What is the difference between poisoning and accidental first aid

To put it bluntly, the most essential difference is that the priority of treatment between the two is completely different. First aid for poisoning is to control the poison, and first aid for ordinary accidents is to save lives.

Last week, two neighboring police cases I attended were very typical. In the same open-air night market, one table at the east stall had vomiting and diarrhea, and a young man had visual hallucinations. Two tables at the west stall had a conflict. A beer bottle broke and scratched a young man's arm, and his brachial artery ruptured and sprayed all over the floor. When we arrived, we were divided into two groups. The group that dealt with the cut didn't ask any questions. They first used a tourniquet to tie 1/3 of the upper arm, gauze to press the wound, and raised the lower limb to give oxygen. They suppressed the bleeding first, and waited until the blood pressure stabilized. The team that dealt with the poisoning went up and put half of the dishes left on the table, as well as the leftover food and garbage in front of the guests, into sealed bags. Those who were not sick yet took two mouthfuls of activated carbon suspension each. They were already dizzy after vomiting. They first dug out the remaining food residue in their mouths to prevent suffocation, and then diuretic, established intravenous access, and installed sampling tubes for the guests' vomit to be taken back to disease control for virus testing.

In fact, we usually have internal discussions during the review. For example, is mass food poisoning like this considered a public health emergency? Many young first responders who have just joined the profession believe that any unintentional emergencies can be classified as accidents, and they can be dealt with in the order of "heavy first, then light". However, most veteran first responders who have worked for more than ten years disagree. If you really encounter a mass poisoning scene, you must first control all the remaining poison sources. Otherwise, after you have just rescued one, two more people fell next to them, and you will be too busy. This is completely different from the logic of handling accidents such as ordinary fires and stampedes.

To use an inappropriate analogy, it’s like if there is a thief in your home. Normal emergency first aid is to save the family member who was stabbed by the thief first. First aid for poisoning is to lock the door first to prevent the thief from calling his accomplices in, and then treat the injured person’s wounds. If the order is reversed, big problems will arise. When I was just in my third year of working in the hospital, I stepped into a trap and answered a police officer who committed suicide by drinking dichlorvos. When I arrived at the scene, I found that he was already unconscious. He was too preoccupied with measuring blood pressure and blood oxygen and establishing intravenous access. I forgot to take away the half bottle of dichlorvos he threw next to his pillow. As a result, he I woke up for a few seconds, grabbed it and took another sip when I wasn't paying attention. Finally, I had to wash my stomach three times and do two hemoperfusions to save me. After that, I forgot about it. When someone is poisoned, no matter what the situation is, finding the source of the poison and eliminating it are always the first priority.

Of course, this does not mean that the two are completely separated. For example, being bitten by a venomous snake or being stung by a swarm of bees can lead to anaphylactic shock. This kind of accident is both an animal injury and a biotoxin poisoning. When dealing with it, you have to take care of both sides. You must first suppress the proximal end to delay the spread of toxins according to the logic of poisoning, and you must first resist shock and deal with the ulceration and bleeding of the wound according to the logic of accidents. When you get to the scene, flexible adjustments are always more important than dead-end definitions.