First first aid.

Removal of poison . If the poison has got through the skin or external mucous membranes (wound, burn), it is removed with a large amount of water - saline, weak alkaline (drinking soda) or acidic solutions (citric acid, etc.). When toxic substances enter the cavity (rectum, vagina, bladder) they are washed with water with enema, douching. From the stomach, the poison is removed by washing, emetic or reflexively causing vomiting of the pharynx tickling. It is forbidden to induce vomiting of unconscious streets and poisoned cauterizing poisons.
Before reflexing of vomiting or ingestion of emetic agents, it is recommended to drink several glasses of water or 0.25-0.5% sodium bicarbonate solution (drinking soda), or 0.5% potassium permanganate solution (pale pink solution), a warm solution of table salt 2-4 teaspoons per glass of water). As emetics use the root Ipecacuanas, etc., you can soapy water, a solution of mustard. From the intestine, the poison is removed with laxatives. The lower part of the intestine is washed with high siphon enemas. Poisoned give an abundant drink, for better allocation of urine appoint diuretics.

Neutralization of poison . Substances that enter into a chemical compound with a poison, transferring it to an inactive state, are called antidotes, so the acid neutralizes the alkali and vice versa. Uniatiol is effective in poisoning with cardiac glycosides and in alcoholic delirium. Antarsin is effective in poisoning with arsenic compounds, in which the use of unithiol is contraindicated. Sodium thiosulfate is used for poisoning with hydrocyanic acid and its salts, which in the course of chemical interaction pass into nontoxic rhodanous compounds or cyanhydrides easily removed with urine. The ability to bind toxic substances have: activated carbon, tannin, potassium permanganate, which are added to the wash water. With the same purpose. Use a plentiful drink of milk, protein water, egg whites (according to indications).

Covering agents (up to 12 egg whites per 1 liter of boiled cold water, vegetable mucus, jelly, vegetable oil, aqueous mixture of starch or flour) are especially indicated for poisoning with irritating and cauterizing poisons, such as acids, alkalis, salts of heavy metals.

Activated carbon is injected into the interior in the form of a water slurry (2-3 tablespoons per 1-2 cups of water), has a high sorption capacity for many alkaloids (atropine, cocaine, codeine, morphine, strychnine, etc.), glycosides (strophanthin, digitoxin and Etc.), as well as microbial toxins, organic and to a lesser extent inorganic substances. One gram of activated carbon can adsorb up to 800 mg of morphine, up to 700 mg of barbiturates, up to 300 mg of alcohol.

As a means of accelerating the passage of poison along the gastrointestinal tract and preventing absorption, petrolatum oil (3 ml per 1 kg of body weight) or glycerol (200 ml) can be used for poisoning with petrol, kerosene, turpentine, aniline, phosphorus, etc. fat-soluble compounds, ).

Methods of accelerated elimination of poison from the body.

Active detoxification of the body is carried out in specialized centers for the treatment of poisoning. Apply the following methods.

1. Forced diuresis - based on the use of diuretics (urea, manpitol, lasix, furosemide) and other methods that contribute to increased urine output. The method is used for most intoxication, when excretion of toxic substances is carried out mainly by the kidneys.

Water loading is created by abundant drinking of alkaline waters (up to 3-5 liters per day) in combination with diuretics. Patients in a coma or with pronounced dyspeptic disorders make subcutaneous or intravenous administration of a solution of sodium chloride or glucose solution. Contraindications to carrying out the water load - acute cardiovascular insufficiency (pulmonary edema) or renal failure.

Alkalinazatsaya urine is created by intravenous drip injection of sodium bicarbonate solution up to 1.5-2 liters per day under the control of the determination of alkaline urine reaction and reserve alkalinity of blood. In the absence of dyspeptic disorders, sodium bicarbonate (baking soda) can be given inside for 4-5 g every 15 minutes for an hour, then 2 g every 2 hours. Alkaline urine is a more active diuretic than water pressure, and is widely used for acute poisoning with barbiturates, salicylates, alcohol and its surrogates. Contraindications are the same as with water load.

Osmotic diuresis is created by intravenous injection of osmotically active diuretics, greatly enhancing the process of reverse absorption in the kidneys, which allows you to achieve urine release a significant amount of poison circulating in the blood. The most known drugs of this group are: hypertonic glucose solution, urea solution, mannitol.

2. Hemodialysis is a method in which the "artificial kidney" apparatus is used as an emergency measure. By the rate of purification of blood from poisons is 5-6 times higher than forced diuresis.

3. Peritoneal dialysis - accelerated elimination of toxic substances that have the ability to accumulate in fatty tissues or to firmly bind to blood proteins. In the operation of peritoneal dialysis, a fistula inserted into the abdominal cavity is injected with 1.5-2 liters of sterile dialysate fluid, changing it every 30 minutes.

4. Hemosorption - a method of perfusion (distillation) of patient's blood through a special column with activated carbon or another sorbent.

5. Operation of blood substitution is carried out with acute poisoning with chemical substances that cause toxic damage to blood. Use 4-5 liters of one-group, Rh-compatible, individually selected donor blood.

Resuscitative measures and symptomatic treatment.

Poisoners demand the most careful observation and care in order to take timely action against threatening symptoms. In the event of a drop in body temperature or cold extremities, the patients are wrapped in warm blankets, rubbed and given a hot drink. Symptomatic therapy is aimed at maintaining those functions and systems of the body that are most damaged by toxic substances. Below are the most frequent complications from the respiratory, gastrointestinal, kidney, liver, cardiovascular system.