At food poisoning prescribe a pathogenic therapy aimed at detoxification, restoration of water and electrolyte balance and hemodynamics.Medical tactics is defined first of all by the severity of illness, rather than its etiology. The first urgent medical event is gastric lavage 2 - 3 liters of warm boiled water, 2% sodium bicarbonate or 0.1% solution of potassium permanganate to obtain pure wash water. For this purpose the best use of a gastric tube. At presence at patients of a nausea and vomiting necessarily wash out a stomach, irrespective of time last from the beginning of disease. Patient should drink hot sweet tea. It is also necessary to warm the extremities (warmer to the feet). In the early terms of the disease are also recommended to use adsorbents (activated carbon, enteropolisorb, enterodez, etc.). Under indications use antispastic drugs. These activities are carried out in less severe food poisoning.
Patients who after gastric lavage are continuing nausea, vomiting, diarrhea, there are signs of dehydration I - II degree and mild or moderate intoxication, prescribe oral rehydration therapy and detoxication. For the treatment of diseased use of water-salt solution containing in 1 liter of boiled water 3.5 g sodium chloride, 2.5 g of sodium bicarbonate, 1.5 grams of potassium chloride and 20 g of glucose. Since ready-made solutions can be stored for no more than 12 - 18 hours, more convenient use of the drug glucosolan in batches, having of similar composition. Even more persistent storage are medications rehydron and tsitraglyukosolan in which sodium bicarbonate is replaced by sodium gidrotsitratom. Packet contents should be dissolved in 0.5 or 1 liter of warm boiled water. The patient should drink the solution for several hours at the rate of 1.5 volume of drinking solution on a volume of fluid lost with the faeces over the previous 4 - 6 h. If repeated vomiting solution can be administered via nasogastric tube. Water-salt therapy provides an opportunity to get both positive rehydration and detoxification effects.
In severe food poisoning, toxi-infectious shock, a pernicious vomiting, dehydration III, and sometimes IV degrees, rehydration prescribe by intravenous injection of warm polyionic solutions of "Trisol", "Hlosol", "Kvartasol" with rate 80 - 120 ml/minutes The total number of polyionic solutions depends on the degree of dehydration. While taking into account the data history, clinical picture, the results of emergency laboratory tests homeostasis, measuring patient weight, hemodynamic parameters and diuresis. When a reaction to the introduction of saline solution (chills, fever), the liquid is introduced slowly and in addition intravenous infusion system administered by 60 - 90 mg prednisone, 2% solution promedola in combination with 2.5% sodium pipolfena or 1% solution dimedrola (by 1 - 2 ml). Using unbalanced solutions (isotonic sodium chloride solution, 5% glucose solution) or colloidal blood substitutes (reopoliglyukina, poliglyukina) with significant dehydration can lead to development adrenal insufficiency
Of the features of the pathogenesis of food poisoning that antibiotics and chemotherapy in this disease is impractical because it promotes the release of an even greater amount of endotoxin, as well as the development of intestinal dysbiosis.
Question on hospitalization patient with alimentary toxinfections solve individually taking into account an epidemic situation and clinical indications. Patients with mild disease can be treated at home.
Hospitalization in the infection department to be patients with moderate and severe forms of food poisoning, and concomitant diseases, as well as those living in dormitories and related decreed contingents: workers of public catering, trade, children's kitchens, hospitals and health institutions. Hospitalization patient with alimentary toxinfections can be not only in infectious, but also in other units of hospital, equipped with medicines and equipment necessary for rehydration therapy, considering that alimentary toxinfections are not contagious diseases. Transporting patients by special transport.
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