Poisonings — it is a chemical injury as a result of penetration of the toxic dose of foreign chemical substances
Two stages of acute poisoning are distinguished: early clinical — toxigenic, when a poison is in the organism and exerts its specific effect on it; somatogenic that arises after a poison removal or its degradation when disorders of homeostasis are maximally pronounced and have arisen already at the first stage, and affection of structures and functions of different organs and systems. In the process, these events may be of greater significance in the clinical picture of poisoning than specific effect of the poison itself.
A diagnosis of poisoning is established at the place of accident by the presence of specific smell (ethyl alcohol, organophosphorus insecticides, dichlorethane, iodine, acetic essence, etc.) and by the character of clinical picture (myofibrillation, convulsions, cyanosis, edema of mucous membrane of the oral cavity, etc.).
One should clear up as far as possible: a kind of toxic substance, a dose of its introduction into the organism and the time of its entry. These data may be obtained from the patient, witnesses of what had happened, as well as upon examination of the living spaces or production floor areas where the injured person was found with search for tablets, packages, labels, bottles, etc. In case of suicidal attempt patients may conceal these data. Sometimes, one fails to establish exact diagnosis, particularly, if the patients are in coma, then a poisoning from unknown poison is diagnosed.
For a choice of measures of the first medical aid and further treatment the most acceptable is their systematization by the principle of the advantageous injurious action on the organism:
— neurotoxic;
— cardiovascular toxic;
— hepato- and neurotoxic;
— hematotoxic;
— irritable;
— corrosive;
— inhibiting respiratory enzymes.
Intensive care and resuscitation should be carried out in three directions:
— urgent removal of toxic substance from the organism (urgent detoxication);
— by syndrome (symptomatic) therapy;
— specific antidote therapy.
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