The relationship between poisoning and accidental first aid is

Poisoning itself is one of the most common accidental first aid scenarios, and the response efficiency and handling standardization of poisoning first aid directly determine the overall success rate of the accidental first aid system. The two are a typical nested relationship of "subdivided scenario requirements - public system support" and are by no means two independent propositions.

Two summers ago, I was on duty at a community emergency department. In the middle of the night, I picked up a family of three who came from 120. The adults could not stand upright due to vomiting and diarrhea. The 5-year-old child had fallen into a semi-conscious state and his face was red from holding back. After asking, I found out that the child had eaten braised edamame beans that had been stored in the refrigerator for three days. The family was so panicked that they fed the child two large cups of mung bean soup to "detoxify" on the way, which caused the vomit to choke into the trachea. He had to deal with inhalation asphyxia first, which delayed the treatment of the poisoning itself.

Don't tell me, this kind of case is really too common in emergency rooms. Data from the National Center for Disease Control and Prevention in 2023 show that poisoning accounted for more than 17% of accidental first aid calls throughout the year, second only to traffic accidents and fall injuries. In particular, the fatality rate of mass foodborne poisoning, drug poisoning, and pesticide poisoning accounted for 22% of accidental first aid deaths.

In fact, in the past few years, in the pre-hospital first aid circle, there have been quite a few differences regarding the positioning of poisoning in the entire accident first aid system and the pre-hospital treatment authority of ordinary people.

Most people who do public science work prefer "pre-treatment": after all, the 1 hour after the poison is ingested is the golden detoxification window. If you wait until 120 arrives before processing, many water-soluble and non-corrosive poisons will have been absorbed by the intestines and stomach, and the effects of subsequent gastric lavage and hemofiltration will be compromised. So you see a lot of popular science content nowadays will teach you that after eating spoiled food, common poisonous mushrooms, etc., you can induce vomiting first while you are awake, and drink egg whites and milk to neutralize the poison and minimize absorption.

However, most front-line emergency doctors have reservations about "ordinary people handling it themselves". I have seen too many counterexamples: the aunt who drank the toilet cleaning liquid + 84 mixture, her family members induced vomiting and burned her esophagus twice. ； A young man who was unconscious after taking a large amount of sleeping pills choked on water given to him by his friend and developed severe pneumonia. ； Some patients who drank diquat even had their families force-fed half a bottle of soapy water. When they were sent to the hospital, their entire digestive tract was bleeding. It’s not that pre-treatment is wrong, but it’s hard for ordinary people to judge the type of poison and not assess the patient’s state of consciousness, so it’s easy to do bad things with good intentions.

Putting aside these operational controversies, looking at the bigger picture, poisoning is actually the most important "sentinel detector" in the accident first aid system. Last autumn, seven cases of poisoning from wild mushrooms were reported in our jurisdiction within half a month. The 120 dispatch center immediately synchronized the data to the disease control and community. On the same day, the community posted a "Do not eat wild mushrooms" notice on the downstairs of each community. In the following half month, the number of similar cases dropped to 0. If there were no reporting and early warning of poisoning cases, and we waited until a mass death event occurred before responding, we don’t know how many more lives would have been lost.

Even now, the optimization of the entire accidental first aid process is mostly driven by the need for poisoning treatment. In the past, the 120 police response only had a general inquiry template, but now it has added a special poison inquiry list: what you ate, how long you ate, whether you vomited, whether you were conscious, and whether there are any leftover poison packages around you - ask these questions, and you can bring the corresponding antidote when the ambulance leaves. You can also prepare a gastric lavage machine and a hemofiltration machine in advance for the emergency department. The entire first aid process can save at least 20 minutes. For poisoning patients, these 20 minutes may be the difference between life and death.

I met a very sober young man before when I was on duty. Half an hour after taking the "weight loss capsules" I bought online, he started to feel panicked and his hands were shaking. When we called 120, we took a photo of the ingredients list of the capsules and sent them to us. When we saw that there was banned sibutramine in them, we directly notified the emergency department and prepared the corresponding anti-arrhythmic drugs. He was stabilized in half an hour after being sent to the hospital, and he did not even need to be hospitalized. You see, as long as the front-end information is transmitted quickly enough, poisoning treatment can actually minimize accidental damage.

After all, poisoning and accidental first aid are inherently tied together. Don’t think that poisoning is far away from you. A bad stomachache in the summer, carbon monoxide poisoning from using a coal stove in the winter, an elderly person taking the wrong antihypertensive medicine, and a child swallowing disinfectant. These small things that every household may encounter are essentially poisonings and all fall into the category of accidental first aid. There is no need to worry about whether you should deal with it yourself first or wait for 120. If something happens, call 120 as soon as possible to explain the situation clearly. Follow the dispatcher's guidance on what you can and cannot do. It is 10,000 times more effective than blindly searching for folk remedies on the Internet.