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Venomous snakes are undoubtedly the most significant cause of both major morbidity and mortality among all terrestrial venomous and poisonous animals. Although poisoning by other animals may affect large numbers of people, mortality is comparatively rare, and thus venomous snakes are the leading cause of death from venomous and poisonous animals in all environments.
In some parts of the rural tropics,
snakebite is in the top 10 to 15
most important health problems.
2.54 million venomous snakebite and at least 125000 death per year.
Even though there are aproximately 3000 species of snakes globally, only about 600 species are venomous, and all of them are found in some snake families:
Colubridae
Elapidae: Walterinnesia aegyptia , Naja spp. or African and Asian cobras)
Hydrophidae
Snake venome generally consist of a complex mixture of substances, each of witch may exhibit one or more distinc toxic action.
Function: acquisition, digestion, defense.
water soluble
Acidy
1)Neurotoxin
Paralytic effect mediated at the neuromuscular junction.
Postsynaptic neurotoxin
Presynaptic neurotoxin
Anticholinesterase
2) Myotoxin
Systemic myolysis of skeletal muscle
Massive release of myoglobin, creatin kinase and potassium
3) Hemostatic system toxin
Interference with normal hemostasis causing either bleeding or thrombosis
4) Hemorrhagins
Vascular wall damage(endothelium ) causing bleeding
5) Nephrotoxins
Direct renal damage
6) Necrotoxin
Direct tissue injury at the bite site/bitten limb
Local effect
Bit mark vary from a single fang puncture to classic double puncture from paired fangs. Local swelling, erythma, hemorrhage, blistering, frank necrosis.
General effect
Headache, nausea, vomiting, abdominal pain, diarrhea, dizziness, collapse, hypotension/hypertension, tachycardia/bradycardia and ….
Specific effect
Paralysis: That caused by neurotoxins affects skeletal muscle and respiration muscle.
Ptosis, dysphonia, droolin and diplopia.
Myolysis: Muscle pain, tenderness, weakness and paralysis, myoglubinuria.
Cardiotoxicity: arrhythmias to cardiac arrest
Coagulopathy and hemorrhaging effect
Pain; Inflammation (++)
Nausea & vomiting
Drowsiness
Blurred vision
Lethargy
Weakness
Paralysis of skeletal and respiratory
Lower necrosis and hemorrhage of the site
Pain and inflammation(+++) improve in organ
Higher necrosis and hemorrhage at the site
Hemorrhage from Other site (GI, GU, ORAL)
Nausea & vomiting
Weakness
Drowsiness
Lower paralysis
Coagulation disorder
Pain and inflammation (+)
High muscle pain
Drowsiness
Nausea and vomiting
Paralysis skeletal and respiratory
Myoglubinuria (urine color)
Pressure Immobilization? For bites by nonnecrotic species includig many elapidae ( but not most cobras) is both safe and effective.
Incision and suction?
Cutting :× or ІІІ and suction
Tourniquet(±): good for hydrophidea
Ice compress(-)
Gently washing : N/S or diluted betadin
NSAID
Tetabulin
FFP (after antiserum)
Prophylaxy antibiotic (no recommended)
AB: ( metronidazol, cephalosporine)
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