Acute poisoning is very harmful and timely treatment is the key

Acute poisoning refers to poisons that enter the human body through the skin, mucous membranes, respiratory tract, digestive tract, etc. in a short period of time, causing damage to the body and organ dysfunction. Acute poisoning has an acute onset, severe symptoms, and rapid changes in the condition. If not treated in time, it is often life-threatening, and diagnosis and emergency treatment must be made as soon as possible. So, what are the common causes of acute poisoning? How to treat acute poisoning in time? A reporter from Wulong Daily interviewed Wu Xiangchao, an emergency doctor at Wulong District People's Hospital.

Acute poisoning is dangerous

Wu Xiangchao introduced that the vast majority of patients with acute poisoning recovered because they first received timely symptomatic and supportive treatment, and then relied on the body's own detoxification and detoxification capabilities. Only a very small number of poisons can be neutralized or effectively removed by antagonists or blood purification therapy.

It is understood that compared with other emergency clinical diseases, acute poisoning is more sudden, group-based, rapid and highly lethal. Severe poisoning is still a difficult problem in clinical treatment, and the mortality rate is high. Deaths from poisoning in my country are mainly caused by pesticides and rodenticides, such as organophosphorus pesticides, paraquat, and strychnine. The difficulty in treatment lies in the high toxicity of the poisons, which quickly lead to multiple organ failure, and the fact that most poisons have no specific antidotes and are difficult to be quickly eliminated from the body.

The concept of time is life. We must grasp the timeliness of treatment. In the time window for the treatment of acute poisoning, appropriate treatment measures should be taken to achieve the best clinical treatment effect for patients within a unit of time. The same treatment measures may have different treatment effects and outcomes when used in different time periods. The timeliness of acute poisoning treatment runs through the entire process from on-site first aid to the emergency room, and also includes various ways to quickly remove poisons and the use of drugs.

Pesticide poisoning is one of the main causes of acute poisoning

According to reports, pesticide poisoning is mostly acute life-related poisoning, mainly caused by accidental ingestion and abuse of pesticides. Organophosphorus poisoning and paraquat poisoning are common around us.

"Organophosphate poisoning is one of the most common emergencies with a high mortality rate in the emergency department. It has become the poisoning incident with the most reported cases of acute poisoning of a single disease, with a mortality rate of up to 10%-20%." Wu Xiangchao said that organophosphate poisoning is mainly due to the fact that organophosphates inhibit acetylcholinesterase and affect acetylcholine in the synapses, thereby producing cholinergic toxicity and muscle weakness.

It is reported that although there are effective antidotes for organophosphorus pesticide poisoning, they are not very effective for treating large doses of drugs and severe poisoning symptoms. If not treated in time or improperly, patients may suffer from multiple organ dysfunction or even die in a short period of time.

"At present, the development of new technologies and methods has become inevitable. Blood purification methods such as hemoperfusion and plasma exchange have been recognized by many experts." Wu Xiangchao introduced that blood purification has a significant effect on severe poisoning. Early and repeated use can quickly remove accumulated organophosphorus pesticides in the body and improve the survival rate of treatment.

"In addition, paraquat is also one of the most common pesticide poisonings. It has become the second most common pesticide poisoning after organophosphorus pesticide poisoning and the first in terms of absolute number of deaths." Wu Xiangchao said that after paraquat poisoning, there is no specific antidote and it often induces multiple organ damage, including liver, kidney, and lung, with a mortality rate as high as 50% to 70%; the prognosis and recovery effect of internal medicine drug treatment are poor.

It is reported that the publication of the "Expert Consensus on the Diagnosis and Treatment of Acute Paraquat Poisoning (2013)" provides a high standard of treatment principles for the treatment of paraquat poisoning. Taking measures to remove the poison from the body as soon as possible and actively is the basis for the successful treatment of acute paraquat poisoning. There is a basic consensus on the role of blood perfusion in removing paraquat. It is recommended that blood perfusion should be performed as soon as possible, and the effect is better if it is carried out within 2 to 4 hours. Clinical practice has proved that the "3-2-1-1" plan has a positive effect on early small-dose paraquat poisoning, and the short-term and long-term prognosis are good.

Beware of poisonous mushroom poisoning and snake bites in summer

"It is now officially summer, and poisoning from eating poisonous mushrooms and snake bites are one of the important causes of acute poisoning among citizens." Wu Xiangchao said. From June to September every year, it is the peak period for the growth of wild mushrooms. Although the relevant departments of our district have repeatedly issued orders to prohibit citizens from privately picking wild mushrooms, there are still many citizens who cannot resist the delicious temptation of wild mushrooms.

"Since there is no obvious difference in the appearance of many poisonous mushrooms and edible mushrooms, or some are even very similar, poisoning accidents caused by mistakenly picking or eating poisonous wild mushrooms occur from time to time." Wu Xiangchao reminded the general public that poisonous mushrooms are highly toxic and accidental ingestion can damage multiple systems such as the digestive tract, liver, and kidneys, leading to acute gastroenteritis, acute liver damage, hemolytic mania, etc., and in severe cases can be life-threatening.

What should you do if you accidentally eat poisonous mushrooms? Wu Xiangchao introduced that in order to save time for treatment and alleviate the poisoning, you should immediately take measures to stimulate vomiting before the doctor treats you to reduce the absorption of toxins; for those with severe vomiting and diarrhea, you should drink more water and replenish electrolytes, usually oral saline solution for diarrhea sold in pharmacies; at the same time, send the patient to the hospital for emergency treatment as quickly as possible to avoid delaying the best treatment time. At the same time, be sure to leave the real wild mushrooms or photos as a basis for identification after poisoning, to help early symptomatic treatment.

In summer, snakes are more and more active. Especially when people go out for fun, they are often bitten by poisonous snakes. So, how can you save yourself if you encounter a snake in the wild?

"Serious snake bites can cause respiratory paralysis, hemolysis, heart and kidney failure, etc." Wu Xiangchao said that if you are bitten by a snake by accident, you must stay calm, avoid emotional tension, and remember not to run. In the absence of any medical emergency, you can use a large amount of clean water to wash the snake bite site, and after simple treatment, rush to the hospital for treatment. At the same time, remember the size and color of the snake, etc. After arriving at the hospital, it will help medical staff to identify which snake bite it is and which serum to use for more effective treatment.

Treatment of acute poisoning

In life, it is inevitable that some accidents will cause some harm to the body. Acute poisoning is a common phenomenon. When acute poisoning occurs, everyone must master the correct treatment methods to reduce the harm to the body. In addition, we should strive for a shorter time for further treatment to minimize the harm caused by accidents to the body. So what are the treatment methods for acute poisoning?

1. On-site rescue

1. Toxic gas: leave the scene quickly. Inhaling oxygen helps dilute the toxic gas and promote its discharge, maintaining vital signs. Protective measures must be taken when rescuing high-concentration gas, avoid mouth-to-mouth artificial respiration, and do a good job of environmental protection, especially for hydrogen sulfide, cyanide, etc.

2. Skin contamination: Remove contaminated clothing quickly and rinse with plenty of running water. Avoid hot water as the rinse solution. Do not emphasize the use of neutralizers to delay the time. Do not neglect the scalp, perineum and skin folds when rinsing. Special poisons require special treatment.

3. Eye contaminants: Irritating, corrosive gases, liquids, and solid chemicals should be rinsed with running water for at least 10 minutes. You can also put your face in clean water, open your eyelids, and move your head. Special poisons require special treatment.

4. Oral vomiting: Use emetics or emetic drugs to prevent vomit from being inhaled into the lungs (sitting forward). Corrosive chemicals are contraindicated. Apomorphine induces vomiting quickly and has good effects. It is contraindicated for people with coma, liver disease, convulsions, pregnant women, and children.

2. Eliminate the cause

1. Gastric lavage: Choose the appropriate gastric lavage method based on the scene and the poison. For those who have taken poison orally, gastric lavage should be performed regardless of whether vomiting is induced. Some poisons, such as organophosphorus and powdered granular poisons, can slow down intestinal peristalsis, and gastric lavage is still required for more than 6 hours. After the gastric tube is placed, the gastric contents should be withdrawn for poison analysis. The gastric lavage time should not be too long and should be completed within half an hour. About 500 ml of gastric lavage fluid should be irrigated each time to avoid gastric dilatation. The gastric lavage fluid should be selected according to the poison, generally water, and the operation process should be standardized. Comatose patients can be treated with gastric lavage after endotracheal intubation.

2. Adsorbents: (1) Activated carbon: small particles, high pore volume, large surface area, strong adsorption of many poisons such as phenobarbital, opioids, tricyclics, poisonous mushrooms, etc. Adults generally take 50g, children take a reduced amount, prepare a suspension and enter the stomach to retain it and then aspirate it.

(2) Fuller's earth and bentonite can be used for paraquat poisoning.

(3) Sodium alginate has a special affinity for strontium.

3. "Precipitation" method: Use drugs to form insoluble substances in the stomach. For example, sodium sulfate can form barium sulfate with barium; Plutus blue is used for thallium compounds to form thallium salts. Calcium can form calcium fluoride with fluoride, and can also form calcium oxalate with glycol and oxalic acid (oxalic acid).

4. Catharsis: Magnesium sulfate, sodium sulfate, sorbitol, and mannitol are commonly used. Alcohols are not absorbed by activated carbon.

5. Enema: It is most suitable for the rectum to absorb poisons.

6. Diuresis: The use of large amounts of glucose and diuretics will result in different detoxification effects depending on the poison.

Source: Wulong District Science and Technology Association

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