Slightly gas poisoning quickly move the patient to a place with fresh air, bed rest, warmth, keep the airway open. (Gas poisoning generally refers to carbon monoxide poisoning)
Principles of gas poisoning treatment
(1) general treatment? Breathing fresh air; heat preservation; oxygen inhalation; breathing weak or stop breathing patients, must be immediately artificial respiration; if necessary, the use of hibernation therapy; serious condition, can be first bleed and then blood transfusion.
(2) Prevention and treatment of cerebral edema.
(3) Supportive therapy.
Carbon monoxide poisoning is the product of incomplete combustion of carbon-containing substances through the respiratory tract caused by inhalation poisoning. The mechanism of poisoning is that the affinity of carbon monoxide and hemoglobin is 200-300 times higher than that of oxygen and hemoglobin, so carbon monoxide is very easy to combine with hemoglobin to form carboxyhemoglobin, so that hemoglobin loses its ability to carry oxygen and its role in causing asphyxiation of tissues. To the whole body's tissue cells have toxic effects, especially on the cerebral cortex of the most serious effects.
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These are the most important of all the processes. Extended Information:
Saving measures
(1) Correct hypoxia? Rapidly correct the hypoxic state. Inhaled oxygen accelerates COHb dissociation. Increase the discharge of CO. Inhalation of fresh air, CO by COHb release half the amount of about 4 hours; inhalation of pure oxygen can be shortened to 30 to 40 minutes, inhalation of 3 atmospheric pressure of pure oxygen can be shortened to 20 minutes. Hyperbaric oxygen chamber treatment can increase the dissolved oxygen in the blood, increase the partial pressure of arterial blood oxygen, so that the oxygen in the capillaries is easy to diffuse to the cells, and can quickly correct tissue hypoxia. In case of respiratory arrest, artificial respiration should be performed early, or respiration should be maintained with a ventilator. Plasma exchange may be considered in critically ill patients.
(2) prevention and treatment of cerebral edema? After severe poisoning, cerebral edema can develop to its peak in 24-48h. Dehydration therapy is important. Currently the most commonly used is 20% mannitol, intravenous rapid drip. When the phenomenon of increased cranial pressure improves after 2 to 3 days, the amount can be reduced. Furosemide can also be injected for dehydration. Adenosine triphosphate, adrenal glucocorticoids such as dexamethasone also help to relieve cerebral edema. If there are frequent convulsions, the current drug of choice is diazepam, followed by a phenytoin drip after the convulsions stop.
(3) Treatment of infection and control of high fever? Throat swabs, blood and urine cultures should be taken, and broad-spectrum antibiotics should be selected. High fever can affect brain function, physical cooling methods can be used, such as head with ice cap, body surface with ice packs, so that the body temperature is maintained at about 32 ℃. If there are chills or difficulty in decreasing body temperature during the cooling process, hibernation drugs can be used.
(4) promote brain cell metabolism? Application of energy combining agent, commonly used drugs are adenosine triphosphate, coenzyme A, cytochrome C and a large number of vitamin C and so on.
(5) Preventing and controlling complications and post complications? Nursing care during coma is very important. Keep the airway open and perform tracheotomy if necessary. Turn over regularly to prevent pressure sores and pneumonia. Attention to nutrition, if necessary, nasal feeding. After patients with acute CO poisoning wake up from coma, they should rest and observe for 2 weeks as much as possible to prevent the occurrence of neurological and cardiac complications. If there are complications, give appropriate treatment.
References:
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