What is the difference between poisoning and accidental first aid?

The most essential difference between the two is that the controllability of the source of injury and the underlying logic of first aid priority are completely different.

I have been on the front line of a tertiary emergency department for 7 years. I encounter these two types of police situations three or five times a week. The difference in actual operations is really not the slightest. Last month, two comatose patients were brought to the night shift at the same time. One was accidentally injured by a falling object at the construction site, and the other was methanol poisoning caused by drinking fake wine. Their vital signs were unstable when they were brought over, but our treatment sequence was completely different.

For the patient who was smashed, we first checked whether the airway was unobstructed and whether there was active bleeding. The blood oxygen on the fingertips dropped quickly. We immediately intubated the patient and put him on a ventilator, and then quickly took a CT scan to find the location of the internal bleeding. Most of the sources of ordinary accidental injuries are external forces, high temperatures, and impacts that have already completed their effects. Injuries will not be accumulated. The core of first aid is to first plug the immediately fatal loopholes to avoid secondary injuries, and then deal with the rest slowly.

But the logic of poisoning treatment is completely reversed. The patient who drank fake wine was sent to us before we even had time to perform a CT scan. We first inserted a gastric tube to instill water into the stomach and lavage it, and at the same time injected the antidote folic acid and ethanol, and then arranged for someone to go to the family to collect the remaining wine samples for testing. After all, the source of poisoning damage is substances that continue to be absorbed and release toxic substances in the body. Even if the treatment is delayed by 10 minutes, the additional absorbed toxins may cause irreversible brain damage or organ failure. Therefore, the first priority is always to cut off the continued intake of toxins, accelerate the elimination of ingested toxins, and then deal with the organ damage caused by the toxins.

Oh, by the way, there are actually different voices in the academic circles now. In public health statistics, poisonings are often classified into the category of "accidental injuries." After all, most poisonings are unintentional emergencies. However, our frontline first aid personnel basically do not confuse the two. When we arrive at the scene, we treat the trauma and check the physical signs in the same way as ordinary accidents. It is easy to miss the best window period for vomiting and gastric lavage for poisoning, and subsequent treatment will be much more difficult.

To give an example that everyone encounters every day, if you meet an elderly person who falls while walking at home, the first thing you have to do is not to move around casually, but first confirm whether he is conscious and whether there is obvious bleeding. If there is a fracture or cervical spine injury, moving around will aggravate the injury. This is a typical accidental first aid idea.； But if the old man accidentally eats the wrong pesticide, don’t rush to help him lie down and measure his blood pressure. Induce vomiting immediately and call 120. When calling 120, explain clearly what he ate and how much he ate, so that the emergency personnel can bring the corresponding antidote. This is the core requirement of first aid for poisoning. Don’t panic if you are really unsure. When calling 120, explain clearly the cause and effect. The operator will guide you on the first step of handling the situation. Don’t just guess and get the wrong priority.