Snake toxicology

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2021年5月13日 (木) 17:08時点におけるVaccipedia.admin (トーク | 投稿記録)による版 (→‎treatment)
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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

  1. reassure
  2. immobilise whole body, esp. bitten limb
  3. remove tight rings etc.
  4. apply pressure pad/bandage on bitten sites
  5. 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