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Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
 
 
 
 
 
 
 

Is the patient envenomed?

 

Is it likely that a clinically relevant injection of venom has taken place?

D  Diagnostics

Inquire re:

  • time of the bite,
  • local pain,
  • nausea, vomiting.

Assess:

  • state of consciousness (restlessness, sleepiness, coma).

Measure:

  • blood pressure/pulse,
  • breathing (respiratory rate).

Observe/investigate:

  • local swelling,
  • local redness,
  • eyes (contact with urticating hairs): conjunctivitis, keratitis, iritis, chorioretinitis.

Systemic reactions:

  • sweating,
  • hypersalivation,
  • increased bronchial secretion,
  • priapism,
  • abdominal pain, board-like abdominal rigidity (differential diagnosis acute abdomen)
  • bradycardia/tachycardia/cardiac arrhythmia,
  • arterial hypotension/hypertension,
  • clinical signs of pulmonary oedema,
  • clinical signs of shock,
  • generalised muscle pain and cramps,
  • muscle weakness.

Record and measure:

  • ECG,
  • blood sugar.

Exclusion of a clinically relevant systemic reaction

D  Diagnostics

Monitoring for signs and symptoms of systemic envenoming (see above) for 12–24 h.