一小節觸鬚，包含大量 nematocysts 刺絲胞, 刺絲胞非常小, 其結構是微米級別的(微米uM=百萬分之一公分).
cnidarians 刺細胞動物門
stenoteles 刺絲胞
cnidocyte 刺絲胞
穿刺刺絲囊（penetrant）
刺絲胞有三種不同型態, 第一種是 stenotele , 第二種是 isorhiza, 第三種是 desmoneme
In this study, two types of nematocysts were observed in both Caribbean Millepora species. These nematocysts were identified as stenoteles and macrobasic mastigosphores according to Weill's classification (16, 17). Measurements of the capsule size of the nematocysts, made from the SEM photographs, showed that in both species the macrobasic mastigophores were present in medium (10.6 - 13.0 x 18.1 - 21.6 µm) and large (17.5 - 21.8 x 25.0 - 33.1 µm) size classes, while stenoteles were present in only one size (10.5 - 15.6 x 18.7 - 25.0 µm).In this study, two types of nematocysts were observed in both Caribbean Millepora species. These nematocysts were identified as stenoteles and macrobasic mastigosphores according to Weill's classification (16, 17). Measurements of the capsule size of the nematocysts, made from the SEM photographs, showed that in both species the macrobasic mastigophores were present in medium (10.6 - 13.0 x 18.1 - 21.6 µm) and large (17.5 - 21.8 x 25.0 - 33.1 µm) size classes, while stenoteles were present in only one size (10.5 - 15.6 x 18.7 - 25.0 µm).
刺絲包如果看得到的可以用卡片刮
黃醫師表示，經驗是：
1. 看不到刺細胞。皮膚變化就是像上圖那樣，不過是比較散在性，不抓比較小顆，抓上癮就會腫大。那麼密集的通常是被整條觸鬚電到，要不然就是不上岸一直玩一直玩的。
2. 我猜急診室應該不會看到病人帶著觸鬚，因為被電到真的很痛，有什麼也都甩掉了。如果萬一碰到還有殘留的，我大概就是用卡片刮掉。
3. 有人說醋酸有人說酒精，看過一篇paper，不同的水母品種對於治療的反應不同。所以每篇所研究的水母品種需要考慮在內。
4. 經驗有限，目前在海邊還沒遇到過重症的。
1. 看不到刺細胞。皮膚變化就是像上圖那樣，不過是比較散在性，不抓比較小顆，抓上癮就會腫大。那麼密集的通常是被整條觸鬚電到，要不然就是不上岸一直玩一直玩的。
2. 我猜急診室應該不會看到病人帶著觸鬚，因為被電到真的很痛，有什麼也都甩掉了。如果萬一碰到還有殘留的，我大概就是用卡片刮掉。
3. 有人說醋酸有人說酒精，看過一篇paper，不同的水母品種對於治療的反應不同。所以每篇所研究的水母品種需要考慮在內。
4. 經驗有限，目前在海邊還沒遇到過重症的。
吳醫師表示： 如果是游泳潛水遇到，不要用手摸受傷部位，可以輕輕撥海水到受傷部位，用水沖掉刺絲胞。通常到急診，該受傷都應該都中獎了。刺絲胞非常小。
(在急診，用生理食鹽水可以除污，不要用自來水)
(在急診，用生理食鹽水可以除污，不要用自來水)
高醫師表示： 1 在恆春旅遊醫院 都是泡熱醋酸水2 登革熱 血小板要追蹤 不住院每2 天要驗一次 最好住院才好追蹤 個人以為會爆發登革熱死亡的個案都有基本抵抗力就不好的慢性病
刺絲胞看不到，可用水沖洗，非熱帶的水母螫傷，珊瑚蟲螫傷，可以用海水沖洗。熱帶水母螫傷，可以用含醋溶液沖洗， 之後再用海水沖洗，不要用淡水，因為淡水可能引發刺絲胞釋放毒液。
箱型水母螫傷，醋可以抑制刺絲胞放毒，可以用含醋溶液做第一次沖洗，之後再用海水沖洗。不要用淡水。
葡萄牙戰艦(僧帽水母)螫傷，用海水沖洗。不要用醋。
葡萄牙戰艦(僧帽水母)螫傷，用海水沖洗。不要用醋。
Treatment
Removal of tentacles
Symptomatic treatment
Various rinses to treat pain and deactivate nematocysts, depending on the specific animal
Cnidaria sting treatment includes removal of adherent tentacles with a forceps (preferably) or fingers (double-gloved if possible) and liberal rinsing to remove invisible stinging cells. The type of rinse varies by the stinging organism:
For jellyfish stings sustained in nontropical waters and for coral stings, seawater rinse can be used.
For jellyfish stings sustained in tropical waters, vinegar rinse followed by seawater rinse can be used. Fresh water should not be used because it can activate undischarged nematocysts.
For box jellyfish stings, vinegar inhibits nematocyst firing and is used as the initial rinse if available, followed by seawater rinse. Fresh water should not be used because it can activate undischarged nematocysts.
For Portuguese man-of-war stings, saltwater rinse can be used. Vinegar should not be used because it can activate undischarged nematocysts.
http://www.merckmanuals.com/professional/injuries-poisoning/bites-and-stings/cnidaria-coelenterates-such-as-jellyfish-and-sea-anemones-stings
Removal of tentacles
Symptomatic treatment
Various rinses to treat pain and deactivate nematocysts, depending on the specific animal
Cnidaria sting treatment includes removal of adherent tentacles with a forceps (preferably) or fingers (double-gloved if possible) and liberal rinsing to remove invisible stinging cells. The type of rinse varies by the stinging organism:
For jellyfish stings sustained in nontropical waters and for coral stings, seawater rinse can be used.
For jellyfish stings sustained in tropical waters, vinegar rinse followed by seawater rinse can be used. Fresh water should not be used because it can activate undischarged nematocysts.
For box jellyfish stings, vinegar inhibits nematocyst firing and is used as the initial rinse if available, followed by seawater rinse. Fresh water should not be used because it can activate undischarged nematocysts.
For Portuguese man-of-war stings, saltwater rinse can be used. Vinegar should not be used because it can activate undischarged nematocysts.
http://www.merckmanuals.com/professional/injuries-poisoning/bites-and-stings/cnidaria-coelenterates-such-as-jellyfish-and-sea-anemones-stings
Medscape 的建議，可以用4-6％的醋浸泡30秒以上
箱型水母和僧帽水母可用 42-45度Ｃ熱水浸泡 20 分鐘(43度C以上，大部分的人都無法接受吧)
不要使用甲基化酒精、酒精、尿液
. 含硫酸鋁的商業產品，效果並沒有比較好。
Inactivate nematocysts: Vinegar or acetic acid in solutions of 4-6% is the most widely accepted treatment of initial stings. Pour vinegar over adhering tentacles for at least 30 seconds. Hot water (42-45°C) for 20 minutes is likely beneficial in envenomations by C barnesi and Physalia species. Methylated spirits, ethanol, and urine should not be used. Commercial products containing aluminum sulfate have not been shown to be better than vinegar or sea water in the inactivation of nematocysts or resolution of pain.
Removal of tentacles: Vinegar-treated tentacles may be removed easily and safely. If vinegar is not available, forceps or similar instruments are recommended. Detached live tentacles should be treated with caution as envenomation may still occur for several hours.
http://emedicine.medscape.com/article/769538-treatment#d9
Inactivate nematocysts: Vinegar or acetic acid in solutions of 4-6% is the most widely accepted treatment of initial stings. Pour vinegar over adhering tentacles for at least 30 seconds. Hot water (42-45°C) for 20 minutes is likely beneficial in envenomations by C barnesi and Physalia species. Methylated spirits, ethanol, and urine should not be used. Commercial products containing aluminum sulfate have not been shown to be better than vinegar or sea water in the inactivation of nematocysts or resolution of pain.
Removal of tentacles: Vinegar-treated tentacles may be removed easily and safely. If vinegar is not available, forceps or similar instruments are recommended. Detached live tentacles should be treated with caution as envenomation may still occur for several hours.
http://emedicine.medscape.com/article/769538-treatment#d9
沒有留言:
張貼留言