2,994
回編集
差分
ナビゲーションに移動
検索に移動
編集の要約なし
{{TM menu}}
==epidemiology==
*all continents have venomous snakes
*Papua New Guinea >300
*many survivors suffered from serious disability > 60,000 DALYs
==species==
*''Viperidae''
*''Elapidae''
*''Lamprophiidae''
*''"Colubridae"''
*1/4 of snakes are venomous
==venom==
*enzymes, proteins, polypeptides
*90% dry weight
*>100 different agents in each venom
*≈50% of all snake bites by venomous snakes inject no venom - "dry bites"
**traditional but dangerous and not effective therapies mimic effective
*neurotoxic
*coagulation inhibition
==first aid==
#reassure
#immobilise whole body, esp. bitten limb
#remove tight rings etc.
#apply pressure pad/bandage on bitten sites
#consider to give anticholinestarase
===never do===
*vacuum extractor
*too tight bandage
*incisions
==physical exam==
*exclude shock/hypovolemia
**postural hypotension
*exclude neurotoxicity
**bilateral ptosis, let patient look upward
*exclude coagulopathy/bleeding
**20 min whole blood clotting test - always use glass container
==snake bites in Japan==
