The difference between poisoning and accidental first aid

The core of poisoning first aid is to "stop the loss first and then trace the source." The first priority is to cut off the contact path between the poison and the human body and reduce the absorption of the poison as much as possible. Even if it is not clear what the poison is, emergency measures such as inducing vomiting and getting rid of the poison source must be done first.； The core of ordinary accidental first aid is to "save lives first, deal with them later." Priority is given to dealing with immediate fatal risks such as respiratory arrest, massive bleeding, and airway obstruction. No matter how scary the trauma is, vital signs must be stabilized first before subsequent problems are dealt with. The operational logic of the two is completely different from the first step of preparation after receiving the alarm.

I have been working in pre-hospital emergency care for almost 6 years, and I have seen too many examples of things being delayed due to confusion between these two logics. Last month, the police attended two emergency calls in the same community, and I was particularly impressed: In one case, an elderly man living alone mistakenly took half a bottle of his grandson's anti-allergic medicine as an antihypertensive medicine. When the family members found out, they were speechless. When we got in the car, our first reaction was not to ask for the specific name of the medicine. We first took out the emetic and gave it to the old man. At the same time, we inserted a gastric tube to prepare for gastric lavage. After we settled in the car, we slowly asked the family members to find the medicine box. Oh, yes, by the way, there are still disagreements in the industry about whether to routinely induce vomiting after poisoning: The American Heart Association’s guidelines updated in the past few years clearly stated that routine pre-hospital induction of vomiting is not recommended for the ingestion of non-corrosive and non-toxic poisons, for fear of causing vomitus asphyxiation, but in China we do pre-hospital Most people will still seize the 1-hour golden window, especially in remote areas where the drive to the hospital is long. It would be better if you can wait a little longer - of course, if you drink corrosive poisons such as strong acids and alkalis, you must not induce vomiting, otherwise you will repeatedly burn the esophagus. This is a red line, and the guidelines are consistent regardless of which school. The first aid lecturer who came to the United States for an exchange last time debated for half an hour about common poisoning and vomiting. In the final analysis, it still has to be judged based on the actual scenario, and there is no absolute standard answer.

On the same day, another group of colleagues responded to the police report. A 7-year-old child climbed up the balcony and fell into the air on the lawn downstairs. His family members cried and said that his legs were deformed. When my colleagues arrived at the scene, their first reaction was not to touch his legs at all. They knelt down to feel the carotid artery, opened his mouth to see if there was any vomit blocking the airway, and felt that the pupil's light reflex was normal. Then he dared to carefully turn it over to check for bleeding spots. If an uninformed family member saw the child's leg crooked and hurriedly helped him up, if there was a cervical vertebra fracture, it might directly cause lifelong paraplegia. To use an inappropriate analogy, the logic of these two first aids is like repairing a computer: if you are poisoned, the first reaction is to unplug the network cable and disconnect it. Don't let the virus continue to transmit data, and then slowly check what virus it is. ； If the computer is dropped and cannot be turned on, you must first plug it in and see if it can turn on, and make sure the motherboard is OK before worrying about whether the casing is broken or whether the hard drive is damaged.

Many people will think, "Isn't poisoning also a kind of accident?" This is true, but when it comes to first aid operations, small differences can make a huge difference. For example, if you suffer from vomiting and diarrhea after eating undercooked wild mushrooms in the summer, this is food-borne poisoning. What you need to do is to induce vomiting as soon as you are conscious and drink warm water to dilute it. Don’t take antidiarrheal drugs blindly - that is equivalent to leaving the poison in the body to help absorb it. ； But if you fall down and break your temple while running to the toilet after eating a bad meal, you must first find a clean cloth to hold down the bleeding area. Regardless of whether your stomach still hurts, deal with the potentially fatal trauma first.

Of course, there are special situations where the two overlap. For example, a person with gas poisoning breaks his head when he faints. At this time, should he move to a ventilated place first or treat the head injury first? There is no unified operating standard in the industry. We usually have two people dividing the work when dispatching police: one person is responsible for quickly moving the person to a ventilated area, unbuttoning the collar to maintain smooth breathing, and the other person is responsible for checking vital signs and dealing with trauma and bleeding at the same time. No one can be delayed. The priority depends on the specific situation at the scene.

In the end, there is no need to memorize too complicated rules and regulations. Just grasp the general direction when encountering an incident: first think about how to "drive out" and "isolate" the poison when you are poisoned. In an accident, first check whether the person is still breathing and whether there is heavy bleeding. If you are not sure, call 120 as soon as possible. The operator will teach you step by step how to do it, which is much more reliable than trying to figure it out on your own.