Chinese Classification Number R542. 2 Literature Identifier B Article Number 1672-3783(2012)08-0353-01 Keywords: Caowu, Poisoning, Caowu is commonly used in China's folklore for healing wounds and relieving pain, treating joint pains, lumbar pains, etc. However, it is often taken improperly or in large doses, resulting in poisoning or severe poisoning, or even death. However, it is often taken inappropriately or in too large a dose, resulting in poisoning or severe poisoning, or even death. The following is a description of four patients admitted to our hospital from December 2010 to May 2012 with Cao Wu poisoning. The first aid back to the countermeasures are introduced as follows:

1, clinical information

Patients, all male, age 45-62 years old, are taking homemade grasshopper on the 50-100 ml 0.5-1 hours after the appearance of dizziness, blurred vision, tightness in the chest, nausea and vomiting, dyspnea, and numbness of the limbs, and so on.

2, nursing

2, 1 first aid nursing countermeasures

Patients to the hospital immediately placed in the rescue room, keep the airway open, oxygen, and immediately set up intravenous access, rapid and effective application of rescue medication; briefly asked about the history of the patient, to understand the time of taking the grass wu, the amount of and any discomfort, to determine the degree of poisoning of the patient; cardiac monitoring, pay attention to the close observation of heart rate, blood pressure, cardiac monitoring, pay attention to closely observe the heart rate, blood pressure, respiration and oxygen saturation is stable, there is no arrhythmia, in order to timely treatment. In this group, there are two cases of shallow respiration and cyanosis when they came to the hospital, and they were immediately intubated, and after artificial respirator assisted respiration, the patients' color became red and oxygen saturation level increased.

2.2.2 Rapid removal of unabsorbed grasshopper in the gastrointestinal tract

2.2.1 Rapid, thorough and effective gastric lavage is the first step in preventing further absorption of grasshopper toxin and in saving the patient's life. In the process of gastric lavage, the nurse must be at the patient's bedside, closely monitoring the changes in condition. The patients in this group were all gastric lavage, in which two patients in the process of gastric lavage appeared frequent ventricular premature beats, and immediately be treated with symptomatic treatment after the patient turned to safety.

2,2,2 Conducting diarrhea, after gastric lavage, is to prevent the absorption of grass wool into the intestine, which is a key measure to save the patient's life. Three patients in this group were given 50% magnesium sulfate diarrhea.

2,3 Rapidly remove the toxin that has been absorbed into the blood.

2,3,1 Hemodialysis in hemodialysis closely observe the patient's vital signs, consciousness, expression changes, to prevent bleeding coagulation, air embolism and other complications. In this group, 3 cases used hemodialysis to remove the grasshopper toxin that had been absorbed into the blood. None of the postoperative complications occurred.

2,3,2 Infusion of fluids and diuresis by appropriate rehydration, followed by diuresis to promote the excretion of aconitine was a common detoxification method in the past. Indwelling urinary catheterization, record the 24-hour in and out, closely monitor the changes of water electrolytes, urine volume and vital signs. Strictly in accordance with the changes in the condition to adjust the rate of infusion.

2, 4 dynamic cardiac monitoring

Caowu poisoning caused by arrhythmia is characterized by: ① poisoning early sinus bradycardia, atrial arrhythmia, atrioventricular block; ② and then appeared rapid ventricular arrhythmia; ③ has a "variety of", "speed deformation (iii) "diverse", "tachyarrhythmic" and "fatal". Two cases in this group had frequent ventricular premature beats on admission, which were corrected after administration of lidocaine 50-100 mg intravenously, and two cases had ventricular fibrillation about 2 hours after admission, which were corrected after immediate electrical defibrillation.

2,5 Psychological care

The poisoned patients originally took the grasshopper because of the injury, have suffered from the harm of poisoning, no matter the severity of the disease, the psychology is more difficult to bear, so it is very important to strengthen the psychological care. First of all, we must care for and considerate of the patient, and then have a rapid, agile, skillful first aid technology to let the patient get a sense of security, and must do a good job of patient explanation.

3. Results

All the cases in this group were cured and discharged after treatment.

4, Summary

Cao Wu is the dried tuberous root of Bei Wu Tou and Wu Tou of the plant of the family of Mulleinaceae. Its flavor is pungent, warm, and its function is to drive away wind and dampness, dispersing cold and relieving pain. Clinically, it is used for the treatment of rheumatic (or rheumatoid) arthritis, contracture of hands and feet, sciatica, migraine, bruises and pain. Its highly toxic components are mainly aconitine, aconitine, aconitine, aconitine and other bilipid alkaloids, toxicity is very strong, oral 0.2mg will be poisoned, 3-4mg will kill people. Aconitine on the vagus nerve has a strong excitatory effect, thus see lead to slow heart rate, atrioventricular block, aconitine can also directly act on the ventricle and produce high-frequency ectopic rhythms resulting in ventricular tachycardia and ventricular fibrillation, in addition to the central and peripheral nerves have a first excitation and then paralyzed, so severe poisoning can be due to arrhythmia and respiratory center paralysis and death. Caowu use should be noted: (1) clinical use of medicines must be concocted to reduce the toxicity of treatment, aconitine nature is unstable, water, heating is easy to hydrolyze into a less toxic alkaloids, so often used to soak and bleach, licorice and black bean **** cooking or the original herbs placed in high-pressure canisters to high-temperature steaming, the toxicity of its reduction to the original 0.5 ﹪ of the original medicine; (2) reasonable compounding. There are data that with ume, licorice, ginger, to reduce the toxicity of the pairing; (3) strict control of dosage, general internal use of the first dose of the lowest value of the commonly used, and then gradually increased to the appropriate dose, internal use for a long time should also be wary of accumulation of poisoning; (4) the raw herb can only be externally used, the skin can not be used for those who broke; (5) pay attention to the toxicity of the observation, the auricular intoxication, the more the first numbness of the tongue and lips, nausea, vomiting, and then movement disorders, sensory abnormalities, irritability, chest tightness, panic, heartburn, and other symptoms of the poisoning. Irritability, chest tightness, panic, pallor, cold limbs, slow heartbeat or arrhythmia, drop in blood pressure, difficulty in swallowing, speech impediment, slow or inhibited breathing. During the period of taking Cao Wu, if the above symptoms occur, the medicine should be stopped immediately and appropriate treatment measures should be taken to avoid adverse consequences.