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26 Cards in this Set
- Front
- Back
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% venomous snake bites and % venom injected? # deaths/year
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10% 10-70% inject venom - 50-100K
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5th most import cause of death in Burma
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Russell's Viper
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Families of snakes
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Viperdae - Cotalinae -ratt, moc, vip
Viperinae-Rus vip, saw tail carpet viper Elapidae - Cobra of A and A, mambas, kraits, coral, Aust tapan, adder, sea snakes Hydrophiida - true sea snakes (some call elapids) Colubridae - Af boomslang, E As Yamagashi Atractaspdidae - burrowing snake, stiletto snake |
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Toxins are
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protein
cytolytic enzymes - digestive cause local nec & procoagulant enz cause consumption coagulapathy Metlloproteinase - dam vascular epi platelet activators and inhibitors anticoags pp post synaptic neurotoxic and myotoxic activ |
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describe crotalid
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rattlers - cytotoxic toxin. swelling, edema, local pain 10 min. skin discolor, ecchymosis over several hours. weakness, sweating, nausea
local inj to local tissue |
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Describe Viperinae
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relatively local cyto, hematologic. bleed from gums and wound. impairment of coag - prol blding time, circulatory collapse
Russell's is more neurotoxic, hemolytic - can test for coags in lab |
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Describe Elapid
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Cobra - neurotoxic
pain 10 min, slow inset swelling, weakness, salivation, paralysis of face, lips, tongue, larynx. eventual flaccid paralysis, ptosis, headache, convulsion. |
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Other Elapids besides Cobra, describe effects
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Asian cobra and spitting cobra - large, local sytotox
Aust & N Guinea - neuro, rhabdo, hemolytic Coral - little local effects, delayed neuro, no coag |
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Hydropiidae
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True sea snake - neurotox, cytotox
mild local pain, skel mm pain with mvment, parasthes of tongue mouth, diff swallowing, trismus, ptosis, pupill dilatation - renal failure |
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Describe Colubrid effects
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Af Boomslang, yamagashi
hematologic, cytotox mild local delayed systemic N/V abd pain, bleeding, DIC like pic, death later to renal |
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Describe Atractaspididae
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burrowing asp, stiletto
cyto, no true neuro tox p/sw/blistering/local nec/f/n/v gen weakness/shock/mycard ischemia no antiven available |
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Tx from snake bite
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NO - local inc/suction/cryotherapy/electric shock/ tourniq
IMMOBILIZE TO REDUCE SPREAD OF VENOM |
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What is purpose of press immobiliza bandage
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constricts lymph but not arterial flow
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When do you immobilize w P
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Aust elapids. hypotension when release due to venom bolus
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Should you use immobil- P for crotalids
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no, prim neurotoxic
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Describe first aid for snakebite
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Airway, Breathing, Circ
Control pain but no aspirin, Nsaids Control V and position pt. |
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ANTIVENOMS - how derived
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bovine or ovine iggs, sig risk of serum sickness and allergic rxn - up to 80% anaphylaxsis - consider use .1% epi
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When to use antivenom, for sure
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All coral snakes, crotalids and cobras.
evidence of shock/neurotox/prog necrosis/nephrotox/coag disorder |
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What to watch for in Allergic rxn
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Anaphyl/anaphylactoid rxn - hypoten, bronchospasm, urticaria. Tx: epi, antihist, steroids
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What to watch for with Serum Sickness
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Rash, fever, arthralgias, adenopathy 3 d- 3 w later. Glomerulonephritis, neuritis
Tx: antihis/steroids |
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Pain mgmt for snake bite
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supportive care: ventilation, pressors, dialysis prn
prophy antibiotics for lg necrotic lesions, debride,drain, fasciotomy if compartment pressure elevated. surg interventions - wait for hemostasis |
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Describe venomous lizards
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Gila - Heloderma suspect
Mexican bearded lizard- heloderma horridom Venom in Saliva Pain for months no ice/no abx |
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paralytic shellfish poisoning comes from what and describe
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dinoflagellate seen in red tides- saxitoxin.
Temp areas - late spring - early fall. concentrted by bivalves. HStabile neurotox CLAMS AND MUSSELS |
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What is diaahretic shellfish
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N/V SELF LIMITING fish and bird die offs |
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Neurotoic shellfish poisoning from
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Brevetoxins
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Amnesic shellfish poisoning
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Prince Edward Island - gi to severe neuro, even death
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