Intensive Care of Emergency Conditions - V. M. Zaporozhan 2006

Acute Poisoning

Poisoning is a chemical injury resulting from The entry of a toxic dose of foreign chemical substances into the body.

Acute poisoning is generally divided into two stages: the early clinical (toxicogenic) stage, when the poison remains in the body and exerts a specific toxic effect; and the somatogenic stage, which occurs after the poison has been eliminated or degraded. In the latter stage, the Homeostasis disruptions initiated During the first phase reach their maximum severity, alongside Structural and functional impairments of various Organs and systems. Notably, these secondary manifestations often play a more critical role in the clinical picture of poisoning than the specific action of the poison itself.

The Diagnosis of poisoning is established at the scene based on specific odors detected from the patient (such as ethyl alcohol, organophosphate insecticides, dichloroethane, iodine, or acetic essence) and the characteristic Clinical presentation (including myofibrillation, convulsions, cyanosis, and edema of the oral mucosa).

Whenever possible, investigators should determine the type of toxic substance, the dose ingested, and the time of exposure. This information can be gathered from the patient, eyewitnesses, or by inspecting the living or working quarters where the victim was found, looking for pills, packaging, labels, or bottles. In cases of suicide attempts, patients may deliberately conceal these details. Sometimes, establishing an exact diagnosis is impossible—particularly when patients are in a coma—in which case it is diagnosed as poisoning by an unknown agent.

To guide first-aid measures and subsequent Treatment, the most practical approach is to classify poisons based on their primary damaging effect on the body:

— neurotoxic;

— cardiovasculotoxic;

— hepato- and nephrotoxic;

— hematotoxic;

— irritant;

— corrosive;

— respiratory Enzyme Inhibitors.

Intensive care and resuscitation should be directed along three main lines:

— prompt elimination of the toxic substance from the body (Urgent Detoxification);

— syndromic (symptomatic) therapy;

— specific antidote therapy.