Platypus Afɔkpodzi Spur Aɖi kple Australia Funnel-Web Akpɔkplɔ Atracotoxin Nyaƒoɖeamenu Immobilization Bandage¶

Australia nye afisi aɖi eve siwo to vovo wu le atikeŋutinunya me le aɖiŋutinunya le atikewɔnyawo me, si bia se siwo tsi tre ɖe wo nɔewo ŋu kura do ŋgɔ na kɔdziyiyi ƒe aɖidodo ƒe sewo: Australian Funnel-Web Spider (Genera Atrax kple Hadronyche, kpe ɖe Mouse Spider [Missulena]) kple ŋutsu Platypus ŋu. (Ornithorhynchus anatinus, si nye lã si naa no wo viwo ƒe akpa aɖe si ƒe fu le abe aɖi ene le xexeame). Sydney Funnel-Web (Atrax robustus) alo Northern Tree-Dwelling Funnel-Web (Hadronyche formidabilis) ƒe ɖuɖu doa delta-atracotoxins, peptide neurotoxins siwo xea mɔ na amegbetɔ ƒe voltage-gated sodium channels ʋuna eye wòʋãa fulminant, agbe-fɔku catecholamine kple cholinergic ahom le eme Aɖabaƒoƒo 10 va ɖo 60 (aɖuɖɔtoe ƒe ʋuʋu, aɖe ƒe ʋuʋu, fifia kple tsi si le dodom, ʋusɔgbɔdɔ sesẽ, ahɔhɔ̃mekawo ƒe aklã ƒe ʋuʋu, kple dzi ƒe gbagbã). Funnel-web kple mouse spider ɖuɖu bia Australia ƒe Pressure Immobilization Bandage (PIB) zazã enumake kpe ɖe splint sesẽ ŋu, dɔnɔa ƒe ʋuʋu keŋkeŋ, kple CSL Funnel-Web Spider Antivenom dodo kpata. Le go bubu me la, ne tɔƒodela aɖe si le ka aɖe ɖem, kayak-ʋukula, alo gbemelãwo xɔla lé platypus ŋutsu aɖe ŋu la, etsɔa keratinous calcaneal (ankle) spurs eve siwo me do le siwo le eƒe megbefɔwo dzi la yia eme abe calipers ene, eye wòdoa crural gland venom (siwo me defensin-like peptides [vDLPs], C-type natriuretic peptides [OvCNPs], kple lãmekawo ƒe tsitsinu). Platypus ƒe aɖi mewua amegbetɔwo gbeɖe o, aɖiwutike aɖeke mele eme o, eye mele be woaxatsae ɖe Pressure Immobilization Bandage GBEÐE o; ke boŋ eʋãa 10/10 vevesese si nu sẽ, si nu metsina o kple abɔ kple afɔ ƒe ʋuʋu gã aɖe si xɔ ŋkɔ be melɔ̃a morphine si wodona ɖe ʋuka me o eye wòbia kɔdzi ƒe nutome lãmekawo ƒe mɔxexe. Ne akpɔkplɔ yibɔ gã aɖe ɖu ame aɖe le Australia alo lãkle aɖe ʋãe la, ƒo ka na miaƒe nutoa me tɔwo xexlẽdzesi siwo wozãna kpata (000 le Australia) enumake. Dzro mía nɔviwo ŋuti mɔfiamegbalẽ siwo ku ɖe... Ahosi Ameyibɔ kple Redback vs Brown Recluse akpɔkplɔ ƒe ɖuɖu, . ʋetsuviwo kple akpɔkplɔ ƒe ɖuɖu, kple da ƒe ɖuɖu.

Wò nu vevitɔ enumake enye be de dzesii nenye be èle nu wɔm kple Big Black Spider (Funnel-Web / Mouse Spider) alo Platypus ankle spur: le ameyibɔ gã aɖe si ɖu ame le Australia ƒe ɣedzeƒe alo dzigbe gome la, na amesi ŋu wowɔ nuvevii la nanɔ anyi kpoo keŋkeŋ, xatsa broad elastic Pressure Immobilization Bandage (PIB) ɖe lãvi la dzi eye nàɖiɖi-kple-afɔ bliboa dzi, splint abɔ kple afɔ, eye nàyɔ 000 hena Funnel-Web Spider Antivenom. Le ŋutsu Platypus spur injury gome la, MÈGADE PIB o, ɖe spurs la ɖa blewuu, tsɔ sling eye nàna asi la nagaʋuʋu le dzi ƒe seƒe o, tsɔ cool pack si woxatsa (megaɖe ice gbeɖe o), eye nàtsɔe ayi kɔdzi hena bupivacaine regional nerve block.

Wɔ esia fifia¶

1. Ƒo ka na 000 enumake le Australia (alo wò nutoa me xexlẽdzesi kpata tso míaƒe xexeame katã xexlẽdzesi siwo wozãna kpata directory). Gblɔ na ambulance dzikpɔla enumake nenye be akpɔkplɔ yibɔ gã aɖe (si wosusu be Funnel-Web alo Mouse Spider) ɖu dɔnɔa alo Platypus ŋutsu aɖe ʋãe. Funnel-Web akpɔkplɔ si le Sydney alo ati me ƒe ɖuɖu ate ŋu ana yaƒoƒomɔ̃wo nado si ate ŋu ade ame ƒe agbe afɔku me, aklã me ʋuʋu, eye wòadze anyi le aɖabaƒoƒo 15 va ɖo 60 me, vevietɔ le ɖeviwo gome.
2. NA AME YEYE ƑE ƑOMEVI GÃWO (Funnel-Web Atrax / Hadronyche alo Mouse Spider Missulena): Tsɔ Pressure Immobilization Bandage (PIB) kple splint de eme le sɛkɛnd 60 me, eye nàna dɔnɔa nanɔ anyi kpoo keŋkeŋ.
3. Xatsa elastic blage si keke sentimeta 10 va ɖo 15 sesĩe ɖe teƒe si nèɖui la dzi tututu gbã, emegbe nàƒo ya ɖe anyi vaseɖe asibidɛwo alo afɔbidɛwo dzi eye nàƒoe vaseɖe abɔta alo akɔta vaseɖe abɔta alo akɔta le sesẽ si wozãna na afɔkpodzi si vuvu (40 va ɖo 70 mmHg), eye nàgblẽ asibidɛwo alo afɔbidɛwo ƒe nugbɔwo ɖi wòadze nyuie be woalé ŋku ɖe pink capillary reill ŋu.
4. Bla aŋe sesẽ (ati, magazine si woxatsa, alo akɔtakpoxɔnu) ɖe abɔ si wobla la ŋu ale be ƒunukpeƒeawo nagabɔbɔ o, eye tsɔ ambulance ƒe ʋuƒoa va dɔnɔa gbɔ (mègana dɔnɔa nazɔ gbeɖe o, elabena lãmekawo ƒe pɔmpi ƒoa delta-atracotoxin doa goe le ʋukawo me yia ʋukawo me).
5. NA ŊUTSU PLATYPUS ANKLE SPUR INJURY: MÈGAZE Pressure Immobilization Bandage (PIB) alo arterial tourniquet GBEÐE o. Platypus crural venom wɔa dɔ le teƒea ɖe nociceptive pain fibers kple capillary beds dzi be wòana abɔ kple afɔ ƒe vuvu gã, si me ʋuʋudedi le kple microvascular leakage. Ne wobla aŋe si wotsɔ blaa asi si wotsɔ platypus ƒoe sesĩe la, eléa aɖi ƒe peptideawo ɖe teƒea, enaa vevesese si gbã ŋku na ame xoxo la nu sẽna ɖe edzi, eye wòdea afɔku me be ʋuka siwo me ʋu sina tona la gblẽna.
6. Ne Platypus ŋutsu aɖe gakpɔtɔ le asi alo afɔ ŋu to eƒe megbefɔti ƒe afɔtiwo dzi la, do alɔ lãa ƒe ŋutilã ƒe kpekpeme eye nàkeke eƒe megbefɔwo ɖe vovo blewuu be nàɖe kɔsɔkɔsɔ siwo le ƒoƒom ɖe eme la ɖa. Mègahe wò asi sesĩe alo avuvu wò asi ɖa le platypus ŋu gbeɖe o; lãa xatsa eƒe megbefɔwo ɖe asibidɛ alo ŋgɔgbea ŋu eye wòtsɔa afɔti eve siwo woƒo ƒu si didi sentimeta 1.5 la yia eme yia wo nɔewo gbɔ abe tsikpe ƒe asike ene, eyata ne ehe aɖatsi goglowo le lãkusiwo kple lãmekawo me.
7. Na Platypus spur abi: klɔe blewuu kple adzalẽ kple tsi dzadzɛ, ɖe asigɛwo, gaƒoɖokuiwo, kple asigɛwo katã ɖa enumake, ɖiɖi abɔa ɖe sling me, eye nàtsɔ compress fafɛ alo tsikpe si woxatsa asisi ɖe eŋu (mègatsɔ tsikpe ƒuƒlu alo tsikpe si ana wòaxɔ tsikpe gbeɖe o). Massive non-pitting swelling spreads from the hand up to the shoulder within 30 to miniti 90 eye wòatrɔ asigɛ ɖesiaɖe wòazu tourniquet si lãa asibidɛ.
8. Le kɔdzi: bia CSL Funnel-Web Spider Antivenom (ampoule 2 va ɖo 4 IV) enumake HAFI nàɖe PIB la ɖa na Funnel-Web ƒe ɖuɖu ƒe dzesi ɖesiaɖe; ne èdi Platypus spur la, bia be woawɔ nutome lãmekawo ƒe mɔxexe si wotsɔ ultrasound fiaa mɔe enumake (0.5% bupivacaine/ropivacaine) elabena morphine kple opioid siwo wodona ɖe ʋuka me mete ŋu ɖua platypus ƒe vevesese si gbɔ eme dzi edziedzi o.

Nyametsotsoti: Australiatɔwo ƒe Funnel-Web / Mouse Spider kple Ŋutsu Platypus kple Redback Spider ƒe vovototodedeameme¶

flowchart TD
    A["Australiatɔwo ƒe Aɖi ƒe ɖuɖu alo Spur Nuveviwɔame"] --> B{"Lã kae na aɖia va?"}
    B -->|Large shiny black spider with massive downward fangs: Funnel-Web (Atrax / Hadronyche) or Mouse Spider (Missulena)| C["NU KPƆKPƆ KPƆKPƆ KPƆKPƆ KPƆKPƆ LE AMEGBETƆWO ME: Na dzigbɔɖi nanɔ anyi kpoo keŋkeŋ; yɔ 000 FIFIA"]
    B -->|Webbed semi-aquatic mammal in eastern Australian river/creek drove hind ankle spur into hand/leg| D["Atsu si woyɔna be Platypus (Ornithorhynchus anatinus) ƒe Aɖi si wotsɔna ƒoa ƒui"]
    B -->|Small black spider with red stripe on abdomen in dry shed/garden: Redback Spider (Latrodectus hasselti)| E["Latrodectism: MÈGAzã PIB o; de nufamɔ̃ si woxatsa ɖe eŋu; kɔdzi na vevesesenutsitike / Redback Antivenom"]
    C --> F["De Elastic Pressure Immobilization Bandage (PIB) ɖe lãvi kple abɔ kple afɔ bliboa dzi + Rigid Splint; MÈGAKƆ teƒe si woɖu nu le o"]
    F --> G["Kɔdzi ED Gbugbɔgadzɔ Xɔ: Na PIB nanɔ edzi vaseɖe esime IV access & CSL Funnel-Web Spider Antivenom (2 va ɖo 4 vials) nasu te"]
    G --> H["Do Antivenom + PEEP Ventilation na aklã me ʋuʋu + Atropine na aɖuɖɔtoe me dɔléle + Ʋusɔgbɔdɔnutsitikewo"]
    D --> I["MÈGAZÃ PIB alo tourniquet GBEÐE o; ɖe kɔsɔkɔsɔwo ɖa blewuu; ɖe asigɛ/gaƒoɖokuiwo katã ɖa enumake; klɔe kple adzalẽ kple tsi"]
    I --> J["Na abɔ kple afɔ naʋuʋu le sling me; tsɔ fafɛ compress de eme; ʋuɖoɖo yi Kɔdzi ED hena vevesese si gbɔ eme 10/10 si womate ŋu akpɔ o"]
    J --> K["Kɔdzidzikpɔkpɔ: Nutome Lãmetsiŋusẽ ƒe Mɔxexe (Asibidɛ/Abɔta ƒe Ʋuka Bupivacaine) + Nitrous Oxide/Ketamine + Abidede tsi & Dɔlékuiwutikewo"]

Ta kple ta tsɔtsɔ sɔ kple wo nɔewo: Funnel-Web Akpɔkplɔ kple Mouse Akpɔkplɔ kple Ŋutsu Platypus Spur kple Redback Akpɔkplɔ¶

Esi wònye be Australiatɔwo ƒe kpekpeɖeŋunana gbãtɔ ƒe mɔfiamewo (ANZCOR ƒe Mɔfiame 9.4.2 kple 9.4.8) de se be woazã atike siwo tsi tre ɖe wo nɔewo ŋu le lãa nu ta la, vovototodedeameme le axadzi le vevie ŋutɔ:

Australiatɔwo ƒe Funnel-Web (Atrax & Hadronyche) kple Mouse Spiders (Missulena): Dɔléleŋutinunya kple PIB Mɔnu¶

1. Nusita Sydney kple Tree-Dwelling Funnel-Webs nye atikewɔwɔ kpata¶

Australia ƒe funnel-web spider ƒomevi 35+ (Family Atracidae, genera Atrax kple Hadronyche) nɔa ave xɔdzowo, gullies, dugã godo agakpewo, kple tsiƒuƒe skimmers le ɣedzeƒe ƒuta tso Queensland ƒe dzigbeɣedzeƒe vaseɖe New South Wales (si me Sydney Funnel-Web, Atrax hã le robustus, si wokpɔ le kilometa 160 ƒe didime tso Sydney) va ɖo Victoria, Tasmania, kple Flinders Togbɛ siwo le South Australia. - Nusitae atsu siwo le tsaglãla tsam le dzomeŋɔli/adame ɖua nu: Le zã siwo me dzoxɔxɔ kple fafa le le tsidzadza gã aɖe megbe (November vaseɖe April) la, Sydney Funnel-Webs ŋutsu tsitsiwo dzona le woƒe do siwo me seda le la me be yewoatsa le nyɔnuwo dim, wogena ɖe anyigbaxɔdzowo dzi enuenu, afɔkpawo, nudzadzra ƒe ƒuƒoƒowo, alo gena ɖe megbexɔ me tsiƒuƒewo (afisi woate ŋu atre mɔ̃ le ya ƒe kuɖɔ aɖe le woƒe ƒodo ƒe fuwo me eye wotsia agbe ne wonyrɔ ɖe ta la ƒe anyigba gaƒoƒo 24 va ɖo 36, eye wòɖua amesiame si fɔ wo hesusu be yewonyrɔ).Atsu Atrax robustus ƒe aɖi nye aɖi wu primatewo zi gbɔ zi 5 va ɖo 6 wu nyɔnu ƒe aɖi elabena atsua koe wɔa **delta-atracotoxin-Ar1 ƒe agbɔsɔsɔ gã (robustoxin) ** ƒe atike. Nusiwo ŋu ŋusẽ le wue nye Anyiehe kple Anyiehe Ati-Dwelling Funnel-Webs (Hadronyche formidabilis kple Hadronyche cerberea) le NSW kple Queensland, siwo hea aɖi sesẽ vɛ le lã siwo wu 50 le alafa me me. - Paraxial Fang Mechanics: To vovo na egbegbe Araneomorph akpɔkplɔwo (abe ahosiwo alo orb-weavers ene) siwo ƒe asikewo ƒoa ƒu ɖe axadzi abe tweezers (diaxial) ene la, Mygalomorph akpɔkplɔwo (Atrax, Hadronyche, Missulena, kple tarantulas) ƒe asikewo nye massive paraxial fangs siwo fiaa asi tẽe yi anyime parallel ɖe wo nɔewo ŋu abe pickaxes veviwo. Be akpɔkplɔ si ƒe didime nye milimeta 5 nate ŋu age ɖe eme la, akpɔkplɔ si woyɔna be funnel-web la fɔa eƒe megbefɔwo dzi eye wòƒoa eɖokui ɖe anyi enuenu, eye zi geɖe la, eléna ɖe eŋu ale be ele be woaʋuʋui alo atsɔ brɔs atsoe.

2. Delta-Atracotoxin ƒe ahom si le eɖokui si si ƒe akpa eve¶

Ne delta-atracotoxin nya ge ɖe ʋumenugbagbeviɣidɔ me ko la, dzesiawo wóna le aɖabaƒoƒo 10 va ɖo 30 me le ɖeviwo me (le ŋutinya me la, ewua ame le aɖabaƒoƒo 15 pɛ ko me le ɖevi sue aɖe me hafi woɖua dɔlékuiwutike) eye aɖabaƒoƒo 15 va ɖo 90 le ame tsitsiwo me:

1. Akpa 1: Hyperacute Excitation Storm (Aɖabaƒoƒo 10 vaseɖe Gaƒoƒo 4):
2. Ahɔhɔ̃mekawo ƒe dzesiwo: Goosebumps (piloerection) kple teƒea ƒe lãmekawo ƒe ʋuʋu le teƒe si woɖui la yia ŋgɔ kabakaba va zua ʋuʋudedi kple ʋuʋudedi ƒo xlã nu kple nuyiwo (perioral paresthesia), aɖe ƒe ʋuʋu si wokpɔna abe nudzodzoe ene (lingual fasciculations), mo ƒe lãmekawo ƒe ʋuʋu, trismus (aɖu ƒe ƒoƒo), kple generalized ƒumeŋuɖui ƒe lãmekawo ƒe fasciculations.
3. Cholinergic (Parasympathetic) Outpouring: Acetylcholine ƒe dodo gã aɖe hea ropy salivation gbogbo aɖe (sialorrhea), aɖatsi (aɖatsi), fifia si ƒona ɖe ame ŋu le afisiafi (diaphoresis), aɖuɖɔtoe me tsi gbogbo aɖewo, ʋuʋudedi, ʋuʋudedi, kple ƒodo ƒe ʋuʋu.
4. Adrenergic (Sympathetic) Crisis kple Pulmonary Edema: Norepinephrine kple epinephrine ƒe dodo le ɣeyiɣi ɖeka me le agbɔsɔsɔ gã me hea tachycardia si gbɔ eme, ʋuka me ʋusɔgbɔdɔ vɔ̃ɖi (zi geɖe la, ewua 200/120 mmHg), ʋu si dona le ta me ƒe afɔku, kple fulminant acute pulmonary edema (neurogenic capillary leak kple acute left ventricular afterload failure si wotsɔ ƒo ƒui), si naa tsi si le pink si me ʋuʋudedi le yɔa yaƒoƒomɔa me eye wòhea hypoxia kple coma sesẽ vɛ.
5. Akpa 2: Catecholamine ƒe vɔvɔ le megbe kple dzitodzitowo ƒe gbagbã (Gaƒoƒo 4 va ɖo 24):
6. Ne dɔnɔa tsi agbe le Akpa 1 lia me dɔlékuiwutike manɔmee la, presynaptic nerve terminals ɖea woƒe catecholamines ƒe nudzraɖoƒewo ɖa esime acidosis kple myocardial stunning dze egɔme Dɔnɔa trɔna kpata tso ʋusɔgbɔdɔ sesẽ me yia profound, refractory hypotension, bradycardia, multi-organ failure, and cardiac arrest.

================================================================================
   AUSTRALIAN PRESSURE IMMOBILIZATION BANDAGE (PIB) TECHNIQUE (ANZCOR 9.4.2)
   [Use ONLY for Funnel-Web / Mouse Spiders, Snakes, Cone Snails, Blue-Ringed Octopus]
   [NEVER use for Platypus Spur, Redback Spider, Stonefish, or Stingray]
================================================================================

  STEP 1: Broad Pressure over Bite       STEP 2: Wrap Whole Limb + Splint
  --------------------------------       ---------------------------------------
       |     |                                | \ / | <-- Wrap ALL the way up to
       |=====| <-- Wrap 10-15 cm wide         | / \ |     armpit or groin at
       |=====|     elastic bandage            | \ / |     40-70 mmHg (firm ankle
       |=====|     over bite site             | / \ |     sprain tension).
       |  *  |     first (DO NOT              | \ / |
       |     |     wash bite).           [SPLINT]==== <-- Bind rigid splint so
      /       \                               /     \     joints CANNOT bend;
     ( Fingers )                             ( Toes  )    keep patient STILL.
================================================================================

3. Kɔdzi gbugbɔgagbɔ kple CSL Funnel-Web Spider Antivenom ƒe ɖoɖowɔɖi¶

1. Na PIB la nanɔ teƒea Vaseɖe esime Gbɔgbɔyɔyɔ Nasɔ:
2. Ne dɔnɔa va ɖo dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ kple PIB le teƒea la, mègaɖe aŋea le triage me o. Ne delta-atracotoxin ƒe bolus gã aɖe xaxa ɖe abɔ kple afɔ ƒe ʋukawo me la, asiɖeɖe le aŋea ŋu kaba hea aklã me ʋuʋu kple ʋusɔgbɔdɔ ƒe kuxi si nye afɔku vɛ enumake le miniti 5 me.
3. Ðo IV ka eve siwo me do gãwo le, de ECG/BP/SpO2 ƒe ŋkuléleɖenuŋu si yia edzi la ɖe eŋu, dzra yaƒoƒomɔ̃ ƒe mɔ̃ siwo wotsɔna dea ya me ɖo, eye nàna CSL Funnel-Web Spider Antivenom ƒe ampoule 2 nahe ɖe aba dzi hafi aɖe PIB la ɖa.
4. CSL Funnel-Web Akpɔkplɔ ƒe Dɔlékuiwutikewo Dzikpɔkpɔ:
5. Wowɔe tso hyperimmune rabbit IgG si ŋu wokɔ si wonyi ɖe Atrax robustus aɖitsu (si wɔa dɔ ŋutɔ ɖe Atrax, Hadronyche, kple Missulena ƒomeviwo katã ŋu ŋutɔ, eye nulɔdɔ ƒe dzidziɖedzi le sue ŋutɔ ne wotsɔe sɔ kple sɔ ƒe dɔlékuiwutikewo).
6. Agbɔsɔsɔme: Ne aɖi le ɖoɖo nu ƒe dzesi ɖesiaɖe (perioral tingling, tongue fasciculations, fifia, aɖuɖɔtoe, ʋusɔgbɔdɔ, ʋuʋu), do 2 ampoules (250 units) si woɖe ɖe 100 mL normal saline IV me le miniti 15 va ɖo 20 me. Ne aɖi sesẽ (aklã me ʋuʋu, alɔ̃madɔmadɔ, ʋusɔgbɔdɔ sesẽ) la, dze egɔme kple 4 ampoules IV enumake eye nàgbugbɔ ampoule 2 aɖabaƒoƒo 15 ɖesiaɖe vaseɖe esime autonomic kple neuromuscular dzesiwo katã nu nayi.
7. Critical Care Yameʋuɖoɖo kple Ʋumenugbagbeviɣi ƒe Kpekpeɖeŋu:
8. Do oxygen si sina fũ, CPAP, alo endotracheal intubation kple Positive End-Expiratory Pressure (PEEP, 10 va ɖo 15 cmH2O) na aklã me ʋuʋu.
9. Na IV atropine (0.6 va ɖo 1.2 mg IV; 0.02 mg/kg le ɖeviwo me) na cholinergic bronchial secretions siwo le nyrɔm kple aɖuɖɔtoe.
10. Da Akpa 1 ƒe ʋusɔgbɔdɔ si ate ŋu ade ame ƒe agbe afɔku me kple ʋuka kekeɖenu siwo wɔa dɔ kpuie, siwo woate ŋu adzi ɖe edzi (abe sodium nitroprusside alo phentolamine ene), eye Mègana beta-blockers siwo wɔa dɔ ɣeyiɣi didi GBEÐE o, siwo hea alpha-ʋukawo ƒe ʋuʋu si ŋu wometsi tre ɖo o vɛ kaba eye wònaa dzitodzitowo ƒe gbagbã si wua ame kabakaba ne dɔnɔa trɔ yi Akpa 2 lia me ʋusɔgbɔdɔ si nu sẽ.

Ŋutsu Platypus (Ornithorhynchus anatinus) Afɔkpodzi ƒe Aɖi: Dɔlélenutsiŋutete kple Lãmetsiŋusẽ ƒe Mɔxexeɖedɔléle Dzikpɔkpɔ¶

1. Crural venom system ƒe ŋutilã ƒe wɔwɔme kple ɣeyiɣi ƒe vidzidzi ƒe ŋusẽ¶

platypus (Ornithorhynchus anatinus), si nɔa tsi nyui tɔsisiwo, billabongs, kple tɔʋuwo me tso Queensland yi anyime to New South Wales, Victoria, kple Tasmania, nye lã ʋee siwo naa no wo viwo siwo me aɖi le siwo le Anyigba dzi la dometɔ ɖeka. - Amekae aɖia le: Wodzia platypus viŋutsu kple nyɔnu siaa kple megbefɔti ƒe aŋgba gbãtɔwo, gake nyɔnua ƒe aŋgbawo trɔna ɖe megbe le woƒe agbenɔƒe gbãtɔ me. Platypus ŋutsu tsitsi koe léa keratinous calcaneal (ankle) spurs (anɔ abe milimeta 12 va ɖo 15 [inch 0.5 va ɖo 0.6]) siwo ɖa, siwo le goglo, siwo me do le, siwo wotu ɖe tarsal ƒu siwo kpena ɖe wo nɔewo ŋu siwo woate ŋu aʋuʋu dzi le megbefɔ ɖesiaɖe ƒe akpa si le eme la ɖe asi. - Crural Gland Seasonal Hypertrophy: Wotsɔa lãkusi ɖesiaɖe si me do le la doa ka to lãmeka ƒe mɔ̃ si ƒe gli le ɣie dzi va ɖoa ayiku ƒe nɔnɔme crural venom gland si le ata si le etame la gbɔ. Esi wònye be platypus ŋutsuwo trɔ woƒe aɖi ƒe lãkusiwo koŋ hena atsu kple ŋutsu ƒe anyigbamamaʋawɔwɔ le kele me vidzidziɣi (August vaseɖe October le Australia) ta la, crural glands lolona ŋutɔ eye woɖea aɖi ƒe agbɔsɔsɔ si sɔ gbɔ wu (si ade mililita 4 le ƒoƒo ɖesiaɖe me) ɖe go le dzomeŋɔli ƒe nuwuwu kple kele me. - Alesi amegbetɔwo ʋãnae: Amegbetɔwo ƒe aɖiwo katã kloe dzɔna ne tɔƒodela si si susu nyui le dze agbagba be yeaɖe kɔsɔkɔsɔ si le lãgbalẽgolo si xaxa ɖe tɔƒodemɔ̃ alo yabby mɔ̃ si mele se nu o me, alo ne gbemelãwo dzikpɔla aɖe tsɔ lãa tso ete. Platypus atsu la xaa megbefɔ eveawo ɖe amesi ŋu wowɔ nuvevii la ƒe asi, asibidɛ, alo ata ŋu eye etsɔa afɔkpodzi ƒe afɔti eveawo siaa yia eme abe calipers eve ene, léna ɖe wo ŋu sesĩe eye wòtsɔa aɖi si le ƒuƒlu la ƒua gbe ɖe ŋutigbalẽ kple lãmeka gogloa me enuenu.

2. Nusita Platypus ƒe aɖi naa vevesese si nu morphine te ŋu nɔa te ɖo eye lãmekawo gblẽna ɣleti geɖe¶

To vovo na da alo funnel-web spider ƒe aɖi siwo trɔ be yewoawu lãwo kabakaba to gbɔgbɔtsixe ƒe lãmetutudɔ alo coagulopathy dzi la, platypus ŋutsuwo ƒe aɖi trɔ be hea vevesese si gbãa ŋku, si megate ŋu wɔa naneke o vɛ na atsu siwo le ho ʋlim kplii: 1. Peptide Cocktail tɔxɛ: Proteomic kple genomic numekuku le Ornithorhynchus crural aɖi ŋu de dzesi aɖi ƒe nuŋɔŋlɔ vovovo 83 ya teti le protein ƒome 13 me, si me ornithorhynchus aɖi ene defensin-like peptides (vDLPs), ovCNPs (C-type natriuretic peptides), xɔ aƒe ɖe eme. nerve growth factor (NGF), hyaluronidase, kallikrein-like serine proteases, kple L-to-D-peptide isomerase (si trɔa L-amino acid si le vDLPs kple natriuretic peptides ƒe N-nuwuƒe wòzua D-amino acid, si wɔnɛ be aɖiawo te ŋu nɔa te ɖe amegbetɔ ƒe proteases ƒe gbagbã nu ale be wonɔa dɔ wɔm le abi la me ŋkeke geɖe va ɖo kwasiɖa geɖe). 2. Nociceptor ƒe Dɔwɔwɔ Tsã kple Morphine ƒe Tsitretsitsi: Platypus aɖi peptides ʋua cation mɔwo tẽ le amegbetɔ ƒe megbe ke ganglion (DRG) C-fiber kple A-delta nociceptors dzi, ʋãa teƒea ƒe histamine kple bradykinin ƒe dodo gã aɖe, eye wodoa lãmekawo ƒe tsitsi ƒe dzesiwo ɖe dzi. Esi wònye be tudada sia si me vevesese le la toa mu-opioid xɔla ƒe tɔtrɔ si wozãna ɖaa ŋu ta la, dɔdamɔnu siwo kplɔ wo nɔewo ɖo ka nya ta ɣesiaɣi be morphine, pethidine (meperidine), alo fentanyl si wodona ɖe ʋuka me ƒe agbɔsɔsɔ gã gɔ̃ hã menaa gbɔdzɔe si mesɔ o, si wɔnɛ be dɔnɔa nɔa ʋuʋum le vevesese 10/10 me esime wòle gbɔgbɔtsixetsixe kple ʋuʋudedi si opioid hena vɛ la xɔm. 3. Dɔdaƒe ƒe Nusɔsrɔ̃ (Acute Hyperalgesia, Allodynia, Edema, kple Ɣeyiɣi Didi ƒe Atrophy): - Aɖabaƒoƒo 0 va ɖo 60: Vevesese si xɔa dzo enumake le spur punctures eveawo me la klẽna yia abɔ bliboa dzi va ɖoa axilla kple akɔta ƒe gli gbɔ. Ʋuʋudedi si me ʋuʋudedi le, si me do mele o, naa asibidɛwo, asi, kple abɔta vuvuna wòzua teƒe eve kloe le gaƒoƒo ɖeka me. - Ŋkeke 1 vaseɖe 14: Goglo mɔ̃ kple dzoxɔxɔ ƒe allodynia (ya fafɛ alo avɔ si ka ŋutigbalẽa gɔ̃ hã hea vevesese sesẽ vɛ) kple asibidɛ ƒe ƒoƒo/keke ɖe enu ƒe dɔwɔwɔ ƒe bu. - Kwasiɖa 2 vaseɖe Ɣleti 3: Togbɔ be ahɔhɔ̃mekawo ƒe aɖi si le titina alo ʋumenugbagbeviɣidɔ aɖeke meli o hã la, dɔnɔwo kpɔa alɔ̃madɔmadɔ si nɔa anyi ɖaa, vevesese si le veve sem, kple ƒunukpeƒe ƒe lãmeka siwo le teƒe ɖeka ƒe gbegblẽ (atrophy) si le asi kple abɔta ƒe lãmeka siwo le eme me (si domenɔlae nye aɖi myotoxic/proteolytic components kple wo zazã) si hiã ɣleti geɖe ƒe asi ƒe lãmesẽnyawo gbɔ kpɔkpɔ be wòahaya.

3. Afɔɖeɖe ɖesiaɖe ƒe kpekpeɖeŋunana gbãtɔ kple kɔdzi ƒe ɖoɖowɔɖi na Platypus ƒe aɖi¶

1. Field First Aid (Nusi Nàwɔ Kple Nusi Màwɔ GBEÐE O):
2. Ðe kɔsɔkɔsɔawo dedie: Do alɔ platypus la ale be wòagahe ɖe wò asibidɛ ŋu o, eye nàkeke eƒe megbefɔwo ɖe gota blewuu be wòaɖe asibidɛ siwo le ƒoƒom ɖe eme la ɖa evɔ màvuvu wò ŋutilã o.
3. MÈGAzã Pressure Immobilization Bandage (PIB) alo tourniquet GBEÐE o: ANZCOR ƒe Mɔfiame 9.4.8 xe mɔ ɖe PIB nu tẽ na platypus spurs elabena ne wolé D-amino-acid-stabilized vDLPs kple proteases ɖe asi me la, enaa vevesese si nu sẽ kple vuvu nu sẽna ɖe edzi.
4. Klɔe eye nàɖe asigɛa ɖa Enumake: Klɔ spur punctures la kple adzalẽ kple tsi dzadzɛ, ɖe asigɛwo, gaƒoɖokuiwo, kple asigɛwo katã ɖa le miniti 2 gbãtɔawo me hafi vuvua naxe wo, tsɔ alɔa da ɖe supportive sling me, eye nàde cool compress alo ice pack si woxatsa ɖe towel me (megaɖe tsikpe ƒuƒlu gbeɖe o).
5. Kɔdzi Vevesesenutsitike (Nutome Lãmetsiŋusẽ ƒe Mɔxexe ƒe Sika Dzidzenu):
6. Ne èva ɖo dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ la, na Nitrous Oxide / Oxygen (Entonox) si wogbɔna enumake 50:50 alo Ketamine si ƒe agbɔsɔsɔme le sue (0.1 va ɖo 0.3 mg/kg IV) + fentanyl si wodo ɖe ʋu me si wodo ɖe ʋu me abe tɔdzisasrã ene.
7. Wɔ Regional Nerve Block Enumake: Atikewɔwɔ ɖeka kolia si wɔa dɔ wu si ɖea platypus spur vevesese ɖa keŋkeŋ le miniti 5 va ɖo 10 me enye ultrasound-guided regional nerve block si te ɖe edematous zone ŋu (abe axillary, infraclavicular, alo supraclavicular brachial plexus block, alo median, ulnar, kple radial forearm nerve blocks) si zãa 0.5% bupivacaine alo 0.5% va ɖo 0.75% ropivacaine si wɔa dɔ ɣeyiɣi didi (zi geɖe la, wotsɔa wo dana ɖe perineural nerve block catheter si yia edzi hena gaƒoƒo 48 va ɖo 72 ƒe dodo le dɔnɔdzikpɔƒe).
8. Abi Didi, Radiographs, Kple Dɔlékuiwutikewo ƒe Mɔxexe Ðe Enu:
9. Ne abɔa nya vuvu keŋkeŋ tso nutome lãmeka ƒe mɔxenu gbɔ ko la, xɔ radiographs gbadzaa (X-rays) be nàɖe keratin spur ƒe nugbɔ alo periosteal chips siwo lé ɖe asi ɖa, eye nàtsɔ saline si me dɔlékui mele o si sɔ si me dɔlékui mele o ade tsi togbɛa ƒe mɔ gogloawo blewu (mègatsɔ **megatsɔ aŋe abla doawoe o).
10. Trɔ asi le tetanus ƒe nɔnɔme (Tdap/Td) ŋu eye nàna dɔlékuiwutike siwo ƒe dɔwɔwɔ keke ta siwo tsyɔa tsi nyui Aeromonas hydrophila kple ŋutigbalẽ me numiemiewo (abe ciprofloxacin 500 mg PO zi eve gbesiagbe kpe ɖe amoxicillin-clavulanate alo flucloxacillin/clindamycin ŋu hena ŋkeke 5 va ɖo 7), eye woatsɔ wo ayi asi gbɔ kaba dɔwɔwɔ ƒe atikewɔwɔ ne edema sesẽa nu fa ko be wòaxe mɔ ɖe asi ƒe lãmeka siwo le eme ƒe gbegblẽ tegbee kple ƒunukpeƒewo ƒe sesẽ nu.

Nutome ƒe xexlẽdzesi siwo ku ɖe nudzɔdzɔ kpatawo ŋu kple dɔwɔƒea ƒe ɖoɖowo¶

• Australia (New South Wales, Queensland, Victoria, Tasmania, Anyiehe Australia, ACT):
• Ƒo 000 enumake ne akpɔkplɔ yibɔ gã ɖesiaɖe ƒe ɖuɖu alo platypus ƒe aɖi sesẽ aɖe (alo 112 tso asitelefon si ƒe dzesi gbɔdzɔ gbɔ).
• Te ɖe Australian Poisons Information Center ŋu ​​le 13 11 26 (gaƒoƒo 24 gbesiagbe le Australia katã) be nàdo ka kple atikewɔla si le dɔ wɔm kpata la tẽ kple aɖiŋutinunyala si le atikewɔƒe hena CSL Funnel-Web Spider Antivenom ƒe agbɔsɔsɔme alo platypus nutome vevesesenutsitike ƒe ɖoɖowo.
• Wɔ ɖe ANZCOR Mɔfiame 9.4.2 (Aɖi: Akpɔkplɔ ƒe ɖuɖu) na Funnel-Web kple Mouse Akpɔkplɔwo (PIB + splint) kple ANZCOR Mɔfiame 9.4.8 (Aɖi: Nyaƒoɖeamenu ƒe Mɔxexeɖenu) dzi hena PIB ƒe tsitretsitsi vevie le Platypus kple Redback ƒe aɖiwo me.
• New Zealand: Ƒo ka na 111 hena nɔnɔme kpatawo eye nàƒo ka na New Zealand Dukɔa ƒe Aɖi Dɔwɔƒe le 0800 764 766.
• United Kingdom, Europa Dukɔwo ƒe Ðekawɔha, United States, kple Canada (Lãwo Ŋuti Nuƒoƒoƒu & Nudzɔdzɔ Siwo Mebɔ O): Ƒo ka na 999 (UK), 112 (EU), alo 911 (US/Canada), eye nàƒo ka na US Aɖidzikpɔkpɔ le 1-800-222-1222 alo UK NPIS (TOXBASE). Ele be lãwo dzikpɔƒe, numekukuwɔƒe, alo dukɔmeviwo ƒe adzɔxeƒe ɖesiaɖe si me Australiatɔwo ƒe Atrax / Hadronyche funnel-web akpɔkplɔwo le la nalé be na CSL Funnel-Web Spider Antivenom si ƒe ɣeyiɣi mede o le teƒea alo le nutoa me ƒe kɔdzi si woɖo be woaxɔ nuveviwɔamewo kple keteke dɔwɔlawo le Pressure Immobilization Bandaging enumake.

Nya siwo wobiaa amewo enuenu¶

Nukatae nèblaa Pressure Immobilization Bandage sesẽ aɖe ɖe Funnel-Web akpɔkplɔ ƒe ɖuɖu ŋu, gake MÈblaa Platypus spur alo Redback akpɔkplɔ ƒe ɖuɖu GBEÐE o?¶

Sydney alo Tree-Dwelling Funnel-Web akpɔkplɔ doa delta-atracotoxin, si nye ahɔhɔ̃mekawo ƒe aɖi si wua ame kabakaba si toa ʋuka siwo me ʋu sina tona me yia ʋukawo me eye wònana aklã me ʋuʋu si ate ŋu ade ame ƒe agbe afɔku me eye dzi natɔ te le miniti 15 va ɖo 60 me, evɔ megblẽa nu le teƒea ƒe lãmeka aɖeke kloe o. Ne wobla Pressure Immobilization Bandage (PIB) sesẽ aɖe eye wotsɔ ka bla abɔa la, etɔa ʋukawo ƒe sisi eye wòléa ahɔhɔ̃mekawo ƒe aɖia ɖe abɔa me dedie vaseɖe esime wona CSL Funnel-Web Antivenom le kɔdzi. To vovo na ema la, Platypus ƒe aɖitsu kple Redback akpɔkplɔ ƒe aɖi wɔa dɔ le teƒea be woase veve vevie eye lãmenugbagbeviwo navuvu (aɖi si wua ame kabakaba manɔmee); PIB sesẽ aɖe babla ɖe Platypus spur dzi léa vevesese ƒe peptideawo ɖe asi me eye wònaa vevesese kple abi si le veve sem la gagblẽna ɖe edzi kura.

Aleke mawɔ anya ne akpɔkplɔ yibɔ aɖe si le Australia hiã Pressure Immobilization Bandage?¶

Australiatɔwo ƒe kpekpeɖeŋunana gbãtɔ ƒe mɔfiamewo (ANZCOR Mɔfiame 9.4.2) zãa se bɔbɔe aɖe si xɔa ame ɖe agbe si woyɔna be "Akpɔkplɔ Yibɔ Gã": ne akpɔkplɔ yibɔ si le titina va ɖo gã, si do viviti alo esi le keklẽm (si didi wu sentimeta 1.5) ɖu ame aɖe le Australia (vevietɔ le ɣedzeƒe alo dzigbe ƒuta kple togbɛwo dzi) la, bu eŋu enumake be ate ŋu awu ame Funnel-Web alo Mouse Spider to Pressure Immobilization Bandage kple rigid splint sisi me eye nàyɔ 000. Mehiã be nàde vovototo Funnel-Web me tso Mouse Spider alo Trapdoor Spider si le agble me gbɔ o, elabena PIB zazã le dedie keŋkeŋ na wo katã eye wòɖea agbe nenye be Funnel-Web ye.

Ðe Funnel-Web akpɔkplɔ ate ŋu anɔ agbe le megbexɔ me tsiƒuƒe aɖe gɔme ahaɖu wò nyateƒea?¶

Ɛ̃. Le dzomeŋɔli kple adame zã siwo me dzoxɔxɔ kple tsi dzana le me la, Funnel-Web akpɔkplɔtsu siwo le tsaglãla tsam la gena ɖe megbexɔ me tsitawo me enuenu. Esi wònye be fu siwo me tsi mele o siwo léa ya ƒe ƒuƒoƒo aɖe ƒo xlã woƒe gbɔgbɔtsixe (agbalẽ me lãkusiwo) tsyɔ woƒe ƒodo dzi ta la, Funnel-Web akpɔkplɔ ate ŋu anɔ agbe ne nyrɔ ɖe ta si me klorin le gɔme gaƒoƒo 24 va ɖo 36. Mègatsɔ asi ƒuƒlu afɔ akpɔkplɔ yibɔ si "nyrɔ" tso tadeaguƒe ƒe anyigba alo skimmer box me gbeɖe o; zã ɖɔ alo aŋe si ƒe asi didi ɣesiaɣi.

Ðe aɖi ƒe aŋgbawo le platypus ŋutsu kple nyɔnu siaa ŋua?¶

Ao, platypus atsu tsitsi koe nye aɖi. Wodzia platypus vidzĩtsu kple nyɔnu siaa kple afɔkpodzi ƒe aŋgba suesuesuewo, gake nyɔnua ƒe aŋgbawo gena hafi xɔa ƒe ɖeka. Atsua koe tua keratin-kplu siwo me do le, siwo didi sentimeta 1.5, le megbefɔti eveawo ƒe eme siwo do ƒome kple ata ƒe aɖi glands (crural glands), siwo vuvuna hewɔa aɖi si sɔ gbɔ wu le kele me vidzidziɣi (August vaseɖe October) na avuwɔwɔ kple atsu siwo le ho ʋlim.

Nukatae morphine si wodona ɖe ʋuka me mexea mɔ na platypus ŋutsu ƒe afɔkpodzi ƒe vevesese o?¶

Peptide siwo le abe defensin ene (siwo D-amino acid isomerase na wòli ke ale be amegbetɔ ƒe enzymewo mate ŋu agbã wo o), natriuretic peptidewo, kple lãmekawo ƒe tsitsi ƒe nusi doa dzo na vevesese ƒe lãmeka siwo le asi me (nociceptors) tẽ eye wònaa wosea veve to mɔ siwo dzi mu-opioid xɔlawo mekpɔ ŋusẽ ɖo o la ƒe ƒuƒoƒo tɔxɛ aɖe le ŋutsu platypus ƒe aɖi me. Dɔdaƒewo ƒe nyatakakawo ɖee fia be morphine si wodona ɖe ʋuka me ƒe agbɔsɔsɔ gã gɔ̃ hã mete ŋu tsia vevesese si le dzo dam 10/10 kple asikaka ame ŋu vevie (allodynia) nu o. Ke boŋ ɖɔktawo wɔa nutome lãmekawo ƒe mɔxexe (wodoa bupivacaine ɖe asibidɛ alo abɔta ƒe lãmekawo ŋu) be woatsɔ axe mɔ na elektrikŋusẽ ƒe vevesese ƒe dzesiwo le ŋutilã me be woagazɔ alɔnu ayi ahɔhɔ̃a dzi o.

Ðe aɖi aɖe li na platypus spur stinga?¶

Ao, aɖi aɖeke meli na platypus ƒe aɖi o, eye womeŋlɔ amegbetɔ ƒe ku aɖeke tso platypus ƒe aɖi me kpɔ o. Kɔdzidɔdamɔnua ku ɖe nutome ƒe lãmeka siwo xea mɔ na alɔ̃dɔdɔ enumake (zi geɖe la, wotsɔa ka si wotsɔna tsia lãmekawo nu ƒuna ɣesiaɣi ŋkeke geɖe), nitrous oxide alo ketamine si ƒe agbɔsɔsɔme mede o, tsidede abi me, tetanus kple dɔlékuiwutikewo ƒe mɔxexeɖedɔléle nu, kple asi ƒe lãmesẽnyawo gbɔ kpɔkpɔ be woatsɔ ada lãmekawo ƒe vuvu kple ɣeyiɣi kpui aɖe ƒe gbegblẽ si ate ŋu anɔ anyi kwasiɖa geɖe va ɖo ɣleti geɖe.

Dzɔtsoƒewo kple dziɖuɖumegãwo ƒe mɔfiame¶

• Australia ƒe Gbugbɔgadzɔ ƒe Aɖaŋuɖoha (ANZCOR, Australia kple New Zealand): ANZCOR ƒe Mɔfiame 9.4.2 (Aɖi: Akpɔkplɔ ƒe ɖuɖu) kple ANZCOR ƒe Mɔfiame 9.4.8 (Aɖi: Nyaƒoɖeamenu ƒe Ʋuʋu ƒe Mɔnu).
• Atikewɔwɔ ƒe Mɔfiamewo: Aɖiŋutinunya kple Aɖiŋutinunya (eTG Complete, Australia) & AVRU: Funnel-Web Spider (Atrax / Hadronyche) ƒe Aɖidede, CSL Funnel-Web Antivenom, Mouse Spider Triage, kple Platypus Envenomation ƒe dɔwɔwɔ dzi kpɔkpɔ.
• Australia ƒe Atikewɔwɔ Ŋuti Nuŋlɔɖigbalẽ (MJA): Funnel-Web Spider Envenomation (Isbister et al., MJA) kple Platypus ƒe Aɖi: Nutome Lãmetsiŋusẽ ƒe Mɔxexe Ðe Dɔléle Nu (Fenner, Williamson, & Myers, MJA).
• Seqirus / CSL Behring (Australia): Adzɔnuwo Ŋuti Nyatakaka na Funnel-Web Spider Antivenom (Avugbɔ̃e IgG si Wokɔ).
• Dzɔdzɔme & Domenyiŋusẽfianu Ŋuti Numekuku: Peptides siwo le abe Defensin ene kple L-to-D Peptide Isomerase le Platypus (Ornithorhynchus anatinus) Venom me (Whittington kple ame bubuwo; Torres kple ame bubuwo).

Mɔfiame siwo do ƒome kplii¶

• Black Widow kple Redback vs Brown Recluse akpɔkplɔ ƒe ɖuɖu ƒe vovototodedeameme
• Akpɔkplɔ kple akpɔkplɔ ɖua kpekpeɖeŋu gbãtɔ
• Da ƒe ɖuɖu kple lã siwo tana siwo me aɖi le ƒe nɔnɔme kpatawo
• Dziɖegbe, afɔ alafa ɖeka, kple ƒunukpeƒetetedɔ siwo me aɖi le ƒe ƒoƒo
• Xexlẽdzesi siwo woxɔna kpata le dukɔwo nu