What are the differences between poisoning and accidental first aid

From the perspective of first-line emergency operations, the core difference between the two is that the pre-judgment logic, treatment priorities and follow-up diagnosis and treatment links are completely different, and they must not be confused, otherwise it will easily cause secondary injuries or even endanger lives.

I just saw two police officers in the same neighborhood last week, less than 40 minutes apart. One was a guy from a rental house who fainted while taking a shower. The neighbor thought it was gas poisoning. When they arrived, they found out that he slipped and fell and hit the back of his head. In addition, the bathroom was stuffy and lacked oxygen. It is a typical physical accidental injury; the other was an old lady living alone who ate three-day-old moldy vegetables and suffered vomiting and diarrhea in the living room. Her family members thought it was an accident at first, but when they got closer, they smelled a strange sour smell in her mouth, which was food poisoning.

When the guy arrived, our first reaction was to turn off the water and power first, check if his cervical vertebrae were misaligned, and press the crack on his head with hemostatic cotton to avoid secondary damage during moving. We then lifted him to a ventilated area and measured his vital signs, then transferred him directly to the neurosurgery department for a CT scan. But for the old lady, our first step was to bag up the remaining half plate of pork belly, the antihypertensive drugs, and the sleeping pills on her table and send them for inspection. We were afraid that she might be poisoned by mixing the pills, so we immediately inserted a gastric tube for gastric lavage and gave her metabolism-enhancing drugs. We also contacted the poisoning team of the emergency room in advance to reserve a bed. We also had to monitor the liver and kidney function in the follow-up, for fear that mycotoxins would damage the organs. It was a completely different approach.

Of course, there are different views in the academic community. Some researchers believe that poisoning itself falls into the broad category of accidental injuries. After all, most of them are non-subjective emergencies, such as carbon monoxide poisoning and pesticide exposure poisoning. It seems that they are all caused by accidental exposure. However, in actual practice, we never deal with it according to the logic of ordinary accidents.

I once received a 5-year-old child who accidentally drank toilet cleaning liquid. At first, the parents thought that the child was choking on the water, so they patted his back and poured warm water to induce vomiting because of the choking accident. It turned out that the toilet cleaning liquid was a strong acid and repeatedly burned the esophagus when inducing vomiting. When I was admitted to the hospital, my esophagus had been burned for the second time, and I had to undergo several dilation surgeries before it could heal. If the parents had been able to identify poisoning at the first time, and have given their children warm milk or egg white to neutralize the strong acid, the condition would never have been so serious.

Let’s talk about carbon monoxide poisoning, which is the most common thing everyone confuses. It seems to be an accident involving a water heater in a confined space, but it is essentially poisoning. The core of the treatment is to use high-pressure oxygen as soon as possible to promote the dissociation of carboxyhemoglobin. If you only use ordinary oxygen inhalation as a normal suffocation accident, it is easy to leave the sequelae of delayed encephalopathy. If you have been in this business for a long time, you will know that the slightest difference often makes a huge difference. When ordinary people encounter emergencies, don't deal with them blindly according to common sense. Scan around for suspicious poisons, spoiled food, and empty medicine bottles. If you are really unsure, call 120 and explain the details of the scene clearly. This is better than anything else.