DOCSLIB.ORG

Bites and Envenomations

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Bites and Envenomations Bites and Envenomations History Signs and Symptoms Differential Type of bite / sting Rash, skin break, wound Animal bite Description or bring creature / Pain, soft tissue swelling, redness Human bite photo with patient for identification Blood oozing from the bite wound Snake bite (poisonous) Time, location, size of bite / sting Evidence of infection Spider bite (poisonous) Previous reaction to bite / sting Shortness of breath, wheezing Insect sting / bite (bee, wasp, ant, Domestic vs. Wild Allergic reaction, hives, itching tick) Tetanus and Rabies risk Hypotension or shock Infection risk Immunocompromised patient Rabies risk Tetanus risk Universal Patient Care Protocol Animal bites: Document contact No EMS transport ? with Animal Control Officer if not transported Yes Pain Control Protocol Position patient supine Trauma Protocols Immobilize area or limb Refer to Pain Control Protocol if there is Legend significant pain MR If there is allergic reaction refer to Allergic B EMT B Reaction Protocol I EMT- I I P EMT- P P Notify Destination or M Medical Control M M M Contact Medical Control Pearls Recommended Exam: Mental Status, Skin, Extremities (Location of injury), and a complete Neck, Lung, Heart, Abdomen, Back, and Neuro exam if systemic effects are noted Human bites have higher infection rates than animal bites due to normal mouth bacteria. Carnivore bites are much more likely to become infected and all have risk of Rabies exposure. Cat bites may progress to infection rapidly due to a specific bacteria (Pasteurella multicoda). Poisonous snakes in this area are generally of the pit viper family: rattlesnake, copperhead, and water moccasin. Coral snake bites are rare: Very little pain but very toxic. "Red on yellow - kill a fellow, red on black - venom lack." Amount of envenomation is variable, generally worse with larger snakes and early in spring. If no pain or swelling, envenomation is unlikely. Black Widow spider bites tend to be minimally painful, but over a few hours, muscular pain and severe abdominal pain may develop (spider is black with red hourglass on belly). Brown Recluse spider bites are minimally painful to painless. Little reaction is noted initially but tissue necrosis at the site of the bite develops over the next few days (brown spider with fiddle shape on back). Evidence of infection: swelling, redness, drainage, fever, red streaks proximal to wound. Immunocompromised patients are at an increased risk for infection: diabetes, chemotherapy, transplant patients. Consider contacting the North Carolina Poison Control Center for guidance (1-800-84-TOXIN). Protocol 49 Any local EMS System changes to this document must follow the NC OEMS Protocol Change Policy and be approved by OEMS 2009 Burns: Thermal History Signs and Symptoms Differential Type of exposure (heat, gas, chemical) Burns, pain, swelling Superficial (1st Degree) red and painful Inhalation injury Dizziness Partial Thickness (2nd Degree) blistering Time of Injury Loss of consciousness Full Thickness (3rd Degree) painless/charred or leathery skin Past medical history and Medications Hypotension/shock Thermal Other trauma Airway compromise/distress Chemical Loss of Consciousness singed facial or nasal hair Electrical Tetanus/Immunization status Hoarseness / wheezing Radiation Universal Patient Care Protocol Critical Serious Minor (Red) (Yellow) (Green) 5-15% TBSA 2nd/3rd Degree Burn >15% TBSA 2nd/3rd Degree Burn Suspected Inhalation injury or < 5% TBSA 2nd/3rd Degree Burn Burns with Multiple Trauma requiring intubation for airway No inhalation injury, Not Intubated, Burns with definitive airway stabilization Normotensive compromise Hypotension or GCS < 14 GCS>14 (When reasonable accessible, (When reasonable accessible, (Transport to the Local Hospital) transport to a Burn Center) transport to either a Level I Burn Trauma Protocols Center or a Trauma Center) Remove Rings, Bracelets, and Cool Down the Wound with Normal other Constricting Items Saline Airway Protocol Cover Burn with Dry sterile sheet or dressings Cover Burn with Dry sterile sheet or dressings IV Normal Saline, IV Normal Saline, 2 large bore IVs, infuse total of 0.25 x kg infuse total of 0.25 x kg body wt. x % TBSA per body wt. x % TBSA per I I I hour for up to the first 8 I hour for Legend hours. up to the first 8 hrs. (More info below) MR (More info below) B EMT B I EMT- I I Pain Control Protocol P EMT- P P M Notify Destination or M M Medical Control M Contact Medical Control 1. The IV solution should be changed to Lactated Ringers if it is available. It is preferred over Normal Saline. Pearls 2. Formula example and a rule of thumb is; an 80 kg patient with 50% Burn patients are Trauma Patients, evaluate for multisystem trauma. TBSA will need 1000 cc of fluid per hour. Assure whatever has caused the burn, is no longer contacting the injury. (Stop the burning process!) Critical or Serious Burns Recommended Exam: Mental Status, HEENT, Neck, Heart, Lungs, > 5-15% total body surface area (TBSA); 2nd or 3rd degree burns, or rd Abdomen, Extremities, Back, and Neuro 3 degree burns > 5% TBSA for any age group, or Early intubation is required when the patient experiences significant circumferential burns of extremities, or inhalation injuries. electrical or lightning injuries, or Potential CO exposure should be treated with 100% oxygen. (For suspicion of abuse or neglect, or patients with the primary event is CO inhalation, transport to a inhalation injury, or hospital equipped with a hyperbaric chamber is indicated [when chemical burns, or reasonably accessible].) burns of face, hands, perineum, or feet, or Circumferential burns to extremities are dangerous due to potential any burn requiring hospitalization. vascular compromise secondary to soft tissue swelling. (These burns will require direct transport to a burn center, or transfer once Burn patients are prone to hypothermia - never apply ice or cool seen at a local facility where the patient can be stabilized with interventions burns, must maintain normal body temperature. such as airway management or pain relief if this is not available in the field or Evaluate the possibility of child abuse with children and burn injuries. the distance to a Burn Center is significant.) Protocol 50 Any local EMS System changes to this document must follow the NC OEMS Protocol Change Policy and be approved by OEMS 2009 Burns: Chemical and Electrical History Signs and Symptoms Differential Type of exposure (heat, gas, chemical) Burns, pain, swelling Superficial (1st Degree) red and painful Inhalation injury Dizziness Partial Thickness (2nd Degree) blistering Time of Injury Loss of consciousness Full Thickness (3rd Degree) painless/charred or Past medical history and Medications Hypotension/shock leathery skin Other trauma Airway compromise/distress Thermal Loss of Consciousness singed facial or nasal hair Chemical Tetanus/Immunization status Hoarseness / wheezing Electrical Radiation Legend Universal Patient Care Protocol MR B EMT B P Cardiac Monitor P I EMT- I I P EMT- P P Eye Involvement? Continuous saline M Medical Control M flush in affected eye. Flush are with water or Normal Saline for 10-15 minutes Remove Rings, Bracelets, and other Constricting Items. Remove clothing or expose area Trauma Protocols Identify entry and exit sites, apply sterile dressings Pain Control Protocol (IV only for Burn Patients) I I IV Protocol Normal Saline Bolus Chemical and Electrical Burn Patients Must be Triaged using the Guidelines below and their care must conclude in the Thermal Burn Protocol Critical Serious Minor (Red) (Yellow) (Green) 5-15% TBSA 2nd/3rd Degree Burn >15% TBSA 2nd/3rd Degree Burn < 5% TBSA 2nd/3rd Degree Burn Suspected Inhalation injury or requiring intubation Burns with Multiple Trauma No inhalation injury, Not Intubated, for airway stabilization Burns with definitive airway compromise Normotensive Hypotension or GCS < 14 (When reasonable accessible, transport to a GCS>14 (When reasonable accessible, transport to either a Burn Center) (Transport to the Local Hospital) Level I Burn Center or a Trauma Center) Pearls Chemical Pearls Electrical Refer to Decontamination Standard Procedure (Skill) WMD Do not contact the patient until you are certain the source of the electric Page shock has been disconnected. Certainly 0.9% NaCl Soln or Sterile Water is preferred, Attempt to locate contact points, (entry wound where the AC source however if it is not readily available, do not delay, use tap contacted the patient, an exit at the ground point) both sites will generally water for flushing the affected area or other immediate water be full thickness. sources. Flush the area as soon as possible with the Cardiac monitor, anticipate ventricular or atrial irregularity, to include V- cleanest readily available water or saline solution using tach, V-fib, heart blocks, etc. copious amounts of fluids. Attempt to identify the nature of the electrical source (AC vs DC), the amount of voltage and the amperage the patient may have been exposed to during the electrical shock. Protocol 51 Any local EMS System changes to this document must follow the NC OEMS Protocol Change Policy and be approved by OEMS 2009 Drowning History Signs and Symptoms Differential Submersion in water Unresponsive Trauma regardless of depth Mental status changes Pre-existing medical problem Possible trauma to C-spine Decreased or absent vital signs Pressure injury (diving) Possible history of trauma ie: Vomiting Barotrauma diving board Coughing Decompression sickness Duration of immersion Apnea
Load more

Recommended publications
  • Family Practice
    THE JOURNAL OF FAMILY ONLINE EXCLUSIVE PRACTICE Paul K. Carlton, Jr, MD, Brown recluse spider bite? FACS The Texas A&M University Consider this uniquely Health Science Center College Station, Tex conservative treatment [email protected] An antihistamine and observation work as well— and often better—than more intensive therapies. Practice recommendations oped it in 4 phases, which I describe in • Be concerned about brown recluse this article. Not only does this conser- envenomation when a patient vative approach consistently heal con- reports intensifying localized firmed brown recluse bite wounds, but pain disproportionate to physical should a bite be mistakenly attributed findings after a “bite” (C). to the brown recluse (or one of its rela- tives in the Loxosceles genus of spider), • Prescribe an oral antihistamine there is no harm to the patient, nor any alone to control symptoms, even big expense. with a necrotic wound, and mark the IN THIS ARTICLE patient’s progress over 24 hours (C). z Spider bite z Is a brown recluse • If the patient improves dramatically, to blame? or MRSA? continue the antihistamine; with little Due to limited experience among the Page E6 or no improvement, consider giving an wider medical community in identifying antibiotic with the antihistamine (C). spider envenomation,1-4 bite recognition and selection of appropriate therapy can Strength of recommendation (SOR) be difficult. A Good-quality patient-oriented evidence Early findings can be confusing. B Inconsistent or limited-quality patient-oriented evidence C Consensus, usual practice, opinion, disease-oriented Brown recluse bites typically feel like a evidence, case series pin prick.
    [Show full text]
  • Anatomy and Physiology
    ASSIGNMENT 22 Book Assignment: “Poisoning and Drug Abuse,” pages 22-1 to 22-34 22-1. Poisoning is defined as contact with or 22-6. Which of the following is the method of exposure to a toxic substance. choice for the HM to use to induce vomiting? 1. True 2. False 1. 15-30 cc of syrup of Ipecac 2. 2 teaspoonfuls of dry mustard in water 22-2. Toxicology is defined as the science of 3. 2 teaspoonfuls of an active charcoal poisons. slurry 4. To tickle the back of the victim’s 1. True throat 2. False 22-7. When a patient ingests an acid or base 22-3. A patient presents with dilated pupils, treatment is to give a neutralizing agent fever, dry skin, urinary retention, decreased orally. bowel sounds, and increased heart rate. What toxidrome does this set of symptoms 1. True suggest? 2. False 1. Narcotic 2. Anticholinergic 22-8. If the HM is unable to reach the poison 3. Withdrawal control center or a physician for specific 4. Non-syndrome syndrome instructions, how should the HM treat a victim who has ingested turpentine? 22-4. A patient presents with salivation, 1. Induce vomiting and observe lacrimation, urination, and muscle 2. Give 1 to 2 ounces of vegetable oil weakness. What toxic syndrome does this orally set of symptoms suggest? 3. Neutralize the poison with vinegar and water 1. Anticholinergic 4. Give 1 to 2 tablespoonfuls of milk 2. Cholinergic of magnesia 3. Narcotics 4. Sympathominetic 22-9. Of the following, which is considered the most common agent in inhalation 22-5.
    [Show full text]
  • Spider Bites
    Infectious Disease Epidemiology Section Office of Public Health, Louisiana Dept of Health & Hospitals 800-256-2748 (24 hr number) www.infectiousdisease.dhh.louisiana.gov SPIDER BITES Revised 6/13/2007 Epidemiology There are over 3,000 species of spiders native to the United States. Due to fragility or inadequate length of fangs, only a limited number of species are capable of inflicting noticeable wounds on human beings, although several small species of spiders are able to bite humans, but with little or no demonstrable effect. The final determination of etiology of 80% of suspected spider bites in the U.S. is, in fact, an alternate diagnosis. Therefore the perceived risk of spider bites far exceeds actual risk. Tick bites, chemical burns, lesions from poison ivy or oak, cutaneous anthrax, diabetic ulcer, erythema migrans from Lyme disease, erythema from Rocky Mountain Spotted Fever, sporotrichosis, Staphylococcus infections, Stephens Johnson syndrome, syphilitic chancre, thromboembolic effects of Leishmaniasis, toxic epidermal necrolyis, shingles, early chicken pox lesions, bites from other arthropods and idiopathic dermal necrosis have all been misdiagnosed as spider bites. Almost all bites from spiders are inflicted by the spider in self defense, when a human inadvertently upsets or invades the spider’s space. Of spiders in the United States capable of biting, only a few are considered dangerous to human beings. Bites from the following species of spiders can result in serious sequelae: Louisiana Office of Public Health – Infectious Disease Epidemiology Section Page 1 of 14 The Brown Recluse: Loxosceles reclusa Photo Courtesy of the Texas Department of State Health Services The most common species associated with medically important spider bites: • Physical characteristics o Length: Approximately 1 inch o Appearance: A violin shaped mark can be visualized on the dorsum (top).
    [Show full text]
  • Animal Bites
    Updated 12/16/14/ INDEX ANIMAL BITES 3 BATS AND RABIES 6 CLASSROOM PETS- SALMONELLA 9 BED BUGS 11 HEAD LICE 13 SCABIES 15 WEST NILE VIRUS 17 APPENDICES 19 APPENDIX A: IMPORTANT CONTACT NUMBERS APPENDIX B: REPORTABLE DISEASE LIST APPENDIX C: OTHER INFECTIOUS DISEASES 2 Updated 1/12/15 Return to Index Animal Bites Background: Most wild animals tend to avoid humans, but they can bite if they feel threatened, are protecting their young or territory, are injured or ill, or if people attempt to approach or feed them. Although bites by wild animals can be more dangerous, bites by domestic animals are far more common. Animals’ saliva can be heavily populated with harmful bacteria and secondary infections of wounds often occur. In addition, animals can transmit zoonotic infections such as rabies (See: Bats and Rabies for more Rabies Information), tetanus, hantavirus, etc. Children are more likely to be bitten by animals and can sometimes sustain severe injuries because of their love of animals and inherent curiosity. In a school setting, bites most frequently involve classroom pets; however, bites can also occur from stray pets or wild animals on campus, especially bats, or an animal being brought to school by a student. Common Classroom Pets Rodents (hamsters, rats, gerbils, mice) Reptiles (lizards, snakes, turtles) Amphibians (frogs, toads) Rabbits Fish None of these caged animals pose any rabies risk. The likelihood of a cat or a dog being infected with rabies in Maricopa County is low- the last known rabid dog was documented in 1978. However, if any animal is displaying the possible neurological signs of Rabies (See: Signs and Symptoms) it’s important to call the MCDPH 24/7 Rabies Hotline (602 747-7111) to receive a risk assessment.
    [Show full text]
  • WHO Guidance on Management of Snakebites
    GUIDELINES FOR THE MANAGEMENT OF SNAKEBITES 2nd Edition GUIDELINES FOR THE MANAGEMENT OF SNAKEBITES 2nd Edition 1. 2. 3. 4. ISBN 978-92-9022- © World Health Organization 2016 2nd Edition All rights reserved. Requests for publications, or for permission to reproduce or translate WHO publications, whether for sale or for noncommercial distribution, can be obtained from Publishing and Sales, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi-110 002, India (fax: +91-11-23370197; e-mail: publications@ searo.who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
    [Show full text]
  • Approach and Management of Spider Bites for the Primary Care Physician
    Osteopathic Family Physician (2011) 3, 149-153 Approach and management of spider bites for the primary care physician John Ashurst, DO,a Joe Sexton, MD,a Matt Cook, DOb From the Departments of aEmergency Medicine and bToxicology, Lehigh Valley Health Network, Allentown, PA. KEYWORDS: Summary The class Arachnida of the phylum Arthropoda comprises an estimated 100,000 species Spider bite; worldwide. However, only a handful of these species can cause clinical effects in humans because many Black widow; are unable to penetrate the skin, whereas others only inject prey-specific venom. The bite from a widow Brown recluse spider will produce local symptoms that include muscle spasm and systemic symptoms that resemble acute abdomen. The bite from a brown recluse locally will resemble a target lesion but will develop into an ulcerative, necrotic lesion over time. Spider bites can be prevented by several simple measures including home cleanliness and wearing the proper attire while working outdoors. Although most spider bites cause only local tissue swelling, early species identification coupled with species-specific man- agement may decrease the rate of morbidity associated with bites. © 2011 Elsevier Inc. All rights reserved. More than 100,000 species of spiders are found world- homes and yards in the southwestern United States, and wide. Persons seeking medical attention as a result of spider related species occur in the temperate climate zones across bites is estimated at 50,000 patients per year.1,2 Although the globe.2,5 The second, Lactrodectus, or the common almost all species of spiders possess some level of venom, widow spider, are found in both temperate and tropical 2 the majority are considered harmless to humans.
    [Show full text]
  • Animal Bites
    Who is in charge when an animal Other Biting Animals: All biting animals that bites a person? are not categorized as dogs, cats, or domestic Animal Bites ferrets, free-roaming high-risk, or low-risk • All cities and counties in Texas must must either be euthanized and tested or What should you do if an designate someone to handle animal bite quarantined or suitably confined as deemed appropriate by the LRCA for a 30-day animal bites you? cases. This person is called the "Local Rabies Control Authority" (LRCA). observation period. Rabies is a viral disease that • The LRCA is responsible for investigating What is quarantine? affects warm-blooded animal bites, ensuring proper animals (such as a dog, management of biting animals, and Quarantine means placing the animal in a cat, skunk, fox, raccoon, bat, enforcing state and local rabies laws. facility that provides: etc.). The virus is spread when saliva containing 1. absolute security (no escape possible); rabies virus is introduced into an opening in the What happens to the animal that 2. no contact with other animals or people skin, usually by the bite (or possibly scratch) of bites a person? except for contact necessary for its care; and a rabid animal. You can also get rabies if the saliva from a rabid animal contacts your mucous Dogs, Cats, and Ferrets (Domestic): 3. observation twice daily by a qualified person. Regardless of vaccination status, the membranes or any open wounds. Quarantine must be in a quarantine facility dog, cat, or ferret must be quarantined or licensed by the Texas Department of State If a bite occurs, the following precautions should euthanized (humanely killed).
    [Show full text]
  • ANIMAL BITE PROTOCOL Animal Bites Must Immediately Receive
    ANIMAL BITE PROTOCOL Animal bites must immediately receive medical attention and be reported to the proper authorities, who will supervise the response. Information about the incident should be transferred with the animal and its paperwork at every point along the path to and from an Emergency Animal Care Center. 1. As soon as a bite is observed or suspected, place the suspect animal in a secure cage or crate that is clearly tagged: “This cage/crate contains an animal that has been involved in a bite.” Isolate the caged animal. No one is to handle this animal except professional staff who are specifically authorized to do so. 2. Immediately direct the person who has been bitten to medical attention. As necessary, apply pressure to stop bleeding. Wash wounds thoroughly with plenty of soap and warm water. Run water over the wound for several minutes to make sure it is clean and all soap is rinsed out. After a thorough wash and rinse, apply an antiseptic solution, such as iodine or other disinfectant. See a physician as soon as possible. If a physician of choice is unavailable, go to the nearest emergency-care facility. Explain how the bite occurred, and follow the physician's advice. 3. Determine and clearly document the incident in the animal’s paperwork. Include: The date and time of the bite, The identity of the person who was bitten, The rabies vaccination status of the person who was bitten, The rabies vaccination status of the animal involved, The identity of people who witnessed the bite, Any special circumstances associated with the bite, The identity of the owner of the animal, The time/date of notification of the owner.
    [Show full text]
  • EMS DIVISION 24.1 Rev. 05/14/2021 PROTOCOL 24 ENVENOMATION, BITES, and STINGS
    PROTOCOL 24 ENVENOMATION, BITES, AND STINGS A. North American Pit Vipers B. Coral Snake Bites C. Exotic Snakes D. Brown Recluse Spider Bites E. Black Widow F. Scorpion Stings G. Marine Animal Envenomation H. Marine Animal Stings General Care EMR/BLS 1. Initial Assessment/Care Protocol 1. 2. Attempt to identify the insect, reptile, or animal that caused the injury if it is safe to do so. If unknown or it is a known venomous reptile bite or spider bite, have the FAO contact the Anti-Venom unit. 3. Be alert for the development of any anaphylactic reaction and treat according to the Systemic Reaction Protocol 17. 4. Immobilize the affected area. Keep the patient calm. 5. Remove and secure in a safe location any rings, bracelets, jewelry, etc. that may be in the injured area before swelling becomes too great. 6. Do not apply tourniquets, cold packs, make incisions around the area, or attempt to suction. 7. If unable to contact an Anti-Venom unit, contact the Poison Control Center, 1-800-222-1222 for assistance in managing specific envenomation. Top EMS DIVISION 24.1 Rev. 05/14/2021 PROTOCOL 24 ENVENOMATION, BITES, AND STINGS A. North American Pit Vipers Includes rattlesnakes, copperheads, and cottonmouths. EMR/BLS 1. For any known or suspected bite, refer to Antivenin Bank Procedure 33. Evaluate for specific signs/symptoms: a) Distinct "fang marks" or puncture wounds. b) Swelling and pain at the site. c) Weakness, nausea, and vomiting. d) Paresthesia, fasciculations. e) Numbness and tingling around the face and head. f) Metallic taste, change in taste sensation.
    [Show full text]
  • Risk Factor, Monitoring, and Treatment for Snakebite Induced Coagulopathy: a Multicenter Retrospective Study
    Acute and Critical Care 2019 November 34(4):269-275 Acute and Critical Care https://doi.org/10.4266/acc.2019.00591 | pISSN 2586-6052 | eISSN 2586-6060 Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study Yong Jun Jeon1, Jong Wan Kim2, SungGil Park2, Dong Woo Shin2 1Department of Surgery, Chinjujeil Hospital, Jinju; 2Department of Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea Background: Snakebite can cause various complications, including coagulopathy. The clinical features of snakebite-associated coagulopathy differ from those of disseminated intravascu- Original Article lar coagulation (DIC) caused by other diseases and its treatment is controversial. Methods: We retrospectively reviewed the medical records of patients hospitalized for snake- Received: June 20, 2019 Revised: August 28, 2019 bite between January 2006 and September 2018. Accepted: August 28, 2019 Results: A total of 226 patients were hospitalized due to snakebite. Their median hospital stay was 4.0 days (interquartile range, 2.0 to 7.0 days). Five patients arrived at hospital with Corresponding author shock and one patient died. Twenty-one patients had overt DIC according to the Internation- Yong Jun Jeon al Society of Thrombosis and Hemostasis scoring system. Two patients developed major bleed- Department of Surgery, Chinjujeil Hospital, 885 Jinju-daero, Jinju ing complications. Initial lower cholesterol level at presentation was associated with the de- 52709, Korea velopment of overt DIC. International normalization ratio (INR) exceeding the laboratory’s Tel: +82-55-750-7123 measurement limit was recorded as late as 4 to 5 days after the bite. Higher antivenom doses Fax: +82-55-750-7574 (≥18,000 units) and transfusion of fresh frozen plasma (FFP) or cryoprecipitate did not affect E-mail: [email protected] prolonged INR duration or hospital stay in the overt DIC patients without bleeding.
    [Show full text]
  • Opting out of Industrial Meat
    OPTING OUT OF INDUSTRIAL MEAT HOW TO STAND AGAINST CRUELTY, SECRECY, AND CHEMICAL DEPENDENCY IN FOOD ANIMAL PRODUCTION JULY 2018 www.centerforfoodsafety.org TABLE OF CONTENTS I. INTRODUCTION: CRUELTY, SECRECY, & CHEMICAL DEPENDENCY 1 II. WHAT IS “INDUSTRIAL MEAT”? 7 III. TEN REASONS TO OUT OPT OF INDUSTRIAL MEAT 11 For Our Health 11 For Food Workers 13 For Pollinators 14 For Water Conservation 15 For Animals 17 For Climate 18 For Healthy Communities 19 For Food Safety 19 For Farmers 21 For Local Economies 22 IV. HOW TO OPT OUT OF INDUSTRIAL MEAT 23 1. Eat Less Meat Less Often 24 2. Choose Organic, Humane, and Pasture-Based Meat Products 26 3. Eat More Organic and Non-GMO Plant Proteins 28 V. CONCLUSION & POLICY RECOMMENDATIONS CHARTS Plant-Based Sources of Protein 30 Fish 31 ENDNOTES 32 CENTER FOR FOOD SAFETY OPTING OUT OF INDUSTRIAL MEAT INTRODUCTION: CRUELTY, SECRECY, & CHEMICAL DEPENDENCY hat came first—the chicken or the egg? ible toll on our climate, water, soils, wildlife, and WIt’s difficult to know whether increasing health. What’s more, massive production of animals consumer demand for meat and poultry in these conditions requires intensive production products has driven drastic increases in production of grains for feed, which contributes to high pes - levels, or vice versa. What we do know with cer - ticide use and threatens wildlife. 1 tainty, though, is that demand for and production of meat and poultry products has increased dra - Nevertheless, demand for meat and poultry con - matically in the U.S. and globally in the last 70 years.
    [Show full text]
  • Spider Bite in Southern Africa: Diagnosis and Management the Diagnosis of Spider Bite, Especially When the Patient Is Unaware of Having Been Bitten, Can Be Difficult
    Spider bite in southern Africa: diagnosis and management The diagnosis of spider bite, especially when the patient is unaware of having been bitten, can be difficult. G J Müller, BSc, MB ChB, Hons BSc (Pharm), MMed (Anaes), PhD (Tox) Dr Müller is part-time consultant in the Division of Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University. He is the founder of the Tygerberg Poison Information Centre. C A Wium, MSc Medical Sciences Ms Wium is a principal medical scientist employed as a toxicologist in the Tygerberg Poison Information Centre, Division of Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University. C J Marks, BSc Pharmacy, MSc Medical Sciences Ms Marks is the director of the Tygerberg Poison Information Centre, Division of Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University. C E du Plessis, BSc Microbiology and Genetics Ms Du Plessis is a medical technologist. She is a staff member of the Tygerberg Poison Information Centre and the Therapeutic Drug Monitoring Laboratory, Division of Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University. D J H Veale, PhD Pharmacology Dr Veale is the former director of the Tygerberg Poison Information Centre and currently a consultant clinical pharmacist and lecturer in pharmacology and toxicology. Correspondence to: G Müller ([email protected]) The medically important spiders of southern Africa can be divided completely. The legs are evenly black. The globular or pear-shaped into neurotoxic and cytotoxic groups. The neurotoxic spiders belong egg sacs, which measure 10 - 15 mm in diameter, are white to to the genus Latrodectus (button or widow spiders) and the cytotoxic greyish yellow with a smooth silky surface.
    [Show full text]