The difference and connection between poisoning and accidental first aid

The essential difference between the two is whether the cause of injury is functional/organic damage caused by exogenous poisonous substances invading the body. The core connection is the sharing of the underlying first aid logic of "saving life first, dealing with it later, and giving priority to avoiding secondary injuries." In a large number of real-life cases, the two will occur together, and there is no absolute boundary division.

I have been doing pre-hospital emergency care for almost 6 years, and I have encountered too many situations where ordinary people confuse these two things and delay things. Last month, the police were called to a resident of a community who mistakenly took antihypertensive medication for hypoglycemic medication. He became dizzy, fell down and broke his head. As soon as the family members came in, they were busy bandaging the wound to stop the bleeding. They did not even think to ask whether the elderly person had taken the wrong medicine. By the time they arrived at the hospital, his blood pressure had dropped to over 40, and he almost couldn't be saved. Do you think this is an accident or poisoning? The broken head was a traumatic injury caused by an accidental fall, but the root cause was dizziness caused by drug poisoning. If you only deal with one side, there will definitely be problems.

When I usually do community training, I often encounter students who ask, how to distinguish between the two? Let’s talk about the most commonly used judgment logic on the front line: The essence of poisoning is an “invisible endogenous disorder.” After the poison enters the body, most of the damage it causes is invisible to the naked eye—either it competes with hemoglobin for blood oxygen, or it destroys the metabolic function of the liver and kidneys, or it paralyzes the nerves. Therefore, the core of poisoning first aid is always to cut off the source of poison first: conscious patients with oral poisoning should be given priority to induce vomiting; those whose skin is stained with pesticides should immediately take off contaminated clothes and shower; those who inhale toxic gases should be moved to a ventilated place immediately, and the way for the poison to continue to invade should be blocked first, and then follow-up treatment can be discussed. Conventional accidental injuries, such as falls, burns, fish bones stuck in the throat, and electric shocks, are mostly "visible external injuries." The core of treatment is to deal with the obvious injuries that are immediately fatal: arterial bleeding is first treated with pressure and banding, foreign bodies in the airway are immediately Heimlich, and chest compressions are performed immediately when the heartbeat stops. There is no need to worry about the reason for the injury first, save your life first.

Oh, by the way, there has been controversy in the academic community about classification. For example, should gas poisoning, snake bites, and bee stings be classified as poisoning or accidents? One school of thought believes that it should be classified as poisoning based on the core of the disease. After all, it is essentially the body's reaction caused by foreign toxins. The treatment logic should also follow the process of promoting excretion and using the corresponding antidote in first aid for poisoning. ； The other group advocates classifying the incident as an accident based on the scene of the incident, because they are emergencies that are not subjectively predicted, and are essentially different from poisoning cases in which people take poison voluntarily. In fact, we police officers on the front line don't bother with this classification at all. We deal with emergencies first. Classification is originally for novices to learn, and obsessing over concepts can easily delay things.

But if you really treat these two things as completely unrelated, then there is a high probability that you will get into trouble when you get to the scene. I'm not afraid of making people laugh. When I teach new team members, I never differentiate between first aid for poisoning and first aid for accidents in the first three classes. I first memorize three iron rules: first, no matter what the situation is, first feel the pulse to check breathing. If the heart stops, immediately CPR, and put everything else later. In our jargon, "save the person first, then treat the injury."” ； Second, never give water or medicine to an unconscious person casually. Whether you think he is poisoned and want to induce vomiting or you need to replenish water after falling unconscious, it may choke the airway and cause suffocation, which is not helpful. ； Third, move the person to a safe place first before dealing with it. If you get an electric shock, pull the switch first. If the pesticide leaks, move to a windward place first. Don't save the person and then put yourself in it. This is completely common for poisoning and accidents.

There was an incident last summer that left a particularly deep impression on the police. A few children went on a picnic in the countryside and picked unknown wild fruits to eat. After eating, two children ran to the river with vomiting and diarrhea. They slipped and fell into a shallow ditch and broke their bones. When we arrived, the parents who were traveling with us were busy fixing the fractured child's arm. They didn't take the vomiting and diarrhea seriously at all, thinking they were scared. We first gave both children the corresponding antidote, and then treated the fractures. Fortunately, they were delivered in time without causing irreversible liver and kidney damage. If you look at this scenario, poisoning and accidents are tied together, and it is impossible to deal with them completely separately.

Hi, to be honest, the longer I work in this business, the more I feel that all first aid classifications are for the convenience of ordinary people to learn and sort out. When you are really at the scene of a huge emergency, how can you have so much time to first clarify whether it is poisoning or an accident? If you can call 120 immediately to clarify the address and patient's status, if you can remember not to cause trouble by blindly operating, and if you can guard the patient first to ensure that his breathing and heartbeat are okay, you have already done your best.