推 alexangel:好可怕的蛇>_< 11/19 20:51
※ 編輯: qzpm 來自: 219.81.193.15 (11/19 21:18)
http://blog.pixnet.net/qzpm/post/11003285
毒蛇咬傷的危險因子，決定動物於本身的體重及健康狀態，還有被咬的蛇是屬於哪種毒，及
被咬的部位，還有被咬的蛇的大小品種都有關係及治療時間的快或慢，這些條件都會和治療
成果有關係，如果被咬在頭部接近臉部、心臟部位它的死亡時間都會比較快，在四肢的話就
會比較延緩。蛇毒有分成神經毒和溶血毒。神經毒的話，像眼鏡蛇、雨傘結這類是屬於神經
毒。溶血毒的話像龜殼花、青竹絲、百步蛇是屬於溶血毒，鎖鏈蛇是溶血和神經毒混合。
症狀
出血性毒蛇
傷口灼痛、局部腫脹並擴散、起水泡、淤斑、紫斑、漿液血由傷口滲出、皮膚或皮下組織壞
死 、噁心、發燒、嘔吐、血痰、七孔流血、瞳孔縮小、血尿、低血壓、抽搐、痙攣。6~48
小時之內死亡。
神經性毒蛇
傷口疼痛、局部腫脹、嗜睡、運動神經失調、眼瞼下垂、瞳孔散大、局部無力、顎咽麻痺、
口吃、垂涎、噁心、嘔吐、昏迷、呼吸困難、呼吸衰竭。8~72小時之內死亡。
被蛇咬傷的處理
1. 不要去追打蛇，最好先觀察是哪一種蛇，通常毒蛇頭部多呈三角形(但雨傘節和海蛇的
頭部為橢圓形)，瞳孔可呈直線且花紋鮮豔，有大毒牙。記下蛇的特徵，有相機就拍下
來以便鑑別。
2. 讓病畜安靜下來，安撫牠使其安靜下來。
3. 趕快找到被咬傷的部分。
4. 如果是四肢咬到傷口上方兩吋用絲巾或止血帶綁起來，力道和我們要抽血時使用止血帶
綁住一樣，不要讓血流很快流回心臟，盡量把血由傷口擠出來。
5. 不要把傷口擴大。
6. 傷口儘量保持乾淨，可以用清水跟肥皂清洗。
7. 不要用嘴巴去吸傷口的污血，萬一嘴巴破掉不知道的話可能會因此自己中毒。
8. 傷口不要熱敷或冰敷。
9. 趕快送醫院，動物醫院一般沒有血清，要到人的醫院購買，血清不分人和動物都可以使
用，平常應該先詢問你家附近有哪間醫院有血清，以備不時之需，如果不知道被咬的蛇
種，可能需要買多力價的混合血清，買到血清後趕快到動物醫院救治，在打血清的時候
如果被咬到的部位兩個小時以內，可以一半打在被咬的部份，一半靜脈注射，如果超過
兩個小時打局部可能沒什麼作用，那只好打血管，每兩個小時依病情可以追加血清劑量
有可能會打到十幾瓶，所以買的時候不要只買一瓶。除了注射血清也要點滴和一些必要
的藥物，血清有的會過敏應該做過敏測試，一旦有過敏要治療過敏而不是停止給血清。
Reference:
http://www.royalah.com/modules/articles/article.php?id=12
特別提醒如果寵物被毒蛇咬傷，就醫前應先連絡疾病管制局詢問何處可取得毒蛇血清。
(可參考：http://topvet.topet.net/attachment_1.htm上的資料)
===============================================================================
Snake Bites
Veterinary & Aquatic Services Department, Drs. Foster & Smith, Inc.
Snake venom
Most snake bites are from pit vipers, which are poisonous snakes that are
identified by their triangular heads, retractable fangs, and a special
heat-sensing pit between the eye and nostril. North American pit vipers include
five subspecies of copperheads, three subspecies of water moccasins, three
subspecies of pygmy rattlesnakes, three subspecies of massauga, and at least 26
subspecies of rattlesnakes. Water moccasins and copperheads are found in the
eastern United States and southward through Texas. Rattlesnakes are found
throughout the contiguous United States, with the highest concentration in the
south and southwest.
General Information
Snake bites tend to occur on the pet's head or neck. Bites involving the trunk
of the body have a poorer prognosis. Snake bites may affect one or more body
systems including the cardiopulmonary system, the nervous system, or the
coagulation system. Usually, if the snake is not poisonous or the venom was not
injected, the pain, swelling, and bruising at the bite site will be minimal.
Toxic Dose
Varies. Envenomation does not always occur. The severity of envenomation is
related to the time of the year, the volume of venom present in the snake, the
location of the bite, the number of bites, and the amount of victim movement
after the bite (movement increases the spread of the venom). The amount of
venom is not related to the size of the snake. Systemic signs such as kidney
damage may take 24-72 hours to develop in mild envenomations, so the animal
should be observed closely for several days.
Signs
May see one, two, or several small puncture wounds, bleeding, bruising,
immediate and extremely painful swelling at the site of the bite, and tissue
necrosis. The more severe systemic signs may take up to several hours to appear
and include hypotension and shock, lethargy and weakness, muscle tremors,
nausea, vomiting, and neurological signs including depressed respiration.
Immediate Action
Identify the snake if possible. Restrict movement of the pet. Loosely
immobilize the limb in a functional position if bitten on an extremity. DO NOT
incise the bite wound to aspirate the venom and DO NOT apply a tourniquet
without veterinary assistance. DO NOT apply ice to the area. Seek veterinary
attention.
Veterinary Care
General treatment: The animal will be kept quiet and the bitten area
immobilized if possible to decrease the spread of the venom. The area around
the wound will be clipped and cleaned.
Supportive treatment: Antihistamines may be administered and IV fluids given to
help prevent low blood pressure. Oxygen is given if needed. Antibiotics are
used to prevent secondary infections. Pain medication is provided as necessary.
Laboratory tests to check for bleeding problems and organ damage will be
performed repeatedly. Blood transfusions may be necessary in cases of severe
coagulopathies. The area above and below the bite wounds may be measured every
15 minutes to monitor the edema. Nonsteroidal anti-inflammatory drugs (NSAIDs)
are contraindicated in the early phase (first 24 hours) of treatment because of
the different types of venom and the anticoagulant effects of NSAIDs. The use
of corticosteroids may be contraindicated also, as some research shows they
increase the severity of the bite.
Specific treatment: Antivenin* may be administered. The use of antivenin is
controversial and is used at the discretion of the attending veterinarian. To
be most effective, antivenin should be given within 4 hours of the bite. It
becomes less effective as more time passes.
All snake bite victims should be observed for a minimum of 12 hours, even when
there are no clinical signs. If clinical signs are present, the length of
observation is increased to 48-72 hours, as damage to organs may not appear
immediately.
Prognosis
A study of animals bitten by pit vipers showed that those treated with
antivenin, intravenous fluids, and antibiotics had a mortality rate less than
1% and local tissue damage was rare. The mortality rate in untreated patients
depended on the species of snake involved. For example, in patients bitten by
the Northern Pacific Rattlesnakes, the mortality rate was about 10%. In the
much more dangerous Mojave rattlesnake, it could be as high as 35%.
*Two companies, Fort Dodge and Wyeth Ayerst Laboratories produce antivenin.
Veterinary clinics and human hospitals in areas that have a high population of
pit vipers have this product on hand. Many owners want to carry this product
with them, but because of the intravenous administration and instability of the
product, it is recommended that a veterinarian give it.
Reference:
http://www.peteducation.com/article.cfm?cls=1&cat=1415&articleid=478
==============================================================================
順便附上，如果是人被蛇咬到，該如何做? (其實大同小異)
被蛇咬後的處置分成九要和四不要。
九要：
1.要保持冷靜：保持冷靜是活命的唯一法則，因為毒性發作需要一段時間，勿因慌亂而延
誤就醫時機。
2.要儘量吸出或擠出毒液：毒液屬蛋白成份，只要嘴部沒有傷口，即使吃進毒液，也不會
對人體造成傷害，因此要儘快吸出毒液。
3.要脫下手錶和首飾：蛇咬後傷口會迅速腫脹，所以要取下手錶與首飾等物品，以防止更
大的傷害。
4.要記錄被咬時間：傷口腫脹速度就是毒液量多寡的最佳判斷指標。
5.要將咬傷部位放低於心臟位置，如此可以減緩毒性發作時間。
6.要儘速送醫：儘速至醫院施打抗蛇毒血清，這是抑制毒發的唯一辦法。
7.要儘速將毒牙移開：尤其是神經性毒蛇，如雨傘節和眼鏡蛇等，因為它們的毒牙短小，
毒液量多寡和咬住時間成正比。
8.要儘量記住蛇的特癥：可以有效幫助醫師鑑別是否為毒蛇，以正確施打抗蛇毒血清，爭
取治療時間。
9.要打破傷風，以防止其他可能的感染。
四不要：
1.不要割傷口：割傷口只會讓傷口更加惡化，甚至造成死亡。
2.不要用彈性繃帶：使用彈性繃帶會將傷口侷限於小面積，反而加重該部位之傷勢。
3.不要喝酒：酒精會促進血液循環，促使毒性更快發作。
4.不要冰敷：冰敷是造成截肢的主因。
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如果有醫療或是飼養上的問題，也歡迎一起來討論和研究。
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◆ From: 219.81.193.15
※ 編輯: qzpm 來自: 219.81.193.15 (11/19 20:43)