The relationship between poisoning and accidental first aid

Poisoning itself is one of the top three types of accidents with the highest fatality rate in my country. Poisoning first aid is an indispensable core branch of the accident first aid system, and because of its strong concealment, rapid disease onset, and many treatment contraindications, it has become an important scenario that promotes the continuous iteration of the entire accident first aid standard. To put it simply, the two are subordinate to the "subdivided rigid demand scenarios" and the "universal emergency framework", but the particularity of poisoning gives it separate operating specifications and training priorities in the entire accident first aid system.

Last summer, I went out with the 120 emergency team and encountered a worrying case: a 5-year-old child who lived in an old community ate half a bottle of nifedipine controlled-release tablets that his grandfather had placed on the coffee table as orange candies. Grandma was the first to notice that the child could not stand firmly and fell to the ground, thinking that it was ordinary He accidentally fell down and rubbed his temples and pinched his middle. It took him almost 20 minutes to see the medicine tablet spilled on the floor. He called 120 in a panic. When he was sent to the hospital, the child had symptoms of hypotension and shock. He stayed in the ICU for three days before he was out of danger.

Many people have misunderstandings about poisoning. They always think that poisoning is an extreme event that is far away from them, such as "being poisoned" or "drinking pesticide". In fact, this is not the case. Vomiting and diarrhea after eating leftovers that have been left out for three days are bacterial food poisoning; dizziness and vomiting when burning charcoal with the windows closed in winter are carbon monoxide gas poisoning; spraying pesticides without wearing a mask to make people feel stuffy and panicking is respiratory poisoning; even applying an unqualified facial mask sold by WeChat merchants so that your face is swollen like a pig's head all fall into the category of contact poisoning - these are all unintentional accidents, and the handling principles must first comply with the general logic of emergency first aid: "preserve life first, then reduce damage, and get to the hospital quickly."

The industry has been arguing for many years now about whether first aid for poisoning should be included in universal general education training. Most of those who hold the former view are researchers in the field of public health. They feel that there are too many common sources of risk in families now. It is too common for antipyretics, disinfectants, insecticides, and antihypertensive drugs to be readily available. Everyone must be taught how to induce vomiting and identify poisoning symptoms in order to seize the 15 minutes of golden treatment time after poisoning. However, most front-line clinical emergency doctors do not agree with this statement. Director Zhang of our site always mentions it every time he attends seminars: ordinary people have no ability to judge the type of poison. For example, if you accidentally take a highly corrosive substance such as toilet cleaning spirit, if you induce vomiting, the strong acid and alkali will repeatedly burn the esophagus and throat. The gastric mucosa is damaged, and the throat may need to be cut after vomiting is induced. We encounter at least ten cases of this kind every year. It is better to teach everyone to remember two cores: first, when calling 120, state clearly what you may have eaten/contacted, and second, take the remaining poison and vomit to the hospital. It is more effective than any half-hearted operation.

Last month, I went to the community to give a first aid lecture, and I met an aunt who complained on the spot, saying that her grandson sprayed mosquito repellent into his mouth a while ago, and she followed the tutorial on the short video and picked his throat to induce vomiting. As a result, the child vomited and his throat was congested and edematous. When he went to the hospital, he was scolded by the doctor, who said that the pyrethroid component in the mosquito repellent was weakly corrosive and there was no need to induce vomiting. He could just drink more cold milk to dilute it. The child suffered in vain. You see, this is a typical problem where ordinary people only know one thing but not the other, and apply first aid methods for special scenarios to all poisoning scenarios.

Don’t think that poisoning first aid is a hindrance to accidental first aid. In fact, many new accidental first aid regulations are forced by poisoning scenarios. When self-heating hot pot first became popular two years ago, there were more than a dozen cases of chemical food poisoning caused by leaking heating packs and contaminated ingredients across the country. The previous accident first aid manual did not mention the treatment of this new type of poisoning. In less than half a year, first aid training in public places across the country was There has been a requirement to "keep self-heating food poisoning kits for inspection". Now, in addition to AEDs and hemostatic kits, first aid stations in many shopping malls are also equipped with poisoning emergency kits, which contain activated charcoal powder, saline rinses and other items, which were not available before.

I have been working at the first aid station for almost five years, and I have encountered at least two hundred poisoning cases. To be honest, in many cases, people don’t need to think about poisoning first aid as complicated. It is essentially a part of accidental first aid. The core is not to panic and not to act blindly. If you can be sure that you have eaten ordinary spoiled food, non-corrosive conventional drugs, induce vomiting, and drink more water to promote excretion, there will be no problem. ； If you are not sure what it is, just keep the evidence and send it to the hospital. It will be much more effective than searching for a ten-minute tutorial on the Internet. After all, the reason why accidents are called accidents is that they never follow the script, right?