蛇咬傷到底要不要使用彈性繃帶或止血帶@ 急診小醫師 - 隨意窩

蛇咬傷到底要不要使用彈性繃帶. 止血帶. WHO 針對東南亞的毒蛇咬傷建議不要(如果是elapid眼鏡蛇咬傷. 可以使用彈性繃帶固定.) 台灣疾管署網頁說可以用. 急診小醫師https://dictionary.cambridge.org/zht/日誌相簿影音好友名片 201711130946蛇咬傷到底要不要使用彈性繃帶或止血帶?毒物_環境急症蛇咬傷到底要不要使用彈性繃帶.止血帶.  WHO針對東南亞的毒蛇咬傷建議不要(如果是elapid眼鏡蛇咬傷.可以使用彈性繃帶固定.) 台灣疾管署網頁說可以用.  台灣AILS建議不要 美國CDC建議不要 急診教科書Tintinalli'sEmergencyMedicine建議海蛇咬傷可纏繞患處.  急診教科書Rosen建議眼鏡蛇科及多數毒蛇咬傷可以用.    如果手邊有器材,且知道如何使用.如果是elapid眼鏡蛇咬傷.可以使用彈性繃帶固定. 緬甸山蝰咬傷使用加壓墊已被證實有效果..      加壓固定方式 使用10-15公分寬的彈性繃帶,長度約4.5公尺.  加壓墊大小約5公分見方.厚度約2-3公分.直接放在被咬傷部位上.  針對神經性蛇毒的眼鏡蛇咬傷可用.  RosenEmergencyMedicine,SnakebiteManagement 使用加壓纏繞對於Elapidae(眼鏡蛇科)venorm及多數毒液.有減緩散布效果.對於pitviper蝮蛇咬傷效果不明.(蝮亞科是蝰蛇科的一個亞科，統稱蝮蛇) Out-of-HospitalCare Allsnakebitesareconsideredanemergency,andanyvictimshould bemedicallyevaluated.Theinitial6-to8-hourperiodaftera snakebiteiscritical.Duringthistime,medicaltherapycanhelp  preventthemorbidityassociatedwithsevereenvenomation.Effective  out-of-hospitalcarecanbeimportant.16 Out-of-hospitalcareisrelativelysimpleifguidedbyfourbasic concepts. First,theestimatedtimeuntilarrivalatamedicalfacility, aswellastheskilloftheon-sceneassistants,mustbeconsidered whenfirstaidisinstituted.Separatethevictimfromthesnakeif possibletopreventfurtherbites.Astick,pole,orotherobjectlongerthanthesnakecanbeusedtomovethesnakeawayfromthevictimor,ifnecessary,tokillthesnakebystrikingitbehindthehead.Rapidtransportationtoamedicalfacilityisthebestfirst aidforasnakebite.Anyconstrictingjewelryorclothingshouldberemovedfromanextremitytopreventatourniqueteffectproximaltotheswelling. 彈性繃帶對於眼鏡蛇及多數毒蛇咬傷可以用.對於蝮蛇咬傷效果不明.但腫脹的組織不建議使用彈性繃帶纏繞.可能造成組織壞死更嚴重.不建議切開傷口.不建議冰敷.不建議用抽吸器具吸出毒液   Second,spreadofthevenomshouldbeslowedifpossible; severalmethodsareknown.Thepatient’sexcitementandphysicalactivity,movementofthebittenarea,alcoholconsumption,and greaterdepthofthebitemayincreasethespreadofvenom.Exceptforthelastfactor,theseissuescanbeaddressedbycalmingthevictim,immobilizingthebittenareawithaslingorsplint,andnotgivinganythingbymouth.AmethodoffirstaidforvenomoussnakebitesthatwasdevelopedinAustralia—theimmobilization andcompressiontechnique(alsocalledtheCommonwealthSerum Laboratorytechnique)—slowsuptakeofElapidaevenomand mockvenominhumans.Thebittenextremityiseitherwrappedinanelasticbandageorplacedinanairsplint.InanothertechniquefromAustraliacalledtheMonashmethod,athickpadand bandageareplacedoverthebitewoundandextremity.Boththesetechniqueshavesimilarpostulatedmechanismsofaction:The  lymphaticvesselsandsuperficialveinsarecollapsed,andtheproximalspreadofvenomisslowed.17Althoughthismethodissuccessfulasfirst-aidtherapyforElapidaebites,itsuseforpitvipers hasnotbeendemonstrated.Iflessthan30minuteshaselapsedsincethebite,aconstrictingbandappliedtightlyenoughtoimpedesuperficialvenousandlymphflow,butnotarterialbloodflow,maybeused.Thebandisappliedlooselyenoughtoadmitafingerbetweenthebandandtheskinafterapplication.Itisused withcautiontopreventthedevelopmentofatourniqueteffectunderswollentissue,whichmaycausemoredestructionthanthesnakebite.18Incisionofbitewoundshasnoprovenefficacyandposespotentialdangertounderlyingstructuresandthereforeisnotrecommended.Theuseoficeisnothelpfulinslowingthe spreadofvenom,butanicebagwrappedinatowelandappliedtothebiteareahelpsrelievepain.Icewaterimmersionandpackingoftheextremityinicearedangerousandonlycontributetotissuedestruction.Theuseofsuctiondeviceshasnotbeenshowntobebeneficial.19 Third,whenfeasible,thesnakeshouldbeidentifiedorbroughttothetreatingfacilitywiththevictim,thoughthisshouldnotdelaytransportofthepatienttodefinitivemedicalcare.Identificationofthesnakemustbedonesafely—usuallyonlybysomeoneexpertinhandlingsnakes.Aphotomaybeusefulinidentifying thesnakeifaclose-upoftheheadandtailareincluded.Deadsnakescanbeplacedinahardcontainer,suchasabucketoricechest.Careshouldbetakentonottouchtheheadofthesnakebecauseenvenomationcanoccurevenafterdeath. Fourth,additionalmedicalinterventions,ifavailable,shouldbeinitiated,includingcardiacmonitoring,intravenousfluids,andanalgesics.   ymmcc/Xuite日誌/回應(0)/引用(0)沒有上一則|日誌首頁|沒有下一則回應 全部展開|全部收合 ymmcc's新文章COVID相關文章目錄COVID-19抗病毒藥物Paxlovid(倍拉維)與其他藥物的交互作用COVID-19注射型抗病毒藥物韋如意(瑞德西韋)VEKLURY®(remdesivir瑞德西韋)-用藥須知及醫療人員指引202201.pdf蜜蜂尾針毒囊關於paxlovid-from耶魯大學醫學院COVID-19管理-抗病毒藥物Paxlovid/Molnupiravir需每日至MIS登錄領用情形COVID-19口服抗病毒藥物Paxlovid和Molnupiravir(中文說明書-防疫門診-配賦藥局)新北快篩陽性即判定陽性COVID-19口服抗病毒藥物Molnupiravir莫納皮拉韋COVID-19通報作業 ymmcc's新回應沒有新回應！