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VENOUM SNAKE BITES, image, image, image, image, image, image, image, image…
VENOUM SNAKE BITES
VIPERIDAE
Treatment
First option: Ceftriaxone + Clindamycin or Ceftriaxone + Metronidazole
Second option: Ampicillin + Sulbactam
Bothriechis schlegelii, Bothriopsis bilineata smaragdina, Bothriopsis pulchra, Bothriopsis taeniata, Bothrocophias campbelli, Bothrocophias hyoprora, Bothrops asper, Bothrops atrox,
Clinical manifestations
Systemic
Acute kidney failure
Cardiovascular shock
Hypovolemia
Hemorrhage
Rhabdomyolysis
Coagulation disorders
Local
Ecchymosis, hematoma and phlyctena
Pain
Tissue destruction (rupture and cell necrosis)
Swelling
ELAPIDAE
Hydrophis platurus, Micrurus ancoralis, Micrurus bocourti, Micrurus dumerilii transandinus, Micrurus helleri, Micrurus langsdorffi, Micrurus melanotus, Micrurus mertensi , Micrurus mipartitus decussatus, Micrurus multiscutatus
Clinical manifestations
Local
Mild or moderate edema with or without significant local reaction (phlictenes)
Localized paresthesia in the bite area
Pain
Systemic
Bradycardia
Dyspnea
Hypotension
Gait imbalance
Altered state of consciousness
Neurological
Bilateral palpebral ptosis (neurotoxic facies)
Trismus
Alteration in the articulation of language
Sialorrhea
Diplopia due to ophthalmoplegia
Blurred vision
Loss of head support
Others
Oliguria
Nausea and vomiting
Prolongation of clotting times
Rhabdomyolysis
Treatment
Specific
anticoral antiophidic serum (antielapidic- antimicrúrico)
neostigmine: initially administer intravenously 10 vials of SAO-C dissolved in 500 ml of 0.9% S.S in adults and 250 ml of 0.9% S.S in pediatric patients
General
General assessment of the patient's hemodynamic status
Hydration with crystalloid
In case of pain, administer centrally acting analgesics
Tramadol: Adults, 50-100 mg every 6-8 hours PO or IV.
Paracetamol: Adults, 0.5 g to 1 g every 6 hours, maximum 4 g per day.
Children, 10-15 mg/kg/dose.
