What are the issues related to poisoning and accidental first aid

The two are essentially subordinate, two-way constraints and have a dynamic adaptation relationship - poisoning itself is one of the top three accidental first aid scenarios in the world, and it belongs to the core treatment category of accidental first aid. The extremely special nature of poisoning first aid, in turn, continues to force the continuous adjustment of the accidental first aid process, resource allocation and even the direction of public science popularization.

I encountered a particularly impressive case when I was rotating at the city emergency center two years ago. A family of three in the suburbs ate wild mushrooms they picked after the rain. They had no reaction after eating at noon. The adults started to have vomiting and diarrhea at night. The doctor at the community health service center treated them as ordinary acute gastroenteritis and sent them home after transfusion. As a result, the child suddenly fell into a coma at two o'clock in the morning and was sent over. It was found to be acute liver and kidney failure caused by Amanita poisoning. It took three days to save him. When we reviewed the case at that time, we said that this was essentially because the grassroots first responders did not understand the differences between poisoning accidents and other ordinary accidents. If they had thought of leaving samples to test for toxins during the first consultation and giving liver-protecting drugs in advance, it would not have been so serious.

There are actually different opinions on the relationship between the two in the industry. Many experts in the field of toxicology believe that the professional requirements for poisoning first aid are too high, and the logic of different types of poisoning treatment is completely inconsistent - for example, for chemical splash poisoning, you must shower immediately, and for biotoxin poisoning, you must first seek an anti-toxic agent. Serum and drug overdose poisoning must first induce vomiting/perfusion. It is impossible for ordinary accident first aid personnel to remember so many subdivided rules. It is better to separate the poisoning first aid from the ordinary accident first aid system, set up a dedicated poisoning first aid dispatch line, and assign a designated poisoning treatment center in each city, which will be more efficient. However, most front-line first-aid practitioners do not agree with this statement. After all, most third- and fourth-tier cities and counties simply cannot recruit specialized toxicology teams. Splitting them will only make patients go through an extra referral process and delay the golden treatment time. It is much more practical to add common poisoning treatment specifications to the routine training of general first aid, equip each first-aid station with commonly used antidotes, and install a national toxicology database that can be checked in real time.

When it comes to ordinary people, the boundary between the two is even more blurred. Many people's first reaction when encountering poisoning is to pick their throats to induce vomiting and pour soapy water. This set of "accidental first aid methods" that has been passed down for many years has actually deceived many people. A while ago, we went to the community to do science popularization. An aunt said that last year, her grandson mistakenly swallowed half a bottle of antihypertensive medicine for the elderly. She immediately poured two large bowls of soapy water to induce vomiting, and then she remembered to call 120. Fortunately, the child was fine when he was sent to the hospital in time. I heard that cold sweat broke out on my back. If the child had mistakenly taken strong acids and alkalis such as toilet cleaner at that time, inducing vomiting would repeatedly burn the esophagus and throat. I can’t even imagine the consequences. This is actually because the public generally does not realize that although poisoning is an accident, the logic of first aid is completely different from common accidents such as falls, heart attacks and cerebral infarctions. Many common first aid methods will be detrimental to the poisoning scene.

In fact, the domestic accident first aid system has been adjusting and adapting in the past two years. Take the inquiry process of 120 dispatch as an example. Now, whenever there is a suspected poisoning situation during wiring, they will immediately ask about the type of poison, the time of exposure, and whether there are symptoms such as vomiting and coma. This is because I have accumulated too many lessons in the delay of treatment due to incomplete information in the past few years, so I deliberately added it to the must-ask list. To put it bluntly, whether it is integration or splitting, the ultimate goal is to save people in those few dozen minutes of prime time.