Paraquat, also known as paraquat and gramoxone, is a chemical name of 1,1-dimethyl-4,4′-bipyridine cation, usually made into dichloride, is pure white crystal, stable in acidic and neutral solution, hydrolyzed by alkali. Commercial mostly 20% solution, and add coloring agent, odorant and vomitogenic agent, dark green. It is commonly used in rural areas. Most of the poisoning is self-inflicted or accidentally taken. Paraquat is very toxic to human and there is no special drug. The mortality rate of oral poisoning can be more than 60%, so it has been banned or strictly restricted by more than 20 countries. China failed to reach an agreement to ban or severely restrict the use of paraquat in the Beijing meeting in June 2011. Therefore, paraquat poisoning rescue and treatment is still the focus of prevention and treatment today and even in the future. Some scholars suggested that paraquat should be graded according to the concentration of paraquat in blood or urine, but it is difficult to operate because this technique is less developed. Third, the focus of rescue and treatment: rescue and treatment process: 1. blocking toxic absorption 1.1 emetic, gastric lavage and adsorption (whole gastrointestinal decontamination) Start gastric lavage within 10 minutes of consultation in the emergency room or emergency department. gastric lavage solution can be water or 2% sodium bicarbonate solution, and gastric lavage solution is usually not less than 5L until colorless and tasteless. Upper gastrointestinal bleeding is not a contraindication to gastric lavage, available 8% mg norepinephrine saline gastric lavage. After gastric lavage, 300-500ml of 15% bleach solution or 100g of activated carbon (or 2g/kg) should be injected into the gastric tube, and bleach should still be taken frequently after the gastric tube is removed to remove the poison from the oral esophagus. 1000ml of bleach solution can be used for 24 hours, and gastric motility drugs such as morpholine and mosapride should be given after gastric lavage. 1.2 Induced diarrhea Discharge of bleaching earth within 12 hours of poisoning is successful in inducing diarrhea. After gastric lavage, a variety of effective diarrheal measures can be used according to the intestinal sounds. 30g of rhubarb, 30g of mannitol, 30g of licorice while auxiliary diarrhea, daily decoction or free decoction punch is taken to keep 1-2 times of daily stool, and later still need to take bleaching earth frequently for 3-5 days, and 500ml of 15% bleaching earth daily. 2. Promote the discharge of poison 2.1 Rehydration and diuresis Patients with acute paraquat poisoning are all dehydrated to some extent. Proper rehydration combined with intravenous diuretic is beneficial to maintain proper circulating blood volume and urine volume [1-2 mL/(kg?h)], which may be beneficial to the maintenance of renal function and excretion of paraquat. However, rehydration diuretic therapy requires attention to the patient’s cardiopulmonary function and urine output. 2.2 Hemopurification therapy is effective, but needs to be implemented as early as possible, and the effect is discounted beyond 24 hours, especially after exudative changes in the lungs, hemodialysis clears the intravenously applied drugs, which will discount the effect of glucocorticoids and aggravate the condition instead. It is recommended to use the method of blood perfusion + blood filtration to clear it, try to do it within 2-4 hours, the blood toxic concentration or oral amount decides to use one or more perfusers at a time, because paraquat is almost free in plasma, it is not recommended to perform the method of plasma replacement. 3. Drug treatment 3.1 Glucocorticoids and cyclophosphamide Early combined application of glucocorticoids and cyclophosphamide shock therapy may be beneficial for patients with moderate to severe acute paraquat poisoning. Once the lethal amount (>1g) is reached orally, the application of adrenocorticosteroids should be started. 80mg of methylprednisolone into the pot q6h×7 days, reduce the amount of 80mg into the pot q8h×7 days and gradually reduce the amount, the reduction should start after the lung lesion improves. Usually the course of treatment is not less than 2 weeks. Cyclophosphamide: previously 0.3ivgtt1/day×7 days, is currently being explored stage,can be done as an option, the appearance of limited lesions in the lung is an indication for the application, and diffuse lesions appear treatment ineffective, this method is not necessary, the general total amount does not exceed 4 g. We do not advocate the adaptation of cyclophosphamide and other immunosuppressive agents. 3.2 Antioxidants Alto Moran and high-dose vitamin C can be used with certain efficacy. 3.3 Chinese medicinal preparations Blood Bebop, Salvia preparations, Shuxinin, etc. Only animal experiments and a few cases have been observed. 4. Symptomatic support 4.1 Oxygen therapy Patients with acute paraquat poisoning should avoid routine oxygen administration. Based on the current understanding of toxicological mechanism of paraquat poisoning, it is suggested that Pa02<40 mmHg(5.3 kPa) or ARDS should be considered as the indication of oxygen therapy. 4.2 Application of antibiotics Because acute paraquat poisoning can lead to multi-organ damage, coupled with the use of glucocorticoids and immunosuppressants, prophylactic application of antibiotics can be considered, and macrolides are recommended, which may have a role in preventing and treating pulmonary fibrosis. Once there is definite evidence of infection, strong antibiotics should be applied immediately in a targeted manner. 4.3 Antiemetic In patients with frequent vomiting, use 5-hydroxytryptamine receptor antagonists or phenothiazine antiemetics to control symptoms. Avoid dopamine antagonists such as gastrodiazepines, which may diminish the restorative effect of dopamine on renal function.