1、 What is acute poisoning in children?
It refers to substances with toxic effects entering the human body through different pathways, causing acute damage to tissues and organs in the short term, resulting in a series of symptoms and signs that may endanger life.
1. Types of toxins: agricultural (organic phosphorus, etc.); Industrial (paint, heavy metals, gasoline, etc.); Drug overdose: (antipyretic drugs, etc.); Animal based (venomous snakes, bees, etc.); Plant based (mushrooms, white fruits, etc.); Foodiness: Expired food. 2. Poisoning routes: ingestion poisoning, inhalation poisoning, injection poisoning, contact poisoning, rectal absorption poisoning. 3. Toxic metabolism: Liver: the main organ for toxic metabolism; Kidney: Most toxins are eliminated by the kidneys; Skin: A small amount of toxins are excreted from it; Respiratory tract: volatile toxins; Other: sweat glands, salivary glands, mammary glands, biliary excretion. 4. Symptoms and signs: Digestion: nausea, vomiting, abdominal pain, diarrhea; Breathing: exhaling abnormal odors, breathing faster or slower. Pulmonary edema; Neurological disorders: consciousness disorders, convulsions, visual and auditory hallucinations, blindness; Skin and muscle: Skin redness, paleness, cyanosis, edema, cherry red lips, excessive sweating, no sweating, salivation, muscle tremors, twitching, etc; Cardiovascular: bradycardia, arrhythmia, hypertension, hypotension; Other: high fever, low body temperature, enlarged or reduced pupils, hair loss.
2、 How to identify acute poisoning in children early?
（1） Consultation: Detailed inquiry about medical history and onset of illness, including pre illness diet, lifestyle, activity range, parents' occupation, presence of toxins in the environment, and whether parents have regular medications. 1. The group develops symptoms simultaneously or sequentially, and the symptoms are similar. 2. Acute onset, unknown etiology, multiple organ involvement, and ineffective conventional treatment. 3. Parents are advised to have a detailed understanding of the name, dosage, duration of poisoning, and post poisoning treatment of a toxic substance or medication that may have been ingested by mistake. 4. Sudden change of consciousness and unclear diagnosis.
（2） On site inspection: 1. Check if there are any remaining toxins around the patient. 2. Are there any toxic markers on site. 3. Keep the child's diet, vomit, and utensils. 4. Check if there are any toxic residues on the child's clothes or skin. 5. Check if the child's pocket contains any toxins.
（3） Physical examination: examination of skin, mucous membranes, consciousness, etc; Touch: skin temperature, sweat secretion, muscle condition; Knock: lung examination, abdominal examination; Listening: cardiopulmonary auscultation; Smell: Special odor.
（4） Laboratory examination: Routine examination to understand the organ function of the child: blood, urine, stool routine, liver and kidney function. Water electrolyte and acid-base balance, coagulation function, blood gas analysis. Toxic analysis: qualitative and quantitative.
3、 How to rescue children from acute poisoning?
（1） Handling of contact poisoning: 1. Remove contaminated clothing. 2. Rinse contaminated skin with plenty of water, paying attention to hair and nails. 3. Rinse with corrosive substances for 10-15 minutes (avoid hot water and small amounts of water). 4. Toxic substances that are insoluble in water can be washed with solvents. 5. Antagonist or antidote flushing: Strong acids and bases should not be treated with neutralizing agents, as chemical reactions can exacerbate damage.
（2） Handling of inhalation poisoning: 1. Leave the toxic area and breathe fresh air (indoor poisoning, open doors and windows). 2. Suck out respiratory secretions. 3. Oxygen inhalation if necessary. 4. Coma patients should pay attention to tongue base prolapse and laryngeal edema, which can cause suffocation. 5. Severe cases should be treated with hyperbaric oxygen therapy. (3) Treatment for oral poisoning: 1. Vomiting: stimulation and medication. 2. Gastric lavage: Wash the stomach within 4-6 hours, the faster the better (excluding large amounts of toxins, delayed emptying of toxins such as organophosphates and sedatives in the stomach, absorption of toxins such as opium and organophosphates and secretion from the stomach, and enteric coated pills); Strong acid and strong alkali should not be used for gastric lavage, as it can lead to gastric perforation; Gastric lavage in patients with oil poisoning or coma can lead to aspiration pneumonia; Gastric lavage is most suitable for poisoning from liquid or water-soluble toxins. 3. Diarrhea: commonly used magnesium sulfate and sodium sulfate, 250mg/kg, prepared as a 20% solution orally, taken once every 1-2 hours until bowel sounds or defecation occur; Generally, oil based laxatives are not used to increase the absorption of fat soluble toxins (phenols, phosphorus, iodine); When suffering from carbolic acid poisoning, 30-60ml of castor oil should be taken, followed by magnesium sulfate. 4. Enema: Enema should be administered 4-6 hours later. Enema solution: 1% warm saline solution, 1% soapy water, clean water, and activated carbon can be added to enhance adsorption.
（4） To prevent the continued absorption of toxins: subcutaneous or intramuscular injection or animal bite and sting: use a tourniquet near the injection or wound site, relax for 1 minute every 15 minutes. Shortly after the injection of the poison, inject 0.3-0.5ml of 1:1000 adrenaline into the wound. Place an ice pack locally to delay absorption.
Oral poisoning, induce vomiting, gastric lavage, and administer antagonists simultaneously.
（5） Promote the excretion of absorbed toxins: 1. Diuretic detoxification: infusion, diuresis, monitoring. 2. Blood purification: peritoneal dialysis, hemodialysis, hemoperfusion, plasma exchange.
（7） Symptomatic supportive treatment: close monitoring, oxygen therapy, treatment and protection of organ function, maintenance of water electrolyte acid-base balance, prevention of secondary infections, etc.