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Arabian cobra, which has neurotoxic effects leading to bulbar and respiratory paralysis saw scaled vipers (the most common snakes in Saudi Arabia), which cause severe homeostatic disturbance
Viperidae
Venom : it is a special category of toxic substance that secreted by secretory glands of animals.
Snake venom is a highly modified saliva which is
Hematologic toxicity
Many snake venom produce anticoagulant effect by interfering with activation of clotting factors Local features: Puncture marks rapid swelling discolouration blister formation bleeding from bite site severe pain Generalised bleeding manifestations epistaxis hemoptysis bleeding gums hemauria Hemolysis lead to Renal failure
Neurologic Toxicity
Systemic features: curare like & cranial nerve affection preparalytic stage : emesis, headache
paralytic stage
ptosis, ophthalmoplegia drowsiness dysarthria dysphagia convulsions bulbar paralysis resp failure.
Cardiovascular Toxicity
Hypotension and or cardiovascular shock These effects may be due to release of mediators, increased capillary permeability and reduced cardiac output
Renal Toxicity
Acute renal failure may develop due to either direct venom action or as a complications of anticoagulant effect, cardiovascular shock or hemolysis.
First aid
Investigations/laboratory tests
Antivenom treatment Supportive treatment Treatment of Treatment of
FIRST AID
Assurance of the bitten person. Immobilize the bitten area & keep it
CLINICAL ASSESMENT
VITAL SIGNSPULSE
# Lab. Investigations
Haematologicalleucocytosis(>20,000severe envenomation) thrombocytopenia evidence of hemolysis prolonged CT,PT,PTT
ECG: bradycardia
Urine
hematuria, proteinuria, Hburia Renal : urea, creatinine. Chest XR : pulm.edema intrapulm.Hgs pleural effusion Immunodiagnosis: by immunoassay techniques
Antivenom Treatment
Antivenom is an immunoglobulin purified from the
serum or plasma of a horse or sheep that has been immunised with the venoms of one or more species of snake.
Monovalent
or monospecific antivenom neutralises the venom of only one species of snake. the venoms of several different species of snakes
Antivenin has been started Choice of it , its route, amount (depend on species, site and size of person) e.g.
SERUM SICKNESS
ANAPHYLAXIS
A very serious fatal reaction
smooth
muscle
contraction:
angioedema.
Escape
of
fluid
oedema.
Arrhythmias and cardiogenic shock.
TREATMENT:
Stop ANTIVENOM. ADRENALINE SLOWLY IV. Give intravenous fluids as fast as necessary
Oxygen mask. Intubation or tracheostomy if necessary. If cardiac arrest occurs CPR and electrical
cardio version.
Observe in hospital for 24 hours after
recovery.
SERUM SICKNESS:
7 to 14 days after antivenom.
Skin rashes, angioedema, glandular swelling and joint
pains.
Develops because of antibodies formed against horse
serum.
TREATMENT: Antihistamine and steroids
SUPPORTIVE CARE
ANTIBIOTICS AND ANTI-TETANUS
Mechanism of toxicity
The venom contains numerous digestive enzymes and several neurotoxins. These neurotoxins can cause alterations in sodium channel flow, resulting in excessive stimulation at neuromuscular junctions and the autonomic nervous system (autonomic storm).
Clinical presentation
Most stings result only in local manifestations: burning pain local tissue inflammation numbness and local paresthesis.
In some victims, especially children under age 10 years, Severe pain may be followed by sweating, restlessness Diplopia, nystagmus Vomiting, muscle fasciculation, fever Hypertension, tachycardia Convulsion, paralysis and respiratory arrest.
Diagnosis
The diagnosis is essentially clinical. Due to the quick and intense local pain, the scorpion is often noticed laboratory often shows leukocytosis
Treatment
Healthy adults may not need further treatment. First Aid:
Wash the wound with soap and water.
Apply cold compresses to the affected area to decrease
the pain and slow the venom's spread. This is most effective in the first two hours after a sting occurs.
Try to stay calm so that the poison spreads more slowly.
breathing.