The difference and connection between poisoning and accidental first aid

The most essential difference between the two is whether the cause of the disease is exogenous poisons actively invading the body. The core connection is that both follow the core first aid principle of "saving life first, treating injuries later, treating first and then tracing the source." The priority logic of pre-hospital treatment is highly overlapping, and most basic first aid skills can be used universally.

Two years ago, when I was working as a volunteer first aid lecturer in the community, I encountered such a thing: At the vegetable market at noon in the summer, an old man suddenly fell down while holding the stall. People nearby immediately gathered around him. Some people shouted, "Do you have heatstroke? Get it to a cool place." Someone grabbed half a bag of wild mushrooms he had just bought and shouted, "Don't touch it!" Maybe it's mushroom poisoning and we have to wait for the ambulance to come." The two groups of people argued so loudly that it was delayed for two or three minutes. Later it was found out that the uncle himself had coronary heart disease, and the heat stroke caused his myocardial infarction. It had nothing to do with the poisoning of half a dime. You see, ordinary people can't figure out the difference and connection between the two, and it's easy for them to do bad things at critical moments.

In fact, if you really want to define it, the boundary between the two is far less clear than many people think. Take the accidental consumption of poisonous mushrooms as an example. Some people think that they accidentally ate it. Is it considered an accident? This is actually true. There are currently two different views in the academic community: one is the public health system scholars, who believe that any injury that is not subjective and intentional and cannot be predicted in advance belongs to the category of accidents, and poisoning is just a subdivision of accidents. ； The other type, researchers in the field of clinical toxicology, insists that as long as the cause of disease is the intrusion of poisons (including toxic foods, drugs, chemicals, toxic biotoxins, etc.) into the human body, whether it is intentional or not, it must be included in the poisoning first aid system. The treatment logic of the two is essentially different.

At the practical level, the difference is indeed quite obvious. Let’s talk about the judgment process. Most of the causes of ordinary accidents are obvious: those who fell have wounds, those who have fish bones can clearly say that they have eaten fish, and those who have heat stroke have been in the sun for a long time. Corresponding traces can basically be found at the scene. But poisoning is different. Many times it is a "hidden thunderbolt": after eating poisonous mushrooms, the onset may take two or three hours, and you can't even find any leftovers at the scene. ； There is no peculiar smell in a room poisoned by carbon monoxide, and people feel dizzy when they say they feel dizzy. ； If you encounter a child who mistakenly takes medicine at home and cannot tell what he took, you may not be able to find the empty medicine bottle even after searching for a long time. The difference is even greater when dealing with it: for ordinary trauma, bleeding and immobilization must be stopped as soon as possible to prevent secondary damage. ； However, for conscious patients suffering from oral poisoning, the first priority is to induce vomiting and remove the unabsorbed poison. If you encounter a comatose patient, you cannot induce vomiting casually for fear of choking. There is another detail that is easily overlooked: in poisoning first aid, suspicious samples must be kept as much as possible - vomit, leftover meals, empty medicine bottles, and even clothes stained with poison. These things can help the hospital doctors determine the detoxification plan within a few minutes. Last year, I met a child who accidentally took dichlorvos. The parents were so panicked that they ran to the hospital with the child in their arms, taking nothing with them. It took the doctor more than ten minutes to determine the type of poison. If he had brought half a bottle of pesticide on the table, it would have saved a lot of golden rescue time.

But having said that, when you actually arrive at the emergency scene, you don't have time to take out a classification table to judge whether it is poisoning or an accident before taking action. The underlying logic of the two is actually the same. Regardless of whether you were hit by a car or drank fake alcohol, the first thing you should do is tap your shoulder and ask someone to determine your consciousness, feel your carotid artery to see if there is a heartbeat, and if your breathing and heartbeat have stopped, do nothing but perform cardiopulmonary resuscitation first. This step can be done anywhere. The logic of escaping from dangerous environments is also exactly the same: for carbon monoxide poisoning, the person must be moved outdoors to a ventilated area. In the case of a fire and choking accident, the person must be dragged to a safe area first. In the case of poisoning by strong acid, the corrosive substances on the skin must be washed away as soon as possible. In the accident of being scalded by boiling water, the person must be cooled down by cold water first. In essence, the cause of injury must be cut off first to avoid aggravation of the injury.

Oh, by the way, current first aid training for ordinary people basically does not separate poisoning and accidents into two completely independent modules. This is because for non-professionals, it is meaningless to tangle with classification, and the most important thing is to memorize the general treatment logic. There is also an interesting difference here: academic textbooks clearly break down poisoning, mechanical injuries, and injuries caused by physical and chemical factors, and clearly list the steps to deal with each scenario, but most of the frontline 120 emergency doctors feel that there is no need to be so stuck. I went to the police with Dr. Zhang from 120 before, and we met a patient who was riding an electric scooter and fell into a ditch while hiding from the car. He happened to be contaminated by pesticides leaked in the ditch. Do you think this is a traffic accident or pesticide poisoning? No one bothered about this. First, they pulled the person out of the ditch, stopped the bleeding on his head, then took off his pesticide-stained coat and rinsed his skin with water. At the same time, he contacted the hospital to prepare a dual plan for trauma and detoxification. This was better than anything else.

After all, for us ordinary people, there is really no need to dwell on the academic definitions of the two. It is enough to remember three key points: first, check whether the person's life is in danger, and first save the heart if the breathing and heartbeat have stopped.； Second, move the person away from the dangerous place quickly to avoid getting hurt again. ； Third, if you really suspect poisoning, leave more suspicious things to the doctor and explain the situation clearly when calling 120. Don't panic if something happens to you, any classification will work.