First Aid Handbook on Chemical Accidents (II) Principles and Key Points of On-site First Aid

First, the principle of diagnosis

After chemical accident rescue personnel must quickly diagnose the sick and wounded, in order to make timely and correct treatment. Generally consider establishing the diagnosis from the following four aspects.

(1) According to the accident scene. It should be based on the nature of the accident, the degree, the type and toxicity of the poison, whether there is burning, explosion, suffocation, whether there is a fall, impact, etc. Analysis of the situation may cause injury.

(2) According to the clinical manifestations of the wounded and sick. Quickly and accurately examine and inquire the patient, and analyze and judge according to the clinical symptoms and physical symptoms of the wounded and sick.

(3) According to the site of possible inspections, laboratory tests and monitoring data. When conditional, inspections and tests can be conducted through, for example, mobile X- ray inspections and routine testing service vehicles; monitoring and analysis of air toxicant concentrations and oxygen content through air-gauge equipment can provide evidence for on-site diagnosis.

(4) Do a good job of identifying with other diseases. In the case of unclear reasons and unclear diagnosis, the identification of other diseases should be carefully done. In particular, acute chemical poisoning is often distinguished from other medical diseases and other toxic poisons to avoid misdiagnosis, resulting in delays and failures in rescue.

Second, emergency points

1. General treatment principles for on-site first aid

(1) Immediately release the cause of the disease and escape from the scene of the accident.

(2) The patient with unconsciousness was placed in the lateral position to prevent airway obstruction. The hypoxic person was given oxygen inhalation. The person with respiratory arrest was immediately subjected to artificial respiration. The cardiac arrest was immediately performed with external cardiac compression.

(3) Skin burns should be cleaned as soon as possible, and the wounds should be protected with clean or sterilized gauze. Acid, alkali and other chemical burns should be flushed with plenty of running water and for a sufficient period of time ( generally twenty minutes ) before further disposal. It is forbidden to apply anti-inflammatory powder and ointment to the wound surface;

(4) If serious poisoning is to be immediately implemented at the scene of the cause of treatment and the corresponding symptomatic, supportive care; general poisoning patients should sit or lie flat and rest, close observation of the guardian, at any time pay attention to changes in the condition.

(5) Fractures, especially in the case of spinal fractures, should be minimized in addition to hemostasis without proper fixation, so as not to aggravate the injury.

(6) Do not casually feed the sick and wounded to avoid vomiting into the trachea.

(7) Place the patient in a fresh, safe and quiet environment.

(8) to prevent shock, especially to pay attention to the protection of heart, liver, brain, lungs and kidneys and other important organ functions.

2. Points for on-site treatment of acute chemical poisoning

(1) Move the patient away from the poisoning scene, give oxygen to fresh air, remove contaminated clothing, and rinse the skin with flowing water in a timely manner. Wash the skin thoroughly with chemicals that may cause chemical burns or absorb poisons through the skin. The time is usually not less than twenty minutes, and consider choosing neutralization treatment with proper neutralization agent; priority should be given to rapid flushing when eye poison splashes or causes burns.

(2) Protect the airway and prevent obstruction. Closely observe the patient's consciousness, pupils, blood pressure, respiration, and pulse and other vital signs, and handle abnormalities immediately.

(3) Stop the continued absorption of poisons. When skin flushing is insufficient, rinse or neutralization, oral poisoning, and non-corrosive poisons should be used. Immediately induce vomiting or gastric lavage and catharsis to expel toxic substances from the body. However, in the case of corrosive toxic poisoning, the method of vomiting and gastric lavage is generally not recommended.

(4) Discharge or neutralize poisons that have been absorbed into the body as soon as possible to relieve or counteract poison toxicity. Through infusions, diuresis, accelerated metabolism, detoxification agents and antidotes remove the toxic substances that have been absorbed into the body. Detoxifiers mainly refer to synthetic agents. Antidote refers to specific drugs that can detoxify drugs.

(5) symptomatic treatment, supportive treatment. Protect important organ functions, maintain acid-base balance, prevent water and electrolyte disorders, prevent secondary infections, and complications and sequelae.

3. Precautions for on-site treatment of acute chemical poisoning

(1) On-site treatment of acute chemical poisoning is very important. Proper treatment can block or reduce the development of poisoning lesions; otherwise, it can aggravate or induce severe lesions. Some irritating gas poisoning, such as early quiet rest, can often prevent the occurrence of pulmonary edema, such as too many improper activities, mental stress often leads to the occurrence of pulmonary edema. "Neuro-neuro" toxic poisoning needs to limit the amount of water in the early stage, especially intravenous fluids, such as excessive infusion in the early period of incubation or poisoning, can cause severe cerebral edema.

(2) The condition of poisoning is sometimes heavier and faster, so it needs to be closely observed and recorded in detail. And keep abreast of the main clinical manifestations, timely treatment measures. Treatment should also prevent secondary or concurrent lesions, such as the development of toxic encephalopathy should prevent respiratory depression and cerebral hernia formation, coma should prevent secondary infection; recovery of patients with physical state of mind are not restored, should prevent the occurrence of Other accidents ( such as a fall injury ) .

(3) It is very important to maintain the balance of water, electrolyte and acid-base during the rescue process. Accurately record the amount of water in and out, adjust the total amount of infusion and the amount of electrolytes, so that the environment of the organism remains stable.

(4) There are tens of thousands of poisons that can cause acute poisoning. Some poisons not only lack clinical data, but also lack toxicological information. At the same time, due to individual differences, different inhalation doses or toxic substances contain impurities, causing poisoning patients. The clinical manifestations vary greatly and there are many changes. In this case, symptomatic treatment must be performed according to the condition.

(5) Some drugs, such as detoxification agents and antidote, should be given priority in the field of first aid and should be applied as much as possible. Otherwise, when the poison has caused serious organic diseases, its efficacy will be significantly reduced; at the same time, as the disease progresses, some Secondary or concurrent lesions may become a major contradiction, so that the specific drug can not play its role; too large dose, can produce side effects, it must be adjusted according to specific circumstances at any time dose.

(6) In the on-site treatment of acute chemical poisoning, some traditional Chinese medicine acupuncture and other treatment methods are simple, convenient, effective, and often receive unexpected results.

Third, self-help and mutual aid

Self-rescue refers to the rescue action carried out by the accident unit and the protection and defense actions taken by the person who was harmed by the accident at the accident site when a chemical accident occurs. Self-rescue is the most basic and widest form of rescue in the field of chemical accidents. The main body of self-rescue behavior is the enterprise and the employees themselves. Because they are most familiar with the situation on the site and have the fastest response, they have the greatest role in the rescue. Chemical accidents on-site emergency work can often control or solve problems through self-rescue behavior.

Mutual aid (to save him) refers to all rescue measures and actions when a chemical accident, organization and implementation of aid and rescue teams to another person or business or social rescue forces between each scene of the accident injured personnel.

Reciprocal rescue ( he saves ) is a manifestation of the socialist spiritual civilization that helps the rescue of humanity and help each other. In the event of a major chemical accident, especially a catastrophic chemical accident, it is very important to fight for assistance from others and the rescue of social forces with limited rescue power. Chemical System hospital workers, occupational disease prevention center (), in particular the chemical accident emergency rescue center medical rescue in chemical incident, we should give full play to first aid, technical advice, guidance, role of training for rescue work and make due contributions.

Self-rescue and mutual rescue ( his rescue ) are two important basic forms that cannot be separated from each other in chemical accident emergency rescue work. Rescue workers - The employees of the company, especially medical personnel, must master basic knowledge and basic skills in self-rescue and mutual rescue, such as the use of extrathoracic cardiac compression, artificial respiration, and protective equipment, emergency escapes in emergency situations, evacuation, and burns. Or on-site emergency treatment of electric shock, four major techniques for traumatism and first-aid, and so on, the effectiveness of on-site emergency treatment work is remarkable.

The information in this article comes from the Internet and was reorganized and edited by China Rescue Equipment Network.