Poisoning

Approximately 300,000 different chemical compounds, more or less toxic, surround modern humans. Many of these substances are in close proximity, in work and home environments. This is one reason poisoning ranks as the fourth leading cause of death, following heart and vascular diseases, injuries, and malignant tumors.

The health and life of a poisoned person, and the success of hospital treatment and rehabilitation, often depend on timely and proper first aid, as well as the knowledge and readiness of bystanders to provide help quickly at the scene when medical assistance is unavailable or delayed.

However, the scene of first aid is often a "battlefield" where a direct and decisive fight for the poisoned person’s life occurs, as life-threatening conditions frequently develop in the initial phase of poisoning.

In reality, aid provided to an acutely poisoned person is often inadequate, ineffective, or even harmful, so it’s unsurprising that poisoned individuals sometimes suffer more from incorrect aid than from no aid at all. Psychological factors also play a role. The primal fear of poisons often triggers intense emotional reactions, ranging from paralysis and immobility to fleeing the scene.

Panic and the misconception that a poisoned person must receive an antidote often lead to giving them various "antidotes" found at hand, based on folk traditions, such as milk, brandy, honey, baking soda, or other substances like heart drops or sedatives.

When removing poison from the body, it’s ideal to eliminate it via the same route it entered. If a poison is ingested, first aid can be highly effective, especially if started immediately after ingestion.

The goal of first aid is to expel the poison from the stomach as quickly as possible and take measures to prevent or reduce its absorption into the bloodstream. Three basic first aid procedures exist:

1. Inducing vomiting by stimulating the soft palate or back of the throat with a finger. For those who struggle to vomit, this can be combined with gargling warm soapy water (not detergent).

2. Gastric lavage, which can be performed at home immediately after poison ingestion, involves inducing vomiting first, then drinking warm water and inducing vomiting again. Alternating water intake and vomiting cleanses the stomach more effectively than a gastric tube used in hospitals in certain cases. Lavage continues until the vomited contents are clear. No more than half a liter of water should be consumed at once. Vomiting and gastric lavage must not be used for poisoning with corrosive liquids like acids, alkalis, gasoline, paint solvents, or petroleum distillates. Vomiting should not be induced in unconscious individuals or those resisting.

3. Binding (adsorption) of the poison is achieved using animal or vegetable charcoal. The antidote properties of activated charcoal have long been proven. Since vomiting and gastric lavage may not remove all poison, additional measures are needed to prevent further absorption in the intestines. Activated charcoal is the most effective physical antidote, binding most poisons in the digestive system, whether organic or inorganic. It is administered in quantities five to ten times greater than the ingested poison, with adults receiving at least two large tablespoons dissolved in a glass of water.

Its antidote efficacy was demonstrated centuries ago when French pharmacist Thouery ingested a lethal dose of strychnine with activated charcoal without consequences. Numerous experiments in recent decades have further confirmed its effectiveness.

Poisons in gaseous form, dust, or fumes enter the body through inhalation, directly entering arterial blood via the 80 square meters of lung alveoli (approximately 300 million tiny air sacs). The poisoned person must be removed from the toxic environment to fresh air immediately, and their general condition assessed.

Since poisons are expelled through breathing, maintaining airway patency and enabling respiration is the most critical first aid measure. Artificial respiration may be necessary. If the poisoned person is unconscious but breathing, place them in the lateral recovery position to prevent choking on their tongue or vomit.

Many believe intact skin fully protects against poison entry, but numerous dangerous poisons can penetrate healthy skin, causing potentially fatal poisoning. First aid involves rinsing with large amounts of water, followed by washing with soap.

After removing the poison, antidotes can be administered as part of first aid. Timely and correct antidote use can save lives and significantly aid recovery.

When using antidotes, the fundamental medical principle stated by Roman physician Galen 2,000 years ago applies: "Primum nil nocere" (first, do no harm). No substance should be given unless its medical appropriateness is certain.

Fatal errors often occur due to inappropriate use of "antidotes." For example, milk, often considered a universal antidote, is beneficial only for poisoning with corrosive substances (acids, alkalis, heavy metal salts). In most other poisonings, milk worsens the condition by enhancing poison absorption.