that their children fell from the sofa and fainted. When we went to the scene, we found a small amount of white foam on the corners of the children's mouths, and the armrest of the sofa did have red marks. Parents insisted that it was a fall. As a result, the nurse was sharp-eyed, and she saw that half a board of nifedipine eaten by the old man had fallen under the coffee table. When she picked it up, three were missing. When she asked, she realized that the parents had turned to take a fruit, and the child grabbed it. You see, if it comes up, it should be treated as an accidental fall, and a CT scan should be arranged for the ice pack, which misses the poisoning. Excessive antihypertensive drugs can directly reduce the child's blood pressure to shock, and it can't be saved. When we go out to the emergency department, we often say that if you ask more questions at the scene, you will panic less on the road. This is the reason.

Later, when I sorted out my post notes, I made a list of the core differences between the two, which have been used all the time when I was on a mission for so many years. It is probably enough for ordinary people to remember one:

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But then again, the clinical situation is always more complicated than the textbook. Now there are actually different voices in the industry about the priority of the two types of first aid. Traditional trauma centers advocate that as long as patients have visible trauma, accidental trauma should be given priority, because the death rate of such trauma as cerebral hemorrhage and spleen rupture is calculated in minutes, so it is not too late to take CT to eliminate fatal trauma first and then do toxicology screening; However, the statistical data of the domestic poisoning prevention and control center in the past three years show that the missed diagnosis rate of recessive poisoning has reached 12%. Many comatose patients who live alone can't find a clear history of trauma or clues to poison. These people can get back more time by giving priority to toxicology quick screening. Both statements are supported by real clinical data, and the specific choice depends entirely on the clues on the spot, and there is no absolute right or wrong.

Say two counterexamples that impressed me particularly, both of which were trampled by ordinary people who confused two first-aid methods. Two years ago, a patient who had drunk organophosphorus pesticides was sent here. When his family came, he said that he was afraid of the spread of toxicity, and he was fed half a bottle of soapy water to induce vomiting. As a result, organophosphorus produced more toxic substances when it met with alkali. Originally, mild and moderate poisoning could be cured by direct irrigation and gastric lavage, but the result became severe and he stayed in ICU for a week before coming out. There was also a young man who fell on his bike. When friends from the same trade came up, they helped him up and patted him on the back to ask if he was all right. As a result, his cervical vertebra was fractured and he was directly paraplegic. A good young man had to be in a wheelchair for the rest of his life.

Of course, there are also many overlapping situations. For example, people who are poisoned by gas have been burned by radiators after fainting, which is both poisoning and accidental burns. At this time, they have to drag people to a ventilated place first, and then deal with the burns. There is no fixed rule.

Last but not least, we ordinary people don't need to remember so many complicated identification points. We should call 120 as soon as we encounter something, and report all the details you can clearly-for example, "He just fell down after taking the medicine on the table and hit his head on the corner of the table", which is much more useful than guessing "I think he was poisoned/I think he fell" by yourself. The doctor will prepare the corresponding information in advance according to the information you said.