1. Immediately terminate poison exposure immediately evacuate the patient from the poisoning scene and transfer to a place with fresh air; immediately remove contaminated clothes; wash the poison on the skin and hair with warm water or soapy water without neutralizing it with drugs; rinse thoroughly with water to remove the poison in the eyes, and locally generally do not use antidotes; remove the poison from the wound. 2.Emergency resuscitation and symptomatic supportive treatment Resuscitation and supportive treatment aims to protect and restore the function of patients’ vital organs and help critically ill patients to pass the dangerous period. For patients in acute poisoning coma, keep the airway open, maintain respiratory and circulatory functions; observe the condition of mental, body temperature, pulse, respiration and blood pressure. When cardiac arrest, shock, circulatory failure, respiratory failure, renal failure, water-electrolyte and acid-base balance disorders occur in severe poisoning, immediately take effective first aid resuscitation measures to stabilize vital signs. In case of convulsion, use anticonvulsants, such as sodium phenobarbital, isopentobarbital (sodium amytal) or diazepam; in case of cerebral edema, apply mannitol or sorbitol and dexamethasone, etc. Give nasal feeding or parenteral nutrition. 3, clear the body has not yet absorbed the poison through the mouth poisoning, early removal of the gastrointestinal tract has not yet absorbed the poison can make the condition significantly improved, the earlier and more complete the better. (1) Emetic: Emetic method is easy to cause misabsorption and delay the application of activated charcoal, and is no longer routinely used in clinical practice. Cooperative people can choose this method; coma, convulsions, shock state, corrosive poison intake and no vomiting reflex is prohibited this method. 1) Physical stimulation to induce vomiting: For cooperative patients with clear consciousness, instruct them to stimulate the posterior pharyngeal wall or tongue root with fingers or tongue depressor or chopsticks to induce vomiting. If it does not work, ask them to drink 200-300ml of warm water and then stimulate vomiting by the above method, and so on repeatedly until they vomit out clear stomach contents. 2) Medication to induce vomiting: Emetine (thujone base): is a powerful emetic that causes vomiting through direct local stimulation of the gastrointestinal and central nervous system effects. Oral administration of 30ml of Turgen syrup followed by 240ml of water. vomiting occurs after 20 minutes and lasts for 30-120 minutes. Emetine treatment is no longer advocated as an emetic treatment for poisoned patients due to its susceptibility to aspiration pneumonia. Apomorphine: It is a morphine derivative, a semi-synthetic central emetic, used for accidental poisoning where gastric lavage is not possible. It is injected subcutaneously at 2-5 mg once and the emetic effect occurs after 5-10 minutes. To enhance the emetic effect, drink 200-300ml of water before administration. this product should not be used repeatedly or for narcotic poisoning. Patients in coma, convulsion state or swallowing petroleum distillate or corrosive agent, emetic may cause bleeding or esophageal laceration, gastric perforation, and emetic is contraindicated. (2) Nasogastric tube suction: Apply a small-caliber nasogastric tube placed in the stomach via the nose to suction out the stomach contents. It is effectively used for those who take liquid poison orally. (3) gastric lavage) 1) Indications: Used for oral poisoning within 1 hour; for those who take slowly absorbed poison, gastric peristalsis is weakened or disappeared, the stomach should still be lavaged 4-6 hours after taking the poison. 2) Contraindications: Gastric lavage is not recommended for patients who have swallowed strong corrosive poisons, esophageal varices, convulsions or coma. 3) Gastric lavage method: When lavage is performed, the patient is placed in the left lateral position with the head slightly lowered and turned to the side. Apply a larger caliber gastric tube, lubricate with paraffin oil and send the gastric tube downward by the mouth for about 50 cm. If the gastric fluid can be drawn out, it is proved that the gastric tube is indeed in the stomach; if you are not sure whether the gastric tube is in the stomach, you can inject an appropriate amount of air into the gastric tube, and if you hear a “gurgling” sound in the stomach area, it is proved that it is in the stomach. First of all, suck out all the stomach contents and send them for toxicological analysis. Then, inject 200-300ml of warm water into the stomach each time. An excessive amount of injection will easily promote the entry of toxic substances into the intestinal cavity. When gastric lavage, repeated lavage is required until the lavage fluid is clear. The total amount of gastric lavage solution should be at least 2~5L, even 6~8L or more. When pulling out the gastric tube, the end of the gastric tube should be clamped first so that the liquid in the tube will not flow back into the trachea during the pulling process. 4) Choice of gastric lavage solution: According to the different types of poisons entering the stomach, the choice of gastric lavage solution is different: ① gastric mucous membrane protectant: when swallowing corrosive poisons, use raw milk, egg white, rice broth, vegetable oil, etc. to protect the gastrointestinal mucosa. ② solvent: oral fat-soluble poison (such as gasoline or kerosene, etc.), first 150 to 200 ml of liquid paraffin, so that it is dissolved and not absorbed, and then gastric lavage. ③ activated carbon adsorbent: activated carbon is a powerful adsorbent, can adsorb a variety of poisons. Toxic substances that cannot be well adsorbed by activated carbon are ethanol, iron and lithium. The utility of activated carbon is time-dependent, so it should be given within 60 minutes of ingestion. Activated carbon binding is a saturation process and requires the application of a sufficient amount of activated carbon over the poison to adsorb the poison. The first 1 to 2 g/kg with 200 ml of water should be injected by gastric tube and the application should be repeated at 0.5 to 1.0 g/kg for 2 to 4 hours until the symptoms improve. The ideal ratio of activated charcoal to relieve para-aminosalicylate poisoning is 10:1, and the recommended dose of activated charcoal is 25-100 g. The main complications of applying activated charcoal are vomiting, intestinal obstruction and aspiration pneumonia. ④Neutralizer: Strong acid is neutralized by weak bases (such as milk of magnesia, aluminum hydroxide gel, etc.), do not use sodium bicarbonate, because it can generate carbon dioxide when it meets acid, which inflates and expands the stomach and intestines, causing the risk of perforation. Strong bases can be neutralized by weak acids (such as vinegar, juice, etc.). ⑤ Precipitating agent: Some chemicals act with toxic substances to produce substances with low solubility and low toxicity, and thus can be used as gastric lavage agents. Calcium lactate or calcium gluconate interacts with fluoride or oxalate to produce calcium fluoride or calcium oxalate precipitate. 2% to 5% sodium sulfate interacts with soluble barium salt to produce insoluble barium sulfate. Physiological saline and silver nitrate to produce silver chloride. (6) antidote: antidote and the body of the remaining poison to neutralize, oxidation and precipitation and other chemical effects, so that the poison to lose toxicity. According to the different types of poison, choose 1:5000 potassium permanganate solution, can make the alkaloids, mycoses oxidation and detoxification. (4) diarrhea: after gastric lavage, instill laxatives to clear the intestinal tract poison. Generally do not use greasy laxatives, so as not to promote the absorption of fat-soluble poisons. Induced diarrhea commonly used sodium sulfate or magnesium sulfate, 15g dissolved in water, orally or by gastric tube injection. Excessive absorption of magnesium ion has a suppressive effect on the central nervous system. Renal or respiratory failure, coma and zinc phosphide, OPI poisoning in late stages should not be used. (5) Enema: In addition to corrosive poisoning, it is used for oral poisoning for more than 6 hours, ineffective induction of diarrhea and inhibition of intestinal peristalsis poisoning (barbiturates, belladonna or opioids). Apply 1% warm soapy water for several consecutive enemas. (1) Intensive diuresis and change of urine pH: 1) Intensive diuresis: The purpose is to increase the volume of urine and promote the excretion of toxic substances. It is mainly used for poisoning in which the poison is eliminated by the kidney in its original form. Intravenous fluids are selected according to plasma electrolytes and osmolality; those with heart, lung and kidney dysfunction should not use this therapy. The methods are: ① Rapidly infuse a large amount of 5%-10% glucose solution or 5% sugar saline solution, 500-1000ml per hour; ② Simultaneously inject 20-80mg of furosemide intravenously. 2) Change urine pH: According to the different pH of the poison after dissolution, choose the corresponding liquid that can enhance the elimination of the poison to change the urine pH: ① Alkalinize urine: weakly acidic poison (such as phenobarbital or ①Alkalinize urine: for poisoning with weakly acidic poisons (such as phenobarbital or salicylic acid), apply intravenous sodium bicarbonate to alkalize urine (pH≥8.0) to promote the elimination of poisons from urine; ②Acidify urine: for poisoning with alkaline poisons (amphetamine, stilbene and phencyclidine), infuse intravenous vitamin C (4-8g/d) or ammonium chloride (2.75mmol/kg, every 6 hours) to make urine pH.