#Zhuzhou headlines##湖南省直中医医院#
Confusion, trismus, salivation at the corners of the mouth, spasms of the limbs... Recently, 70-year-old Grandpa Yin mistook topical Chinese medicine powder containing aconitine and developed confusion, malignant arrhythmia, and was dying.
On that day, Grandpa Yin mistakenly consumed the external Chinese medicine powder as pepper due to epigastric discomfort, and then developed numbness, dizziness, vomiting, and chest tightness. By the time he arrived at the hospital, he was in shock, restless, short of breath, and in critical condition. After careful questioning of his family by the emergency physician, it was learned that he had mistakenly taken a topical Chinese medicine powder containing aconitine (main ingredients: raw aconitum, raw aconite, strychnine, snow artemisia, morning glory, asaroxin, raw banxia, raw Aracea, frankincense, and myrrh).
The medical staff of the acute and critical care medical center immediately activated the poisoning emergency plan, and carried out a series of life support treatments such as rapid fluid rehydration, deep venous catheterization to pump drugs to raise blood pressure, emergency gastric lavage, endotracheal intubation, ventilator assisted breathing, and safely escorted the patient to the intensive care unit for further treatment.
After the patient is transferred to the intensive care unit, he is immediately given continuous blood purification to remove residual aconitine from the body, continued fluid rehydration to promote toxic excretion, antiarrhythmic and other symptomatic supportive treatments. Due to the accurate diagnosis, timely rescue, and appropriate measures, Grandpa Yin's condition has improved day by day, and he has recovered and been discharged from the hospital.
Popular science knowledge
What is aconitine and why is it so toxic?
Aconitine is the main medicinal ingredient existing in the Chinese medicinal materials of the genus Aconitum in the family Trichoaceae, such as Chuanwu, Caowu, (Aconitum aconitum), Artemisia snow and other plants, aconitine is the most toxic, pure aconitine 0.2mg can cause toxic effects, 2-4mg can lead to death. Aconitine mainly damages the heart and nervous system and can cause serious symptoms such as irregular heartbeat, heart failure, difficulty breathing, coma, and may even lead to death.
Cause of poisoning
1. Accidental ingestion: taking crude drugs, taking external drugs internally, taking medicinal wine or taking it with alcohol;
2. The dose is too large: The "Chinese Pharmacopoeia" stipulates that the common dosage of Chuanwu and Caowu is 1-3g, 3-10g of aconite, and the maximum usable is 30g;
3. The decoction time is short: the decomposition of aconitine is not complete, and it is not completely hydrolyzed into benzoyl aconitine and acetic acid with weak toxicity;
4. Poor processing quality: the processing process does not follow the national standards for the processing of traditional Chinese medicine;
5. Individual differences: due to different constitutions and different drug resistance, the elderly and infirm, and those with liver and kidney insufficiency are prone to poisoning.
What to do if aconitine poisoning is suspected?
1. Immediately induce vomiting and minimize the absorption of poison: immediately drink a large amount of warm water or warm salt water, and then irritate the throat with your hands or chopsticks and other items to promote vomiting.
2. Dial 120 or send to the nearest medical institution quickly to avoid delaying the best time for treatment. It is best to keep some of the decoctions or medicinal wines that have been consumed and give them to the doctor for identification to clarify the cause and facilitate symptomatic treatment.
Hunan Medical Chat Special Author: Rong Lihui, Emergency Department, Hunan Provincial Hospital of Traditional Chinese Medicine
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(Editor YH)