Environmental Emergencies 2
|Brown Recluse bite usuallyy causes a local skin reaction, some severe enough to require |
|skin graft. |
|Rare systemic effects in younger children.|
|No significant alteration of necrosis from the venom by steroids, heparin, dapsone, or HBO.|
| Dapsone should not be used in children due to the risk of methemoglobinemia. Used only in |
|adult with proven bite.|
|Antivenom is not yet commercially available.|
Heat cramps - occur after the work is done, on relaxing, or on taking a cool shower.
- abdominal muscle cramps may simulate an acute abdomen.
- victim is highly conditioned and acclimatized.
- adequate fluid replacement but inadequate salt replacement.
Heat Exhaustion - 2 types, water depletion and salt depletion.
- thirst, headache, vomiting, lethargy, cramps
- temp around 39.
Heat Stroke - overdressed Infant, Infant in cars, exertion (new athlete), phenothiazine
- Temp > 41
- Circulatory Collapse
- CNS dysfunction
- rhabdomyolysis and renal failure.
|These larvae of nematodes ( hookworm=ankylostoma) can penetrate intact skin.|
|Common in tropical regions, especially on beaches, effects butts and feet.|
|Itchy papules at the entry site with a migratory, raised, erythematous, serpiginous pattern.|
|Can reach lungs and cause eosinophilic pneumonitis (Löeffler syndrome)|
|Albendazole or mebendazole can be used for treatment, some times steroids.|
There are 2 species of poisonous snakes found in USA - PIT VIPERS and CORAL SNAKE.
Features of PIT Vipers which differentiate them from Non Poisonous Snakes -
(i) Two pits with heat-sensitive organs that assist these poor-visioned reptiles to localize their
prey are located on each side of the head, between the eye and nostril;
(ii) Two pupils are elliptical and vertically oriented;
(iii) Two curved fangs or hollow maxillary teeth are folded posteriorly against the palate and
advance forward when the pit viper strikes;
(iv) Head is relatively more triangular; and
(v) Scutes, or scales, on the ventral portion caudad to the anal plate continue in a single
row, whereas nonpoisonous snakes have a cleft, or double row.
PIT Vipers eg. - copper head, diamond back,Rattle Snake, sidewinder and water moccasin.
Cause local and multisystem effects ( CVS, RS, Renal, Neuro, Hematologic)
Rx - CroFab® (Crotalidae Polyvalent Immune Fab) if presents within 12 hours.
Blunt head, round pupils, ventral caudal scutes, two small maxillary fangs and lacks pits.
Red on yellow, kill a fellow. ( Coral Snake )
Red on black, venom lack. (King Snake, non poisonous)
Coral snakes cause less local effects but disabling
Antivenom is available for eastern coral snake.