What are the differences between poisoning and accidental first aid

The core difference between the two is actually the different priority of traceability, treatment targeting and secondary injury prevention and control logic. To put it bluntly, first aid for poisoning requires figuring out "what harmed the person", while ordinary emergency first aid can first stabilize the vital signs and then check "how the injury occurred".

Think about it, if two unconscious patients came to the emergency department at the same time, one was knocked down while riding a bicycle and fell on his head, and the other was found passed out by his family in the bedroom at home, with a half-open bottle of paraquat on the bedside table, the treatment ideas would be completely different. The person who fell on his head first felt the carotid artery and checked his breathing. If there was bleeding, apply pressure to stop the bleeding. If his pupils were dilated, he would immediately apply mannitol to lower the intracranial pressure. As for whether he was hit by running a red light or whether he fell while avoiding a pedestrian, that is something that the traffic police and family members will have to figure out later. They will not delay the first step of saving lives. But this is not the case for people who are suspected of being poisoned by paraquat. You must first confirm whether you really drank the medicine, how much you drank, and for how long. You even have to ask whether you mixed the drink with the drink and whether you spit out part of it. After all, there is no specific antidote for paraquat. The sooner you have a gastric lavage and a hemoperfusion, the prognosis will not be worse. If you follow the same process no matter what kind of poison comes up, you may directly delay the best intervention window.

Many people will think that isn’t it all about first aid? Save your life first before talking about anything else? Really not, the logic of secondary damage prevention and control between the two is also very different. Most common accidental secondary injuries are caused by improper handling. For example, when a patient with a cervical vertebra fracture was moved without wearing a cervical collar, the spinal cord was injured. This can be avoided by following standard operations. But the secondary injury caused by poisoning may be caused by the rescuers. We encountered this when we went to the police last year. The villagers reported that someone had fallen unconscious in the cellar. When we arrived at the scene, we smelled something wrong. We first tested it with a gas detector and found that it was the poisonous gas emitted by the aluminum phosphide fumigation bugs placed in the cellar. If we rushed down without wearing gas masks, the two police officers might have to lie down inside. First aid in such a toxic environment requires first removing danger and then rescuing people. If it were an ordinary cellar where someone had slipped and fallen, as long as he was sure that the cellar would not collapse, he could go down and lift people directly.

Now the industry has different opinions on this. Some scholars who are doing theoretical research on emergency medicine believe that the first step in all first aid should be the assessment of vital signs. There is no need to put the traceability of poisoning in too high a position. However, most of us who go to the hospital do not agree. After all, I have encountered a mass food poisoning police officer. When the first patient got into the car, he didn't ask what cold vegetables he had eaten for lunch. Then three patients with the same symptoms from the same village were sent to him one after another. They didn't even have the reference basis for inducing vomiting or taking medication, which in turn delayed the patient's time by about ten minutes.

To use an inappropriate analogy, ordinary emergency first aid is like the car you are driving having a flat tire and hitting the guardrail. You first flash the car, move the car to the emergency lane, and then check whether it is a tire quality problem or a nail. First aid for poisoning is like driving a car and suddenly losing power and turning the center console black. You have to first determine whether someone has secretly installed a jammer. Otherwise, you might just take it to a repair shop to fix it, but you'll still find a problem when you turn around.

When we go out to the police now, in addition to the regular hemostatic kit and blood pressure monitor, the first aid kit will also include a rapid poison test card. If you encounter unexplained convulsions, coma, or foaming at the mouth, you will be tested twice first. This is all gained from the experience of stepping into the trap before. After all, in this business, a difference of three to five minutes may be the difference between saving a life.