Emergency & clinical flowcharts
| Signs and symptoms1 |
Emergency medical treatment |
Antivenom | ||
| Patient history: Is the patient known to have a Hymenoptera allergy? |
No antivenom available |
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| Nausea, vomiting, abdominal pain, diarrhoea, urticaria, angio-oedema, bronchospasm, arterial hypotension (systemic allergic reaction) |
Treatment of general allergic reactions (see Diagnosis & Treatment: General practitioner / health post) |
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| Extensive local swelling (strong allergic reaction) |
Treatment of local allergic reactions (see Diagnosis & Treatment: General practitioner / health post) | |||
| Extensive local swelling possibly involving the trunk → hypovolaemia → hypovolaemic shock (increased regional capillary permeability) |
Treatment of the hypovolaemia/hypovolaemic shock |
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| Multiple stings Icterus, urine colour, acute renal failure (haemolysis) |
Treatment of the haemolysis, if necessary blood transfusions; |
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| Multiple stings Muscle pain (spontaneous, with active/passive movement), urine colour, ECG changes, signs of paralysis (rhabdomyolysis) |
Treatment of the hyperkalaemia; prevention and treatment of the acute renal failure; treatment of the respiratory insufficiency/respiratory failure; endotracheal intubation and artificial respiration |
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| 1 |
See also the Clinical flowchart as a guide to the dynamics of envenoming. |