Octopus Envenomation Treatment & Management
到院前處置
對於心肺衰竭的病患給予插管及心肺復甦術處置 其他處置比照一般創傷. 可局部抽吸, 但不要切開傷口, 可局部加壓固定, 彈性繃帶纏繞, 壓力約 70 mmHg.
Prehospital Care
Cardiopulmonary support, including endotracheal intubation and cardiopulmonary resuscitation (CPR), as clinically indicated.
What constitutes proper wound care for octopus envenomation is controversial. Options include the following:
Immediately irrigate and care for the wound, as one would for any puncture wound.
Perform local suction without incision or local sequestration of the venom by applying a constricting band proximal to the injury.
Perform pressure immobilization technique, which is done by compressing a cloth pad with a bandage directly over the wound and surrounding tissues at 9.3 kPa (70 mm Hg) or greater of pressure.
Cardiopulmonary support, including endotracheal intubation and cardiopulmonary resuscitation (CPR), as clinically indicated.
What constitutes proper wound care for octopus envenomation is controversial. Options include the following:
Immediately irrigate and care for the wound, as one would for any puncture wound.
Perform local suction without incision or local sequestration of the venom by applying a constricting band proximal to the injury.
Perform pressure immobilization technique, which is done by compressing a cloth pad with a bandage directly over the wound and surrounding tissues at 9.3 kPa (70 mm Hg) or greater of pressure.
章魚咬傷
主要是支持療法, 無解毒劑, 無解藥
視情況考慮插管, 直到毒性解除, 通常需 4-10 小時
視情況打破傷風疫苗 (比照一般外傷)
動物實驗發現, Neostigmine 以及 edrophonium 有助於 河豚毒素中毒病患的肌肉力量恢復.
Emergency Department Care
Treatment of octopus envenomation is supportive.
Provide endotracheal intubation and ventilatory support until the venom has worn off, usually within 4-10 hours.
Confirm that the patient's tetanus status is current.
No antivenin is available.
Neostigmine and edrophonium have shown benefit in restoring muscular strength in some cases of tetrodotoxin intoxication (eg, puffer fish), but have not undergone clinical trials in blue-ringed octopus envenomations.
4-Aminopyridine (Neurelan - US, Pymadine), a drug utilized as an antagonist to nondepolarizing neuromuscular blocking agents (available in the United States as an orphan drug for multiple sclerosis), has been shown to reverse tetrodotoxin toxicity in animal experiments.[12]
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