1/14. Delayed antivenom treatment for a patient after envenomation by crotalus atrox.Bites by the Western diamondback rattlesnake (crotalus atrox) are the most common cause of envenomation in texas. We describe a patient who had delayed administration of antivenom after envenomation by C atrox. Because of an initial adverse response to a test dose, the patient had been unwilling to receive antivenom therapy. When compartment syndrome developed 52 hours after envenomation, however, the patient consented to antivenom therapy as an alternative to fasciotomy. We documented a decrease in compartment pressures and resolution of thrombocytopenia that was concomitant with antivenom administration.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/14. Two cases of bites by the black-bellied swamp snake (Hemiaspis signata).We report two cases of envenomation by the black bellied swamp snake, Hemiaspis signata, with expert identification of the snakes. In the first case a 12 year old boy, who after the removal of the pressure immobilisation bandage, developed decreased fibrinogen levels and positive cross-linked fibrinogen degradation products (XDPs), but normal prothrombin time and activated partial prothrombin time. These changes resolved over 8h with no treatment. In the second case a 7 year old boy had local pain, swelling and axillary lymphadenopathy following the bite. These cases indicate the potential for coagulopathy and local symptoms following bites by large specimens of H. signata in young children.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/14. biology and treatment of the mamba snakebite.Mambas are venomous African snakes that are capable of inflicting fatal envenomation. The mambas (genus Dendrosaspis) are members of the family elapidae [1]. Four species of mamba inhabit equatorial and southern africa. Without medical treatment, mamba bites are frequently fatal. first aid treatment includes lymphatic retardation with immobilization and pressure wrap. Medical management requires the intravenous administration of mamba-specific antivenin.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/14. Bites by puff-adder (Bitis arietans) in nigeria, and value of antivenom.Ten patients bitten by the puff-adder (Bitis arietans) were studied in the North of nigeria. Six showed severe local signs, and four also had evidence of systemic envenoming, including spontaneous bleeding with thrombocytopenia, hypotension, and bradycardia. Two patients died after developing circulatory collapse and renal failure. Antivenom and intravenous fluid restored blood pressure in two hypotensive patients, and antivenom probably prevented the development of local necrosis in four others with massive local swelling. Victims of B arietans who have swelling of more than half the bitten limb or show signs of systemic envenoming should be given at least 80 ml of specific polyvalent antivenom and watched carefully for signs of circulatory collapse. debridement of necrotic tissue may be necessary.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/14. A snake in the clinical grass: late compartment syndrome in a child bitten by an adder.Snakebite envenomation is an uncommon condition in the UK, but requires vigilance with regard to both the systemic effects of the venom and the locoregional impact on the soft tissues. We describe a case requiring delayed fasciotomies for closed compartment syndrome of the leg and thigh, and discuss in detail the controversies surrounding decompression in such a case. Adder bites are uncommon in the UK, but can result in envenomation of varying severity. Apart from the numerous possible systemic effects that require attention, there are local effects that, very rarely, can be limb threatening. Of these, elevated limb compartment pressures are of paramount importance, and recognition of closed compartment ischaemia is vital if the limb is to be saved by surgical decompression. Guidelines on threshold compartment pressures and fasciotomies are indistinct regarding snakebite, with diagnostic emphasis still placed on clinical signs and symptoms. In the paediatric setting, measurement of compartment pressures is a valuable adjunct to clinical suspicion in the diagnosis of acute compartment syndrome secondary to snakebite.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
6/14. Femoral vessel entrapment and compartment syndromes following snakebite.A 15-year-old patient who had been bitten on the ankle by a snake presented with swelling extending to the chest wall, with significant haemostatic abnormalities. Compartment and femoral vessel entrapment syndromes are presented. Compartment syndrome is easily mimicked by snakebite without a compartment syndrome. Current measurement of intracompartmental pressure, diastolic or mean arterial blood pressure and resulting equations used to determine the need for fasciotomy do not take into account regional venous or arterial pressures. Combined vessel entrapment and compartment syndromes due to snakebite warrant urgent surgery once hypovolaemia and coagulopathy have been controlled.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
7/14. Fatal cerebral haemorrhage after tiger snake (Notechis scutatus) envenomation.OBJECTIVE: This case report illustrates the threat to life posed by tiger snake venom-induced coagulopathy, the importance of first-aid, precautions with antivenom administration, the dose of antivenom and the necessity to monitor the coagulation status. CASE SUMMARY: An 11-year-old child was envenomated several times by a tiger snake (Notechis scutatus). Despite administration of three ampoules (9000 units) of tiger snake antivenom, fatal cerebral haemorrhage occurred. Inadequate first-aid had been applied. The bite site was covered with a loose bandage instead of a pressure-immobilisation bandage. In hospital, facilities to monitor coagulation status were unavailable. CONCLUSIONS: More public education is required in first-aid management of snake envenomation. Frequent monitoring of coagulation status is necessary to optimise antivenom and coagulation factor therapy.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/14. Ten years of snake bites at Fremantle Hospital.Seventy-six patients (30% children) were admitted to Fremantle Hospital over 10 years with suspected snake bite. Twenty-nine patients were definitely bitten, with 26 bites being witnessed. Of the 13 patients definitely envenomated, 11 had a coagulopathy although seven were asymptomatic; four other patients may have been envenomated. The dugite (Pseudonaja affinis) was probably responsible for most envenomations. Eleven of the 13 envenomated patients received antivenom (six brown snake, four polyvalent and one tiger snake antivenom). The patient envenomated by the tiger snake (Notechis ater occidentalis), a 13-year-old girl, was initially incorrectly treated with brown snake antivenom at a country hospital, and did not receive appropriate antivenom until 50 hours after the bite. She developed profound paralysis, rhabdomyolysis and renal failure, and required prolonged ventilation during her 53-day hospital admission, but survived without disability. Snake bite wounds should not be washed, so that venom can be identified from the wound. Attempts to kill snakes are dangerous, often leading to bites on the fingers. first aid measures of a pressure bandage and immobilisation, used in 13 of the 29 cases (45%), should be more widely publicised.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/14. lower extremity compartmental syndrome following snake-bite envenomation--one case report.Acute compartmental syndrome develops when the intracompartmental pressure rises rapidly, even if only for a short duration. Loss of function and/or viability of the intracompartmental muscles may occur within a short period. Consequently early recognition and management are essential. We report a case where a young child with severe snake bite envenomation who and acute compartmental syndrome who had complete functional recovery following emergent fasciotomy and delayed primary closure.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/14. Severe myonecrosis in a fatal case of envenomation by the canebrake rattlesnake (crotalus horridus atricaudatus).Severe myonecrosis was found at autopsy in a fatal case of envenomation by crotalus horridus atricaudatus. The degree and extent of rhabdomyolysis were independent of the site of muscle sampling, being no more advanced at the site of envenomation. We conclude that myonecrosis was not enhanced by increased interstitial pressure.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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