This document summarizes various animal-derived poisons, including snakes, scorpions, bees/wasps, centipedes, lizards, spiders, and ants. It describes the types of venom or toxins produced by each animal, common symptoms of envenomation, and recommended first aid and medical treatment. Autopsy findings related to different animal envenomations are also mentioned. The document emphasizes that traditional or improper first aid methods for snake bites should be avoided and only compression bandages or splints are recommended along with rapid medical care.
4. A village person age about 44 yrs
brought to casualty with alleged
history of snake bite.
Attendant killed offending snake and
brought to casualty.
16. Treatment
First Aid
“Do it R.I.G.H.T.”
R. Reassure the patient
I Immobilise in the same way as a fractured limb. Use
bandages or cloth to hold the splints, not to block the
blood supply or apply pressure. Do not apply any
compression in the form of tight ligatures, they don’t
work and can be dangerous!
G. H. Get to Hospital Immediately. Traditional remedies
have NO PROVEN benefit in treating snakebite.
T Tell the doctor of any systemic symptoms such as
ptosis that manifest on the way to hospital.
17. Traditional Methods To Be
Discard
Tourniquets
Cutting and Suction
Washing the Wound
Electrical Therapy and Cryotherapy
Pressure Immobilization Method (PIM)
19. Other Useful Tests depending on availability
Haemoglobin/ PCV/ Platelet Count/ PT/
APTT/ FDP/ D-Dimer
Peripheral Smear
Urine Tests for Proteinuria/ RBC/
Haemoglobinuria/ Myoglobinuria
Biochemistry for Serum Creatinine/ Urea/
Potassium
Oxygen Saturation/ PR/BP/ RR/ Postural
Blood Pressure, ECG
20. Cobra Krait R. Viper S.S.Viper H.N.Viper
Local Pain/ Tissue Damage YES NO YES YES
YES
Ptosis/ Neurological Signs YES YES YES! NO NO
Haemostatic abnorma liies NO NO! YES YES
YES
Renal Complications NO NO YES NO YES
Response to Neostigmine YES NO? NO? NO NO
21. ASV Administration Criteria
Systemic Envenoming
Evidence of coagulopathy: Primarily
detected by 20WBCT or visible
spontaneous systemic bleeding, gums etc.
Evidence of neurotoxicity: ptosis, external
ophthalmoplegia, muscle paralysis inability
to lift the head etc.
22. Severe Current Local envenoming
Severe current, local swelling involving
more than half of the bitten limb (in the
absence of a tourniquet). In the case of
severe swelling after bites on the
digits(toes and especially fingers ) after a
bite from a known necrotic species.
rapid extension of swelling ( for example
beyond the wrist or ankle within a few
hours of bites on the hands or feet).
Swelling a number of hours old is
nogrounds for giving ASV.
23. Dose And Route
Neurotoxic/ Anti Haemostatic 8-10 Vials
Children receive the same dose as adults B/c
it is to neutralize venom which is same
amount in both.
1. Intravenous Injection: reconstituted or liquid
ASV is administered by slow intravenous injection.
(2ml/ min) each vvial is 10ml of reconstituents.
2. Infusion: liquid or reconstituted ASV is diluted in
5-10ml/kg of isotonic saline or glucose.
All AVS over 1 hr in constant speed.
24. Neurotoxic Envenomation
In neurotoxic envenomation neostigmine test is
done with 1.5 -2.0 mg of neostigmine IM, together
with 0.6mg of atropine IV.
The paediatric neostigmine dose is 0.04mg/kg IM
and the dose of atropine in 0.05mg /kg.
Observe victim for 1 hour.
If the victim responds to the neostigmine test then
continue with 0.5mg of neostigmine IM ½ hourly
plus 0.6 mg of atropin IV over 8 hrs in continuous
infusion.
If there is no improvement in symptoms after one
hour, the neostigmine should be stopped.
25. Autopsy findins
Fang mark 1.2 cm deep , 2.5 cm deep
Froth in mouth & nostrils
Changes in Nissle granules in brain
matter, acute granular degeneration of
medula
Evidence of hemorrhage in
git, cerebrum, respiratory and urinary
tract, serosal surfaces of organs, sub
endocardial hemorrhage, regional
lymphadenitis.
Venom Extraction From
26.
27. Medico- Legal Importance
Accidental ; Most common
Suicidal ; Queen Cleopetra
Homicidal; Hannibal & Antiochus
defeated Romans in a naval battle.
Cattle Poison.
29. Scorpion venom
clear and colourless toxalbumin that is
more toxic than the snake venom
The small quantity of venom is
injected.
The scorpion venom consists of a
neurotoxin,haemolysins, proteinases,
phospholipase
A,leucocytolysin, coagulins,cholestrin
and lecithin.
30. SIGNS AND SYMPTOMS
site of a wheal is having a red wheal with a
hole in the centre and severe burning pain
radiates from the site.
The area is swollen, reddened .
Increased temperature with chills and
headache.
There is feeling of giddiness and fainting.
Excessive sweating and salivation
Muscular cramps and convulsions followed
by unconsciousness.
Paresis and muscular weakness persists
31. TREATMENT
Application of tourniquet or pressure bandage above
the site of bite and incising and washing the bitten
area with weak solution of potassium
permagnate, borax or ammonia.
The torniquet should be loosened for 1-2 minutes
after every 10-15 minutes.
Local infiltration of 5%cocaine, or lignocaine solution
in and around the bite relieves pain.
To treat shock, 5% of 500ml of dextrose saline should
be given i.v along with glucocorticoids
i.m.calcium gluconate 10 ml of 10% solution should
be given intravenously to combat muscular cramps.
To prevent pulmonary oedema, atropine sulphate
should be administered
34. Produce a painful local reaction, which recedes
with time.
An allergic phenomenon produced by them may kill
the patient because of prior sensitization.
Number of stings may be so great or the patient is so
young as to be killed with primary toxicity.
Signs and symptoms:
Nausea and vomiting
Thoracic compression
Cardiac irregularities
Pulmonary oedema
Nephrosis
Cyanosis, convulsions and death.
The fatalities may result a short while after the
infliction of stings.
37. Local swelling,excruciatin pain and
necrosis, paralysis and contracture of
extremities, cardiac
irregularities, arthritis and meningism
may occur.symptoms subside in 2to 3
days
45. Sea urchins;-
Hollow, venom filled, calcified spines
hemolysin, proteases, serotonins,
cholinergic substances.
Pain
If spine is retained near vital structure
than chances of granuloma formation
which should get operated.
46. Cone shells
Predator carnivorous mollusks.
Neurotoxic venom delivered through
harpoon like darts.
Wound, perioral, generalised parasthesia.
In severe condition Bulbar Dysfunction &
Systemic Muscular Paralysis.
47. Australian Blue Ringed
Octopus
Neurotoxin (maculotoxin) Na channel
blockage leads to peripheral nerve
transmisson inhibit.
Oral & facial numbness to total flaccid
palsy.
48. Vertebrates
Stingray ;- envenomation + traumatic
wound
Venom –
serotonin, phosphodiesterase, 5`nucleoti
dase.
Pain, Soft tissue swelling
Weakness, nausea, vomiting, diarrhea,
hypotension, syncope, paralysis & death.
Scorpion Fish ;- same as of stingray.
Stonefish, Scorpionfish, lionfish,
Cat fish ;- same as of stingray.
49. Treatment
Hot water immersion
No to cryotherapy
Pain killer,
Inj. T.T.
Antivenom for stonefish & serious
scorpion fish .
Other supportive care.
51. Ornithorhynchus
anatinus
• The venom apparatus is only
present in malesa
•Crural gland only secretes
venom in breeding season
• The use of the venom
apparatus is probably related to
combat with other males for
territory or females.
53. Venomous and Poisonous
Primate?
Nycticebus coucang
Nycticebus coucang inhabits the
rainforests of southeast
Asia, Assam, Burma, Thailand, Indo
-China, certain Malayan states and
East Indian Islands.
• They have a brachial organ, a naked, gland-laden area of skin on surface
of the arm that is licked during grooming.
• When mixed with saliva, the toxin can repel some predators.
• Anaphylaxis has been observed following loris bites.
• N. coucang braAchial organ protein acts as an allergen.