What is the relationship between poisoning and accidental first aid?

The essence of the two is the subordinate relationship between "typical high-risk scenarios" and the "global emergency response system". Poisoning itself ranks among the four most common types of sudden accidents (the other three are trauma, drowning, and physical electric shock). It is one of the core coverage scenarios of accidental first aid. At the same time, the special handling requirements for poisoning are also in turn promoting the ability upgrade of the entire accidental first aid system.

When I was doing emergency science training in the community two years ago, I met an aunt in her 60s who said that her husband mistakenly mistook antihypertensive drugs with similar packaging for her grandson's fruit-flavored calcium tablets and ate half a bottle of it. She panicked and called 120. The operator remotely guided her to induce vomiting for her husband first. The core treatment steps were explained clearly in less than two minutes. Later, she was sent to the hospital for gastric lavage and went smoothly without any sequelae. At that time, I told her that the 120 number she called was an ordinary accident emergency hotline, and the vomiting steps taught by the operator were the standardized poisoning pre-treatment procedures in the accident emergency system. It was the same response logic as instructing victims of car accidents to stop bleeding and use the Heimlich maneuver for airway foreign body obstruction.

However, the industry has always had different opinions on the boundary between the two. Many experts in critical care medicine and toxicology believe that the general procedures for ordinary accidental first aid cannot cope with overly complex poisoning scenarios. To give the most common example, adequate amounts of atropine and pralidoxime must be used for organophosphorus pesticide poisoning, while for toadstool poisoning, as much as possible Penicillin and hemoperfusion were used as early as possible. There is currently no specific cure for tetrodotoxin poisoning, which relies entirely on extracorporeal life support to survive the toxin metabolism period. Many grassroots first aid stations do not have corresponding antidote reserves, and frontline first aid personnel may not be able to accurately judge the type of poisoning. Following the logic of handling ordinary accidents can easily delay things. In the past two years, similar cases occurred in our subordinate districts and counties. A family suffered from vomiting and diarrhea after eating wild mushrooms picked from the mountains. They were sent to the nearest township health center. The doctor on duty had never seen a case of toadstool poisoning and treated two patients as ordinary acute gastroenteritis. For many hours, the patient waited until jaundice appeared before he was transferred to the poison treatment center in the city. In the end, he spent more than 200,000 yuan on plasma exchange to save him. If the patient had been dispatched according to the priority of poisoning emergency treatment at the beginning, he would not have suffered such a serious crime.

But this does not mean that poisoning first aid must be completely separated from the accident first aid system. After all, when ordinary people encounter an emergency, their first reaction will definitely be to call the universal 120, and they will not go out of their way to check the phone number of the local poisoning treatment center. The basic treatment of ordinary accident first aid, such as asking people who have been orally poisoned to stop ingesting poisons, take off their clothes Clothes stained with pesticides and keeping the respiratory tract open can buy up the most valuable dozens of minutes for subsequent professional treatment. To put it bluntly, it is like a fire downstairs in your house. You can't wait for the team that specializes in handling chemical fires to come before calling the police. Ordinary fire brigade will control the fire first and then transfer it to the professional team for handling, which is much more efficient.

Many places in China are now trying to integrate the two. Ordinary 120 first aid stations are required to prepare commonly used antidotes, and all staff must pass the assessment of basic poisoning treatment. At the same time, a direct referral green channel has been established with the local poisoning specialist treatment center. This is equivalent to embedding the needs of the special scenario of poisoning into the entire accidental first aid response network. People do not need to think too much about anything when encountering problems, and just call 120.