What are the issues related to poisoning and accidental first aid

Essentially, poisoning itself is one of the top five types of accidental injuries with high incidence in the world, and the handling standards for first aid for poisoning are not only an indispensable core component of the accident first aid system, but also the module with the largest deviation in public perception and the most controversy in practice.

I was doing emergency science popularization in the community a while ago, and I met an old man who patted his chest and said that he knew poisoning first aid, "No matter what you eat, induce vomiting first, and it will be fine after you vomit it up." This is actually the inherent knowledge of many grassroots first responders, but if you really want to go to the emergency department of a tertiary hospital, many doctors are firmly opposed to it. - If you mistakenly take highly corrosive substances such as toilet cleaners and pipe cleaners, stomach acid mixed with corrosive poisons will repeatedly wash away the esophagus and throat when vomiting is induced, which will cause secondary burns. If you encounter someone who is already unconscious, inducing vomiting can easily cause the vomit to be choked into the trachea, directly causing suffocation. Both statements are supported by clinical data. To put it bluntly, the applicable groups are different. Most first responders at the grassroots level deal with situations where the patient is awake and it is difficult to send him to the hospital in a short time. They prioritize reducing the absorption of poisons. Hospitals have seen too many secondary injuries caused by incorrect induction of vomiting, so they will naturally be more cautious.

Actually, many people don’t know that the underlying logic of first aid for poisoning is completely the same as our common first aid for accidents such as bumps, burns, and electric shocks. The core is to cut off the source of injury first, then preserve vital signs, and finally talk about targeted treatment. Last month we had a pre-hospital police case. At a small restaurant in the suburbs, a family suffered from vomiting and diarrhea after eating home-made stinky dried seeds. The first community worker who arrived did not bother to ask what they had eaten. They first arranged the child who had fainted. Lying on the side, I dug out the vomit in my mouth to avoid choking. When we arrived, the blood oxygen was measured and it was still stable. We were sent to the doctor and had a stomach lavage before being discharged not long after. If the person was suffocating at that time, it would be useless to find the corresponding antidote quickly.

Not all opinions in the industry are unified now. For example, when it comes to home emergency treatment after accidentally ingesting poisons, many first aid guides in Europe and the United States also recommend that families keep medical activated carbon. It is said that drinking it within 1 hour after accidental ingestion can absorb most poisons and reduce absorption. However, most of our country's current emergency treatment guidelines do not recommend this operation for ordinary families, not that activated carbon is used. Charcoal is useless, but it is difficult for ordinary people to judge the applicable scenarios - if you accidentally take strong acids, alkalis, or petroleum products, drinking activated charcoal will be useless, and may also increase the burden on the gastrointestinal tract. If the elderly and children choke into the lungs when drinking, it may also easily cause aspiration pneumonia. Different recommendations are essentially adapted to different public first aid literacy levels, and there is no absolute right or wrong.

Many people always think that first aid for poisoning is a "special skill" and has nothing to do with ordinary first aid for accidents. They even think that if they encounter someone who is poisoned, they can only wait until 120 and dare not move. In fact, it is not that complicated. Just like if you encounter someone who gets an electric shock, you should turn on the switch first. If you are suffering from gas poisoning, first open a window and drag the person to a ventilated place. If pesticides are on your skin, quickly take off the pesticide-stained clothes and rinse them with cold water for more than 15 minutes. There is no threshold for these operations. They are all the core requirements of "stop loss first" in accident first aid. They are much more useful than searching for folk remedies everywhere to find antidotes.