「Snake toxicology」の版間の差分
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| 25行目: | 25行目: | ||
*coagulation inhibition | *coagulation inhibition | ||
| − | == | + | ==first aid== |
#reassure | #reassure | ||
#immobilise whole body, esp. bitten limb | #immobilise whole body, esp. bitten limb | ||
| 37行目: | 37行目: | ||
*incisions | *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== | ==snake bites in Japan== | ||
2021年5月13日 (木) 17:08時点における版
epidemiology
- all continents have venomous snakes
- America 4,000 deaths
- Africa >>20,000 (too under-reported)
- Asia >75,000
- India 58,000
- Japan ≈10 deaths amongst 2-3,000 bites
- Europa <50
- Papua New Guinea >300
- many survivors suffered from serious disability > 60,000 DALYs
species
- Viperidae
- Elapidae
- Lamprophiidae
- "Colubridae"
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
