The difference between poisoning and accidental first aid

The core priority of poisoning first aid is "blocking the continued absorption of poison + accelerating metabolic excretion", while the core priority of accident first aid is "stopping bleeding and braking + avoiding secondary damage". The processing logic of the two is completely different from the first action. In essence, they compete with the "velocity of poison metabolism" and "speed of injury deterioration" respectively.

Last Saturday, I and Class 120 took on two police officers with completely different scenes in half a day, which was enough to explain this point clearly. The first one was poisonous mushroom poisoning in a suburban house. After eating fried mushrooms picked from the mountains, a family suffered from vomiting and diarrhea. The family members were helping the people to pile into the private car and wanted to take themselves to the hospital. As soon as we arrived, we induced vomiting and injected activated carbon suspension into the conscious people. We contacted the emergency department on the way, sent photos of the mushrooms, and prepared special antidotes for mushroom poisoning and hemodialysis equipment in advance. Later, the family was fine. Another police officer who was transferred immediately was hit by an electric car while running a red light. The rider fell three to four meters, suffered an open fracture in his left leg, and a cut on his head and was bleeding profusely. The first thing we did when we arrived was to immobilize the cervical vertebrae with a cervical collar to compress and stop the bleeding, and clamped his legs with splints. We didn’t dare to move him casually during the whole process. Halfway through, he complained that he was thirsty and his lips were peeling. We didn’t dare to give him a drop of water. In case of intracranial injury, giving water can easily cause vomiting and suffocation, which is a bad thing.

Speaking of this, some people may ask, does poisoning require vomiting? This is actually a controversial point in the first aid community that has been quarreling for several years. Guidelines in the early years recommended inducing vomiting as soon as possible for those who were orally poisoned and were conscious. Later, more and more clinical cases found that if corrosive poisons such as strong acids and alkalis are accidentally ingested, inducing vomiting will cause the acids and alkalis to repeatedly burn the esophagus and throat, and even cause perforation in severe cases. The current mainstream view is that this kind of situation Do not actively induce vomiting. Just take a small amount of egg white or milk to protect the gastric mucosa. However, many colleagues in primary care believe that if the ingestion occurs within 10 minutes and the patient is fully conscious, a slight stimulation to induce vomiting can also reduce poisonous residues. The specific choice must be judged based on the on-site situation. There is no absolute standard answer.

I have come across too many examples of ordinary people confusing the logic of these two treatments. The one that impressed me the most was a police officer last summer. An old man living alone accidentally took paraquat in a mineral water bottle at home. After taking two sips, he felt something was wrong. He called his son. The son rushed home thinking it was heat stroke. He pinched people and poured Huoxiang Zhengqi water. By the time we arrived, it had already been delayed for almost 40 minutes. Later, the old man's pulmonary fibrosis progressed very quickly. He was only 61 years old when he left. It was really a pity. There are also many people who see someone fall down and faint. No matter what the situation is, they go up to help and give water first. If it happens to be an accident involving cerebral hemorrhage or spinal injury, such help and movement may directly lead to paralysis, and the person who could have been saved cannot be saved.

Of course, not all situations are so clear-cut. I once encountered a worker working on a construction site. First he stepped on the air and fell down, kowtowing, and at the same time breathed in a lot of leaked toxic gases. In this kind of compound situation, you can't follow the rules rigidly. You have to see which one is more fatal first - at that time He was suffocated and unconscious. We immediately opened the airway and performed cardiopulmonary resuscitation. At the same time, we connected him to high-flow oxygen to detoxify him. We waited until his vital signs were stable before fixing the spinal wound. Whichever priority was the highest priority? How could there be so many step-by-step steps at the scene?

In fact, for ordinary people who have not received professional training, there is no need to memorize so many complicated operating standards. If you really encounter something, take 10 seconds to judge: Is there a clear history of exposure to poisons? For example, are there any empty medicine bottles or detergent bottles around you? Have you just eaten food from unknown sources? Is there any smell of pesticides or gas leakage around you? If there is any, move the person to a ventilated place first. Don't feed the unconscious person anything. If the conscious person can vomit, vomit as much as possible. When calling 120, be sure to clearly explain what poison he may have been exposed to. If it is clear that the accident was caused by a fall, bump, or burn, don't move the person casually. First, find a clean cloth to press the bleeding area. Move the neck and spine as long as possible. Just wait for 120 to arrive.

I am doing pre-hospital first aid this year. To be honest, life and death often depend on the first three to five minutes. I cannot understand the difference between poisoning and accidents, and doing it blindly will not help. If you really can’t remember so many knowledge points, just remember these six words: clean up the poison first, stabilize the injury first, and leave the rest to us, which is better than anything else.