Basic principles of PMP in acute poisoning. First aid for acute poisoning. General measures for oral poisoning

poisoning called such a state of the body that occurs when it is exposed to poisons that can cause severe damage to tissues and organs even in very small concentrations.

Causes Poisonings are most often accidental ingestion of poisons into the body. It is also possible to deliberately take these substances, especially in adolescence and youth for the purpose of suicide (suicide attempt) or with the parasuicidal purpose of poisoning, that is, the desire to arouse sympathy for oneself, to demonstrate one's protest by this action.

At home, there are poisonings with drugs, poor-quality or poisoned products, household chemicals, poisonous plants, mushrooms, and gases. Possible poisoning and emergency chemically hazardous substances (AHOV), such as chlorine, ammonia and others. as a result of man-made accidents.

Children and adolescents can get poisoned by drinking alcohol, drugs, inhaling gasoline vapors and other aromatic substances.

Permeate poisons can enter the body through the respiratory tract, mucous membranes. But most often they enter the body through the gastrointestinal tract.

Mechanism The impact of poisons depends on their type and penetration into the body.

signs Poisoning depends on the type, amount of the toxic substance that has entered the body and the routes of its penetration. So sleeping pills, alcohol, drugs primarily act on the central nervous system. Carbon monoxide interferes with the supply of oxygen to the body. When poisoning with methyl alcohol, visual acuity is impaired, and when poisoning with organophosphorus compounds, constriction of the pupils (miosis) is noted.

When toxic substances enter through the respiratory tract, there are cough, shortness of breath, chest pain. The intake of poison through the gastrointestinal tract is manifested by vomiting, diarrhea.

The more toxic substances that have entered the body, the more severe the poisoning will be.

Manifestations many types of poisoning are made up of a combination of mental, neurological disorders and disorders of other organs and systems of the body (cardiovascular, liver, and others).

With mild poisoning, the general condition of a person may suffer slightly. In cases of severe poisoning, violations of the organs and systems of the body will be sharply expressed up to loss of consciousness and coma.

Principles of emergency care for acute poisoning.

In cases of acute poisoning, it is necessary to urgently call an ambulance to the victim.

Measures to provide emergency care in case of acute poisoning should begin before the arrival of the ambulance, since any delay threatens with an even greater intake of toxic substances into the body. These measures should primarily be aimed at stopping the action of the toxic substance and its speedy removal from the body.

If toxic substances enter through the respiratory tract, it is necessary to remove (take out) the victim from the contaminated atmosphere or put on protective equipment (gas mask, cotton-gauze bandage). In cases of poison getting on the skin, mucous membranes, eyes, it is necessary to immediately rinse them with running water for 15 minutes.

In case of poisoning with toxic substances that have entered the gastrointestinal tract, it is necessary to urgently rinse the stomach before the arrival of an ambulance doctor. To do this, the victim is given to drink glasses of water (for an adult up to 1.5-2.0 liters, for a child - depending on age), after which vomiting is caused by mechanical irritation with the fingers of the root of the tongue. Rinse the stomach should be repeatedly to "clean water".

If it is not known what poisoned the victim, then the first wash water should be placed in a separate bowl and stored until the doctor arrives. Examination of wash waters with residues of a poisonous substance makes it possible to determine the composition of the poisonous substance.

Before and after gastric lavage, the victim is given activated charcoal to drink (1 tablespoon of crushed charcoal is diluted with water until a slurry is formed). After gastric lavage in order to remove the poison from the intestines, a saline laxative (100-150 ml of a 30% magnesium sulfate solution) is given and an enema is made.

The arrived ambulance doctor continues these activities, gives the victim an antidote (if it is known what the poisoning happened), introduces medicinal substances that support the function of the cardiovascular system, diuretics and decides on the urgent hospitalization of the victim.

L I T E R A T U R A

1.Valeology (Textbook for students of pedagogical universities, edited by Prof. V.A.Glotov). Publishing house of OmGPU, Omsk, 1997

2. Mezhov V.P., Dement'eva L.V. First Aid for Injuries and Accidents (Tutorial) .- Omsk, OmGPU, 2000

3. A. I. Novikov, E. A. Loginova, V. A. Okhlopkov. Sexually transmitted diseases. - Omsk book publishing house, 1994

4. Bayer K., Sheiberg L. Healthy lifestyle (English translation) - M .: Publishing House "Mir", 1997

5. Studenikin M.E. Children's health book. - M.: Enlightenment, 1990

6. Chumakov B.N. Valeology (Selected lectures). - Russian Pedagogical Agency, 1997

7. Lisitsin Yu.P. Lifestyle and health of the population. - M .: Publishing house of the society "Knowledge" of the RSFSR, 1982

8. Lisitsin Yu.P. Health book. - M.: Medicine, 1988

9. Sokovnya-Semenova I.I. Fundamentals of a healthy lifestyle and first aid. - M .: Publishing House Center "Academy", 1997

10. Selye G. Stress without distress. - Per. from English. 1974

11. Prokhorov A.Yu. Mental states and their manifestations in the educational process. - Kazan, 1991

12. Meyerson F.Z. Adaptation, stress and prevention. - Enlightenment, 1991

13. Psychohygiene of children and adolescents (Under the editorship of G.N. Serdyukovskaya, G. Gelnitsa.-M .: Education, 1986

14. Kazmin V.D. Forced to smoke. - M .: Knowledge, 1991

15. Levin M.B. Addiction and addict. (Book for teachers.) - M .: Education, 1991

16. Shabunin V.A., Baronenko V.A. Introduction to sexology and sexual education of children during the first six years of life. (Tutorial). Publishing house Ural. state ped. un-ta, Yekaterinburg, 1996

17. Anan'eva L.V., Bartels I.I. Fundamentals of medical knowledge. - M.: Publishing house "Alpha", 1994

18. Internal diseases. (Tutorial under the editorship of Yu.N. Eliseev). - M.: Kron-Press, 1999

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20. Klipov A.N., Lipotetsky B.M. To be or not to be a heart attack. M.: 1981

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22. Zakharov A.I. Neurosis in children and adolescents.- L .: Medicine, 1998

23. Pokrovsky V.I., Bulkina I.G. Infectious diseases with nursing and basics of epidemiology. M.: Medicine, 1986

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29. Modern herbal medicine. (under the editorship of Veselin Petkov) Sofia, Medicine and Physical Education, 1988, p. 503

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ABOUT CHAPTER

In recent decades, emergency conditions in acute poisoning are a fairly common clinical phenomenon. According to the literature, in 60% of cases with acute poisoning, emergency conditions of a different nature develop.

I.S. Zozulya, O.V. Ivashchenko, National Medical Academy of Postgraduate Education named after P.L. Shupyk, Kyiv

These include: toxic coma, acute respiratory, acute cardiovascular, acute liver and kidney failure, exotoxic shock. At the same time, if we consider acute poisoning as a disease of chemical etiology, the most important therapeutic measures are the removal and neutralization of the poison, which is also considered an emergency in clinical terms.
The peculiarity of the provision of emergency medical care for acute poisoning is to conduct complex therapy, including the following therapeutic measures:
prevention of absorption of toxic substances;
carrying out specific (antidotal) and symptomatic therapy;
removal of toxic substances that have entered the bloodstream (artificial detoxification).

Prevention of absorption of toxic substances
The main task in providing emergency care for acute poisoning is the use of methods that help prevent the entry of a toxic substance into the blood. First of all, it is necessary to try to remove the toxic substance in order to exclude its entry into the body.
Skin covers. Corrosive substances damage the outer layer of the skin very quickly and must be removed immediately. In addition, many toxic substances penetrate the skin very quickly. Given these features, the following conditions must be met:
1. Medical personnel should not expose themselves to a toxic substance, it is necessary to use protective equipment (gloves, overalls, glasses).
2. Remove contaminated clothing from the patient and wash off the toxic substance with copious amounts of cool water. Wash the skin thoroughly with soapy water behind the ears and under the nails.
3. Do not carry out chemical neutralization of the toxic substance on the skin, because as a result of a chemical reaction, the heat generated can increase the penetration of the toxic substance into the skin.
Eyes. The cornea is especially sensitive to corrosive substances and hydrocarbons.
1. It is necessary to act quickly to prevent serious damage to the eyes. Flush eyes with plenty of cool tap water or saline. To facilitate washing, drop an anesthetic into the eyes.
2. Lay the victim on his back, using a tube from the intravenous system or any flexible hose, direct the flow of water to the eye area near the bridge of the nose. Use at least a liter of fluid to flush each eye.
3. If the damaging substance is acid or alkali, if possible, determine the pH on the surface of the mucous membrane of the eye after washing. Flush eyes if exposure to toxic substance continues.
4. Do not instill any neutralizing agent as this may further damage the eyes.
5. After washing is completed, carefully examine the conjunctiva and cornea.
6. Patients with severe damage to the conjunctiva or cornea should be taken to an ophthalmologist immediately.
Airways. Substances that damage the respiratory system can be irritating gases or vapours.
1. Medical personnel do not expose themselves to toxic gases or vapors, use respiratory protection.
2. Remove the victim from the zone of exposure to toxic substances and start inhalation of humidified oxygen. Start assisted ventilation if necessary.
3. In case of upper airway edema, which presents with a hoarse voice and stridor, and can quickly lead to airway obstruction, the patient is intubated.
4. The patient should be under the supervision of a physician for at least 24 hours, since during this period non-cardiogenic pulmonary edema may develop as a result of the slow action of toxins, the early signs of which are shortness of breath and cyanosis.
Gastrointestinal tract. There is considerable controversy regarding induction of vomiting, gastric lavage, administration of activated charcoal, and laxatives. The doctor's task is to determine the feasibility of using one or another decontamination method.

Gastric lavage
Stimulation of vomiting
1. Stimulation of vomiting by mechanical means (irritation of the reflex zones of the pharynx).
2. Appointment of emetics, they are used as a solution of table salt or syrup of ipecac.
Indications
Early pre-hospital care for dangerous poisonings, especially at home in the first minutes after taking a toxicant.
Contraindications
1. Violation of consciousness, coma, convulsions.
2. Poisoning by substances that can cause coma, convulsions, hypotension.
3. Poisoning by cauterizing substances (acids, alkalis, strong oxidizing agents).
4. Poisoning by aliphatic hydrocarbons, which can lead to the development of pulmonitis upon aspiration, but do not cause serious systemic damage if it enters the stomach. For those hydrocarbons that have systemic toxicity, it is preferable to prescribe activated charcoal.
Complications
1. Persistent vomiting may interfere with the action of activated charcoal or oral antidotes (acetylcysteine, ethanol).
2. Prolonged vomiting causes hemorrhagic gastritis or Mallory-Weiss syndrome.
3. Vomiting can help pass the toxic substance into the small intestine.
Methodology
1. The patient needs to drink 30 ml of ipecac syrup (namely, syrup, and not its liquid extract, which contains a much higher concentration of emetic) plus 240-480 ml of clear liquid.
2. If vomiting does not occur after 20-30 minutes, you can give the same dose again.
3. If the second dose of ipecac syrup did not cause vomiting, rinse the stomach with a tube method.
4. Magnesium sulfate, mineral water, mustard powder, apomorphine and other emetics should not be used because they are unreliable and sometimes dangerous.
probe method
Gastric lavage with a probe method is a more complicated procedure than inducing vomiting, but more effective. This method is used in the first 30-60 minutes after the use of a toxic substance, but it can be effective at a later date.
1. If the toxic substance is in tablets, then their residues can be in the folds of the stomach for up to 24 hours.
2. Some toxic substances - salicylates or anticholinergic drugs - slow down the evacuation of the contents of the stomach.
Indications
1. Removal of toxic substances.
2. Reducing the concentration and removal of caustic fluids from the stomach, as well as in preparation for endoscopy.
3. In some situations, gastric lavage must also be performed with intravenous ingestion of poison. So, alkaloids of the opium group are secreted by the gastric mucosa and reabsorbed.
Contraindications
1. Violation of consciousness, coma, convulsions. Since these patients have inhibited or absent defense mechanisms, gastric lavage should be performed with prior endotracheal intubation to protect the airways.
2. Ingestion of sharp objects and large parts of plants.
3. Poisoning with cauterizing substances in the later periods, washing in the early stages allows you to remove the caustic substance from the stomach and prepare the patient for endoscopy.
In case of acid poisoning, gastric lavage by the probe method can be carried out in the first 6-8 hours, in case of alkali poisoning - in the first 2 hours.
4. Peptic ulcer of the stomach, varicose veins of the esophagus.
5. Recent operations on the organs of the gastrointestinal tract.
Complications
1. Perforation of the esophagus or stomach.
2. Bleeding as a result of mucosal injury at the time of the probe.
3. Endotracheal intubation.
4. Vomiting leading to aspiration of gastric contents.
Methodology
When performing this technique, the following requirements must be strictly observed:
1. In patients with impaired consciousness, the trachea is preliminarily intubated.
2. Examine the oral cavity, remove dentures (if any).
3. Atropine is administered at a dose of 0.5-1 mg (with heart rate< 120/мин).
4. The patient is placed on the left side, the head is 20 degrees below the body to avoid the promotion of the contents of the stomach into the duodenum during the procedure.
5. Use a large diameter probe (outer diameter - 12-13.3 mm).
6. Before inserting the probe, measure its insertion length (from the earlobe to the incisors and xiphoid process) and make an appropriate mark.
7. After lubricating the probe with gel, it is inserted into the stomach.
8. Check the location of the probe using an aspiration or auscultation test - blowing air into the probe with parallel auscultation of the stomach area.
9. The first portion of the contents of the stomach in the amount of 50-100 ml is taken for a toxicological study.
10. Through a funnel connected to the probe, a liquid for washing (tap water at room temperature or isotonic sodium chloride solution) is poured into the stomach at a dose of 5-7 ml / kg of the patient's body weight.
11. After the introduction of the liquid, the outer end of the probe is placed below the level of the stomach, watching the outflow of the liquid.
12. It is necessary to take into account the balance between the amount of fluid injected and excreted, which should not exceed 1% of the patient's body weight.
13. Total amount of flushing liquid -
10-15% of the patient's body weight, "clean" washing water can serve as an indicator of the adequacy of the technique.
14. Complete the procedure by introducing a suspension of activated carbon - 60-100 g (1 g / kg of body weight).
15. Before removing the outer end of the probe, pinch it to prevent aspiration of the contents of the probe.
The most common mistakes in gastric lavage
1. When the patient is sitting, conditions are created for the flow of fluid into the intestine under the influence of the gravity of the injected fluid.
2. A large volume of a single injected liquid contributes to the opening of the pylorus and the rush of the liquid with the poison contained in the stomach to the intestines, where the most intensive process of its absorption takes place.
3. The lack of control over the amount of fluid injected and excreted leads to the accumulation of a large amount of fluid in the stomach, which contributes to the development of the so-called water poisoning (hypotonic overhydration), especially in children.
4. The use of concentrated solutions of potassium permanganate for gastric lavage is not justified and even dangerous. Pale pink solutions of potassium permanganate in the treatment of acute exogenous poisoning of chemical etiology can only be used for gastric lavage in case of acute poisoning with alkaloids and benzene. Concentrated solutions of potassium permanganate only aggravate the condition, causing the development of a chemical burn of the stomach.
Gastric lavage must be approached differentially, depending on the specific situation. With subjective and objective difficulties associated with the possibility of gastric lavage (lack of a probe, a set for tracheal intubation, pronounced psychomotor agitation of the patient, etc.), and a short period after poisoning (up to 30 minutes), the patient’s rapid hospitalization in a specialized department is justified.

Laxatives
With regard to the use of laxatives to accelerate the removal of toxins from the gastrointestinal tract, experts have different opinions. Many toxicologists use laxatives even when there is little evidence of their effectiveness.
Indications
1. Increasing the passage through the gastrointestinal tract of toxin and activated carbon, reducing the likelihood of desorption of the toxin.
2. Accelerating the passage through the intestines of substances that are not adsorbed by activated carbon.
Contraindications
1. Paralytic or dynamic intestinal obstruction.
2. Diarrhea.
Complications
1. Loss of fluid.
2. Electrolyte disorders (hyponatremia, hypomagnesemia).
Methodology
1. Introduce a laxative (magnesium sulfate at a dose of 20 g in the form of a 10% solution or sorbitol 70%, 1-2 ml / kg) together with activated charcoal (50 g).
2. Repeat this procedure at half the dose after
6-8 hours.

Cleansing enema
A cleansing enema is a common method for removing toxic substances from the colon. The disadvantage of this method is that in the toxicogenic stage this method does not give the desired effect due to the presence of a toxic substance in the upper gastrointestinal tract, so this method is not used at the prehospital stage.
In a hospital setting, it is more expedient to perform siphon enemas.
Indications
1. The use of drugs and various toxic substances.
Contraindications
1. Tumors of the rectum.
2. Bleeding from hemorrhoids.
Complications
1. Injury to the intestinal mucosa.
Methodology
1. A rubber tube (you can use a stomach tube) is inserted into the rectum to a depth of 30 cm.
2. A funnel is attached to the free end of the tube.
3. The funnel is filled with water or saline solution and raised as high as possible, then quickly lowered down, and the water easily exits the funnel.
4. The procedure is repeated until "clean" water is obtained.

Enterosorption
Enterosorption reduces the absorption of toxic substances from the gastrointestinal tract. The most used drug is activated carbon, a highly adsorbent substance. Due to the large surface area (1000 m 2 for 1 g of the drug), it effectively adsorbs most toxic substances. Some toxic substances are poorly adsorbed by activated carbon (cyanides, ethanol, acids, alkalis, ethylene glycol, metals).
Indications
1. Oral poisoning with most toxic substances.
2. The toxic substance is unknown.
3. Repeated doses of activated charcoal help to remove some toxic substances even from the blood.
Contraindications
1. Violations of intestinal motility (weakening or absence).
Complications
1. Constipation.
2. Intestinal obstruction is a potential complication, especially with high doses of activated charcoal.
3. Overdistension of the stomach with a potential risk of aspiration.
4. Possibility of binding oral antidotes.
Methodology
1. Activated charcoal at a dose of 60-100 g (1 g/kg of body weight) is administered per os or into a gastric tube in the form of a suspension.
2. One or two additional doses of activated charcoal may be given at 1-2 hour intervals to ensure adequate intestinal decontamination, especially after large doses of toxic substances. In rare cases, 8 or 10 repeated doses are needed to achieve a 10:1 ratio of activated charcoal, which is sometimes quite dangerous.

Antidote therapy
Antidotes neutralize the toxic effect of the substance and significantly reduce the number of medical prescriptions. Unfortunately, specific antidotes exist for only a small number of toxic substances. They differ in their mechanisms of action. Even if the antidote is available for use, its effectiveness depends on the exposure, concentration and toxic dynamics of the poison, as well as on the patient's condition (plasma pH, concentration of ions in the blood, blood gases, etc.).
In addition, it should be noted that the appointment of an antidote is far from safe. Some of them can have serious side effects, so the risk of prescribing them should be commensurate with the likely benefits of using them. In addition, you need to know that the duration of the antidote is always less than the duration of the poison.
The number of effective specific antidotes that need to be administered at the prehospital stage is relatively small. Cholinesterase reactivators - oximes (alloxime, diethixim, dipyroxime, isonitrozine) and atropine are used for poisoning with organophosphorus compounds; naloxone - for opiate poisoning; physostigmine (aminostigmine, galantamine) - central M-anticholinergic poisons; ethyl alcohol - methanol and ethylene glycol; vitamin B 6 - isoniazid; flumazenil (aneksat) - benzodiazepines.
Specific antidotes of metals (unithiol, tetacin-calcium, desferal, cuprenil), given the toxicokinetics of poisons, are administered over several days.
Features of the toxicogenic stage of various toxic substances, the appointment of antidotes should be based on the criteria for the most effective timing of their use. The proposed approach to prescribing antidotes allows for effective treatment of acute poisoning both at the prehospital and hospital stages. Criteria for the urgency of the use of some antidotes and their dosage are presented in tables 1-3.

Symptomatic therapy
When the patient is in a coma and acute poisoning is suspected, 40 ml of a 40% glucose solution must be administered intravenously. The need for this is due to the occurrence of hypoglycemic coma, correction of hypoglycemia, observed in many poisonings.
Exotoxic shock in acute poisoning has a pronounced hypovolemic character. Absolute (in case of poisoning with cauterizing substances, chlorinated hydrocarbons, pale grebe, etc.) or relative hypovolemia (in case of poisoning with sleeping pills and psychotropic drugs, organophosphorus insecticides) develops. As a result, to correct hypovolemia, the main pathophysiological mechanism for the development of exotoxic shock, solutions of polyhydric alcohols (sorbilact, rheosorbilact) and crystalloid isotonic solutions (glucose, sodium chloride) are used.
The volume of infusion therapy depends on the degree of violations of the central and peripheral hemodynamics. Most acute chemical intoxications are accompanied by the development of metabolic acidosis, which requires correction. In uncompensated metabolic acidosis, sodium bicarbonate is usually used.
A gross mistake of an ambulance doctor is the introduction of diuretic drugs (Lasix, etc.) in order to stimulate diuresis. Any initial therapy aimed at dehydration of the patient's body leads to aggravation of hypovolemia, impaired blood rheology, and progression of exotoxic shock.
The importance of the use of vitamins as essential medicines in the treatment of poisoning has been exaggerated. Vitamin preparations are administered according to indications, if they are antidotes or means of specific therapy (vitamin B 6 is prescribed for isoniazid poisoning, vitamin C - methemoglobin formers).
When conducting symptomatic therapy, it is necessary to avoid polypharmacy, which is associated with a colossal load on the body's natural detoxification systems, primarily the liver.
Comprehensive treatment of acute poisoning is carried out taking into account the severity of chemical injury, the type of toxic agent, the stage of the toxic process due to the interaction of the poison with the body, as well as the adaptive capabilities of the victim's body.

Artificial detox
Methods of artificial detoxification can reduce the amount of toxic substances in the body (specific effect), supplementing the processes of natural cleansing of the body from poisons, as well as replacing, if necessary, the functions of the kidneys and liver.
Artificial detoxification methods enhance the natural detoxification processes. This phenomenon is associated with the presence of the so-called non-specific effects of artificial detoxification, most of the methods of which are based on dilution, dialysis, filtration and sorption.
Artificial detoxification methods include
intra- and extracorporeal detoxification, hemodilution, exchange transfusion, plasmapheresis, lymphorrhea, hemodialysis, peritoneal and intestinal dialysis, hemosorption, hemofiltration, entero-, lympho- and plasmasorption, plasma- and lymphodilysis, quantum hemotherapy (ultraviolet and laser blood irradiation).
Some of these methods are widely used in modern clinical toxicology (hemosorption, hemodialysis, hemofiltration, enterosorption, plasmasorption). Other methods (exchange transfusion, peritoneal dialysis) have now lost their relevance due to relatively low efficiency. The main task of the doctor in the treatment of acute poisoning is to choose the optimal combination of various methods of artificial detoxification and symptomatic therapy, their consistent and complex use, taking into account the specific situation.
Symptomatic therapy for acute poisoning is aimed at maintaining or replacing impaired functions of the respiratory (tracheal intubation, mechanical ventilation) and cardiovascular (infusion therapy, pharmacotherapy of shock and arrhythmias, cardiopulmonary bypass) systems.

Literature
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Poisoning is a systemic damage to the body due to the ingestion of toxic substances. Poison can enter the body through the mouth, respiratory tract or skin. There are the following types of poisoning:

• food poisoning;
• Mushroom poisoning (separated into a separate group, as they differ from ordinary food poisoning);
• Drug poisoning;
• Poisoning with toxic chemicals (acids, alkalis, household chemicals, oil products);
• Alcohol poisoning;
• Carbon monoxide poisoning, smoke, ammonia fumes, etc.

In case of poisoning, all functions of the body suffer, but the activity of the nervous, digestive and respiratory systems suffers most. The consequences of poisoning can be very serious, in severe cases, dysfunction of vital organs can be fatal, and therefore first aid in case of poisoning is extremely important, and sometimes a person’s life depends on how timely and correctly it is provided.

General rules for first aid in case of poisoning

The principles of emergency care are as follows:

1. Stop contact with the toxic substance;
2. Remove poison from the body as soon as possible;
3. Support the vital functions of the body, primarily respiratory and cardiac activity. If necessary, carry out resuscitation measures (closed heart massage, mouth-to-mouth or mouth-to-nose breathing);
4. Call the injured doctor, in urgent cases - an ambulance.

It is important to establish exactly what caused the poisoning, this will help you quickly navigate the situation and effectively provide assistance.

food poisoning

Food poisoning is something that is most often encountered in everyday life, perhaps there is not a single adult who has not experienced this condition on himself. The cause of food poisoning is the ingestion of poor-quality food products, as a rule, we are talking about their bacterial infection.

Symptoms of food poisoning usually develop within an hour or two after eating. These are nausea, vomiting, diarrhea, abdominal pain, headache. In severe cases, vomiting and diarrhea become intense and repeated, general weakness appears.

First aid for food poisoning is as follows:

1. Make gastric lavage. To do this, let the victim drink at least one liter of water or a pale pink solution of potassium permanganate, and then induce vomiting by pressing two fingers on the root of the tongue. This must be done several times, until the vomit consists of one liquid, without impurities;
2. Give the victim an adsorbent. The most common and inexpensive is activated carbon. It should be taken at the rate of 1 tablet for every 10 kg of weight, so a person weighing 60 kg should take 6 tablets at once. In addition to activated carbon, Polyphepan, Lignin, Diosmectite, Sorbex, Enterosgel, Smecta, etc. are suitable;
3. If there is no diarrhea, which is rare, you should artificially induce bowel movements, this can be done with an enema or by taking a saline laxative (magnesia, Karlovy Vary salt, etc. are suitable);
4. Warm the victim - lay him down, wrap him in a blanket, give warm tea, you can put a heating pad on his feet;
5. Replenish fluid loss by giving the patient plenty of fluids - lightly salted water, unsweetened tea.

mushroom poisoning

First aid for mushroom poisoning differs from assistance for ordinary food poisoning in that the victim must be examined by a doctor, even if the symptoms of poisoning at first glance seem insignificant. The reason is that mushroom poison can cause serious damage to the nervous system, which does not appear immediately. However, if you wait for symptoms to escalate, help may not arrive in time.

Drug poisoning

If drug poisoning has occurred, it is necessary to immediately call a doctor, and before his arrival it is advisable to find out what the victim took and in what quantity. Signs of poisoning with medicinal substances manifest themselves differently depending on the action of the drug that caused the poisoning. Most often it is a lethargic or unconscious state, vomiting, lethargy, salivation, chills, pallor of the skin, convulsions, strange behavior.

If the victim is conscious, while waiting for the arrival of a doctor, it is necessary to carry out the same emergency measures as in case of food poisoning. An unconscious patient should be laid on his side so that when he vomits he does not choke on vomit, control his pulse and breathing, and if they weaken, start resuscitation.

Acid and alkali poisoning

Concentrated acids and alkalis are strong poisons, which, in addition to toxic effects, also cause burns at the site of contact. Since poisoning occurs when acid or alkali enters the body through the mouth, one of its signs is burns of the oral cavity and pharynx, and sometimes lips. First aid for poisoning with such substances includes washing the stomach with clean water, contrary to popular belief, it is not necessary to try to inactivate the acid with alkali, nor should one induce vomiting without washing. After gastric lavage in case of acid poisoning, you can give the victim milk or a little vegetable oil to drink.

Poisoning by volatile substances

Poisoning due to inhalation of toxic substances is considered one of the most severe types of intoxication, since the respiratory system is directly involved in the process, therefore, not only breathing suffers, but toxic substances quickly penetrate into the bloodstream, causing damage to the entire body. Thus, the threat in this case is double - intoxication plus a violation of the breathing process. Therefore, the most important first aid measure for poisoning with volatile substances is to provide the victim with clean air.

A conscious person must be taken to clean air, tight clothing should be loosened. If possible, rinse your mouth and throat with a solution of soda (1 tablespoon per glass of water). In the event that consciousness is absent, the victim should be laid with his head elevated and air flow should be provided. It is necessary to check the pulse and breathing, and in case of their violation, carry out resuscitation until the stabilization of cardiac and respiratory activity or until the ambulance arrives.

Mistakes in first aid for poisoning

Some measures taken as emergency aid for poisoning, instead of alleviating the condition of the victim, can cause additional harm to him. Therefore, you should be aware of common mistakes and not make them.

So, when providing emergency assistance for poisoning, you should not:

1. Give carbonated water to drink;
2. Induce vomiting in pregnant women, in unconscious victims, in the presence of convulsions;
3. Trying to give an antidote on your own (for example, neutralize the acid with alkali);
4. Give laxatives for poisoning with acids, alkalis, household chemicals and petroleum products.

For all types of poisoning, it is necessary to call an ambulance, because. hospitalization is almost always required for poisoning. The only exceptions are mild cases of food poisoning, which can be treated at home.

Emergency care for acute poisoning consists in the combined implementation of the following therapeutic measures: accelerated removal of toxic substances from the body; specific therapy that favorably changes the transformation of a toxic substance in the body or reduces its toxicity; symptomatic therapy aimed at protecting and maintaining the function of the body, which is mainly affected by this toxic substance

At the scene of the incident, it is necessary to establish the cause of poisoning, find out the type of toxic substance, its amount and route of entry into the body, if possible, find out the time of poisoning, the concentration of the toxic substance in solution or the dosage in medicines

In case of poisoning with toxic substances taken orally, a mandatory and extreme measure is gastric lavage through a tube. For gastric lavage use 12 - 15 liters of water at room temperature in portions of 300 - 500 ml

In severe forms of poisoning in patients who are unconscious (poisoning with sleeping pills, etc.), the stomach is washed again 2-3 times on the first day after poisoning, since due to a sharp slowdown in absorption in a state of deep coma in the gastrointestinal tract a significant amount of unabsorbed toxic substance may remain. At the end of the lavage, 100-150 ml of a 30% solution of sodium sulfate or vaseline oil is injected into the stomach as a laxative. Equally important is the early release of the toxic substance from the intestines with the help of high siphon enemas.

In a comatose state of the patient, in the absence of cough and laryngeal reflexes, in order to prevent aspiration of vomit into the respiratory tract, the stomach is washed after preliminary intubation of the trachea with a tube with an inflatable cuff

It is contraindicated to prescribe emetics and induce vomiting by irritation of the posterior pharyngeal wall in young children (under 5 years of age), in patients in a soporous or unconscious state, and also in those poisoned by cauterizing poisons.

For the absorption of toxic substances in the gastrointestinal tract, activated charcoal with water is used (in the form of gruel, one tablespoon inside before and after gastric lavage) or 5-6 tablets of carbolene

In case of inhalation poisoning, it is necessary, first of all, to take the victim to clean air, lay him down, ensure the patency of the respiratory tract, free him from tight clothing, and give oxygen inhalation. Treatment is carried out depending on the type of substance that caused the poisoning.

Acute poisoning occurs when toxic substances enter the human body. This painful condition can occur after eating, drinking, taking medications, and after exposure to various chemicals. Such intoxication is characterized by sudden weakness, excessive sweating, vomiting, convulsions and discoloration of the skin. There may be a group defeat of people who dined together or came into contact with dangerous substances. First aid for acute poisoning should be provided immediately. This will save the victim not only health, but in some cases life.

What can cause acute poisoning

Acute poisoning can be triggered by various reasons:

1. Taking overdose or expired medications.
2. Food products of inadequate quality.
3. Poisons of vegetation and animals.

The way poison enters the human body is different. Penetration of toxins through the digestive tract, respiratory organs, mucous membranes of the eyes or through injections of poisons is possible. Toxins can act both locally, which occurs very rarely, and spread the toxic effect throughout the body.

Acute poisoning is often diagnosed in young children. Out of curiosity, children take without asking medicines and detergents that they taste.

Basic principles of first aid

The general algorithm of first aid consists of a number of measures aimed at maintaining the patient until the doctors arrive:

• At the first symptoms of acute poisoning, an ambulance is called.
• In case of respiratory failure or malfunction of the heart, cardiopulmonary resuscitation is performed.
• Carry out activities aimed at the rapid removal of unabsorbed toxins into the body.
• Use specialized antidotes.

Arriving doctors need to show the remnants of food that the victim ate, medicine packaging or a container of chemicals that caused intoxication. This will allow you to quickly identify the toxin and prescribe adequate treatment to the victim.

Resuscitation measures aimed at restoring the work of the heart are carried out only in the absence of a pulse on the carotid artery. Before this, the remnants of vomit are removed from the patient's mouth with a soft cloth. An indirect heart massage and artificial ventilation of the lungs are carried out very carefully so as not to aggravate the situation.

Removal of poison residues from the body that have not had time to be absorbed is carried out in different ways, depending on the localization of the process.

Removal of toxins from the skin and mucous membranes of the eyes

When the toxic substance is on the skin, these areas are washed with running water for 20 minutes.. Residues can be gently removed with a cotton swab. It is not recommended to use alcohol and detergents, as well as to rub the affected area with a sponge. All this leads to the expansion of capillaries and the strongest absorption of poison.

If a toxic substance has got on the mucous membrane of the eye, then it is necessary to moisten the swab in water or milk and rinse the conjunctiva well. Wash the eyes with different swabs to avoid severe damage to the organs of vision.

Prevention of absorption of toxins in acid and alkali poisoning

If poisoning is provoked by burning chemicals, then the victim is given any enveloping products. It can be fat, butter, milk, egg white or jelly.

In case of poisoning with burning substances, it is impossible to perform gastric lavage at home. This threatens with great damage to the digestive organs!

Removal of toxins from food or drug poisoning

If the poisoning is caused by poor-quality food or an overdose of drugs, first aid is provided in the following sequence:

• The stomach is washed with a large volume of water. At home, they take at least 3 liters of clean water for washing or with the addition of table salt. You can use a solution of potassium permanganate, which is pre-filtered to prevent crystals from entering the gastric mucosa.
• They make a cleansing enema, for which they take starch water, a decoction of chamomile or a solution of rehydron. The procedure is performed until the purity of the outgoing waters.
• They give adsorbents, as a first aid, you can give any medicines of this group that are in the house - atoxil, polysorb, smectite, activated charcoal. All sorbents must be diluted with a small amount of water.
• The patient is soldered with a large volume of liquid. Use decoctions of raisins, dried apricots, green apples or just clean water without gas. A little honey is added to the drink, so the electrolyte balance in the body is restored faster.

For children under the age of 3, gastric lavage and cleansing enema are done with great care. Due to the low weight, rapid dehydration can occur, which threatens with serious conditions.

The use of various antidotes, if any, is allowed only in a hospital setting.. In addition, in the hospital, manipulations are also carried out aimed at the rapid removal of toxins from the bloodstream, for example, forced diuresis.

Folk methods of first aid

Often, in case of poisoning, folk methods are used to alleviate the condition of the victim:

• If there are no sorbents or activated carbon on hand, birch charcoal can be used.
• After the cessation of vomiting, the victim is given a decoction of yarrow. This medicinal herb has a bactericidal effect and can help with food poisoning.
• Give a decoction of rice with raisins. For a liter of water, take two tablespoons of rice and a tablespoon of raisins. Boil, strain and drink in small portions every 15 minutes.

To solder children, use honey with lemon juice, dissolved in warm water. Children drink such a delicious drink with pleasure, unlike a solution of rehydron, which is very difficult to drink even for an adult.

Features of first aid

There are several features that need to be considered when providing first aid:

1. In no case should you try to wash the stomach of the victim if there is even the slightest suspicion of perforation of the stomach or esophagus.
2. You should not try to feed a patient with acute poisoning immediately after the main symptoms subside. Any food that enters the stomach will again provoke an attack of indomitable vomiting. After poisoning, therapeutic fasting is indicated for a day.
3. You can not self-medicate and start drinking antibiotics without a doctor's prescription. These drugs are prescribed only after laboratory tests, through which the pathogen is identified.

At the first signs of acute poisoning, it is necessary to call a team of doctors. Especially if the poisoning occurred in children and is caused by chemicals, drugs or poisons. Only a qualified doctor will be able to correctly assess the situation and do everything possible to avoid the consequences.