الرحمن الله بسم الرحيم

Animal Poisoning Animal Poisoning (Envenomations)(Envenomations)

مدبولى/ جودة المنعم عبد ددكتوراة الطب الشرعى و السموم األكلينيكية,

مدرس الطب الشرعى و السموم األكلينيكية,استشاري عالج التسمم بمستشفى بنها الجامعى

Objectives (ILOs)Objectives (ILOs):

Types & Incidence. Study of some types: (Snake & ScorpionSnake & Scorpion)1. Animal ch.ch..2. Mechanism of action3. Clinical presentation4. Diagnosis & DD.5. Treatment & prevention.

Types & incidenceTypes & incidence:

50% …………. Insect sting.30% ………… Snake bite.14% ………… Spider bite.6% other ……………….

فى هنا فى األحصاءات هنا األحصاءاتمصر؟؟؟؟؟؟؟؟؟؟؟مصر؟؟؟؟؟؟؟؟؟؟؟

Snake bite

Poisonous & Non-poisonous snakes:

Non Poisonous Snakes: Head – ---------- Rounded Fangs - --------- Not present Pupils –--------- Rounded Anal Plate ----- Double row of plates Bite Mark ------ Row of small teeth.

Poisonous Snakes: Head -------- Triangle - except Cobra Fangs –--------- Present Pupils ----------- Elliptical pupil Anal Plate ------ Single row of plates Bite Mark ------ Fang Mark

I- Elapidae (Cobra or Krait): Mild Local symptoms: Mild Local symptoms: 1- No swelling1- No swelling 2- painful + necrosis2- painful + necrosis

Marked Neurotoxic effects:Marked Neurotoxic effects:1. Earliest symptom – Vomiting, Shock and

Muscle weakness. 2. Early paralysis: Ptosis- inability to keep

Eyes open. 3. Spreading Paralysis -causing difficulty in

speaking and breathing, Salivation,. Frothing around mouth.

II- Viperidae:

Local symptoms : 1- Severe swelling (massive) 2- Pain + Necrosis

Vomiting, shock (early e’in 30 mints).

Marked VasculotoxicVasculotoxic effects. Bleeding from mucous membrane of the Mouth, Nose and hemorrhages under the skin.

III- Hydrophidae (Sea Snakes): No Local symptoms.

Severe Pain whileSevere Pain while moving Neck, Trunk and Limbs. A few hours later (myalgia).(myalgia).

Acute renal failureAcute renal failure = Urine turns Brown to Black due to the presence of muscle protein Myoglobin Myoglobin.

Management: I- Basic first-aid techniques (Pre-

hospital): Remain calmcalm. Immobilize with a splintImmobilize with a splint the bitten

area and keep it at body level.

Allow wound to free bleed <30 Allow wound to free bleed <30 secsec, Wash with soap & waterWash with soap & water.

Get medical helpmedical help. +/_+/_ If a victim is unable to reach medical

care within 30 minutes, a bandagea bandage, wrapped two to four inches above the bite, may help slow venom.

A suction device (Extractor)A suction device (Extractor) may be placed over the bite to help draw venom out of the wound without making cuts. Suction instruments often are included in commercial snakebite kits.

Allay anxiety and fright: DeathsDeaths have been reported from shock shock

due to frightdue to fright even when the bites were by non-poisonous snakes.

1.1. Not all snakes are poisonous.Not all snakes are poisonous.2.2. Not all poisonous snakes are fully charged Not all poisonous snakes are fully charged

with venom.with venom.3.3. Even those that are fully charged do not Even those that are fully charged do not

always inject a lethal dose.always inject a lethal dose.Keep bitten extremity at body levelKeep bitten extremity at body level,

when the person is lying. Raising it can cause venom to travel into the body. Holding it down, can increase swelling.