Envenomation spur ankle platypus e bannge ɓuuɓɗo ɓuuɓɗo atrakotoksin ɓuuɓɗo ɓuuɓɗo ɓuuɓɗo Ostarali¶

Ostarali ina jogii tookeeji ɗiɗi ɓurɗi teeŋtude e farmakoloji e nder tookeeji safaara, ina ɗaɓɓi kuule baɗɗe faayiida ko adii nde neɗɗo naatata e safrirde : Ɓuuɓri Ostarali (Genera Atrax e Hadronyche, e sara Ɓuuɓri Missula and)le [ (Ornithorhynchus anatinus, ko kañum tan woni daabaaji ɓuuɓɗi, ɓuuɓɗi, ɓuuɓɗi, ɓuuɓɗi, ɓuuɓɗi). Ɓoornugol ummoraade e ɓuuɓri Sydney (Atrax robustus) walla ɓuuɓri leɗɗe to bannge worgo (Hadronyche formidabilis) ina waɗa delta-atrakotoksin, woni tooke neurotoksin peptide coktirgal laabi sodium gonɗi e neɗɗo, ina uddita, ina addana kotelin-kotemin henndu e nder hojomaaji 10 haa 60 (ɓuuɓri perioral, ɓuuɓri ɗemngal, ɓuuɓri ɓuuɓri e ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam tiiɗndi, ɓuuɓri ƴiiƴam neurogenic, e ɓuuɓri ɓernde). Ɓoornugol mboros funnel-web e mouse ina ɗaɓɓi naatgol ko yaawi e bannge ɓuuɓɗo (PIB) mo Ostarali ɓeydi heen ɓuuɓri tiiɗndi, ɓuuɓnude ñawɗo oo haa timma, e ɓuuɓnude CSL Funnel-Web Spider Antivenom e nder sahaa gooto. E ko refti heen, so platypus gorko ina nanngaa e jom liggotooɓe ina ɓuuɓna liggey, ina ɓuuɓna kayak, walla ina hisna kulle ladde, ina riiwta ɓuuɓri ɗiɗi ɓuuɓndi, ina tawee e koyɗe mum caggal ina naata e nder mum no kalifaandi nii, ina ɓuuɓna tookeeji gonɗi e nder ɓalndudepeptides (co-peptides]. Peptideeji natriyuretik mo sifaa C [OvCNPs], e faktoriyaal mawnugol nerve**). Tooke Platypus meeɗaa warde neɗɗo, alaa antivenom, kadi fotaani MEƊƊE ɓuuɓneede e Bande Immobilisation de Pression; e nder ɗuum, ina addana 10/10 hiperalgesia ɓuuɓɗo, mo ustataako e ɓuuɓri terɗe mawndi, ndi nganndu-ɗaa ina waawi saabaade morfiin gonɗo e nder ƴiiƴam, ina ɗaɓɓi blok nerf diiwaan opitaal. So tawii won mo mboros ɓaleejo mawɗo yani e mum to Ostarali walla mo mboros platypus ɓuuɓni ɗum, noddu nokku maa limooje caɗtuɗe (000 to Ostarali) ɗoon e ɗoon. Kadi ƴeewto ardorde men banndiraaɓe e Debbo ɓaleejo e ɓaleejo vs ɓaleejo Recluse ɓuuɓri ƴiiƴam, tikkere e ƴiye ƴiye, e mboddi ina ƴakka.

Ko ɓuri teeŋtude e maa ko anndude so tawii aɗa haɓa e Ɓoggi ɓaleeji mawɗi (Funnel-Web / Ɓoggi Mouse) walla e Ɓoggi Ɓoggi Ɓoornugol Platypus: kala ɓiɗɓe leɗɗe ɓaleeje mawɗe ɓuuɓɗe e fuɗnaange walla fuɗnaange Ostarali, jogo-ɗaa ɓiɗɓe leɗɗe ɗee haa laaɓa cer, ɓoorno-ɗaa ɗum haa timma les-e-dow tergal ngal fof, ɓuuɓna tergal ngal, nodda 000 ngam Antivenom Ɓoornugol Funnel-Web. Ngam gaññeeje spur Platypus gorko, WOTO mbaɗtu PIB, ittu spuruuji ɗii e nofru, ɓuuɓna e ɓuuɓna junngo e tolno ɓernde, waɗta pack cooyɗo ɓuuɓɗo (meeɗaani ɓuuɓde), nawtaa to opitaal ngam blok nerve regional bupivacaine.

Waɗde ɗum jooni¶

1. Noddu 000 ɗoon e ɗoon to Ostarali (walla limoore emergency nokkuure maa ummoraade e aduna men limooje caɗtuɗe directory). Haalan neldoowo ambulance oo ɗoon e ɗoon so tawii ñawɗo oo ko ɓuuɓri ɓaleeri mawndi (ina sikkaa ko Funnel-Web walla Mouse Spider) ɓuuɓni ɗum walla ko Platypus gorko ɓuuɓni ɗum. Ɓoornugol mboros biyeteeɗo Sydney walla Funnel-Web hoɗɓe e leɗɗe ina waawi saabaade ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam, e ɓuuɓri ƴiiƴam e nder 15 haa 60 minit, haa teeŋti noon e sukaaɓe.
2. NGUM ƁURDE ƁURDE ƁURDE ƁURDE ƁURDE ƁURDE (Funnel-Web Atrax / Hadronyche walla Ɓoornugol Mouse Missulena): Waɗde Ɓoornugol Ɓoornugol (PIB) e Ɓoornugol Ɓoornugol e nder leƴƴanɗe 60, tawa ñawɗo oo ina jokki haa laaɓa cer.
3. Ɓoorno-ɗee 10- haa 15 santimeeteer njaajeendi elastik tiiɗde e dow nokku ɓuuɓɗo oo ko adii, caggal ɗuum henndu les haa yettoo koppi walla koyɗe e laawol fof haa dow ŋoral walla ŋoral e tiiɗnaare huutorteende ngam ŋoral ɓuuɓngal (40 haa 70 mmHg), accude ŋoral tofik tofill.
4. Siŋku kaɓirgal tiiɗngal (kaɓirgal, magazine ɓuuɓɗo, walla umbrella) e dow tergal ɓuuɓngal ngal mbele jokkondire ɗee mbaawa ɓuuɓde, e addude ŋoral ambulance to ñawɗo oo (woto meeɗ ɗaccude ñawɗo oo ina yaha, sibu pompirde ɓalndu ina ɓuuɓna delta-atracotoxin e nder lymstream).
5. TO ƁOOƊO ƁOOƊO PLATYPUS GOORKO : WOTO MEƊƊU waɗde bannge ɓuuɓɗo (PIB) walla tourniquet arteriel. Tooke crural platypus ina gollira e nokkuuji e dow fiɓnde ɓuuɓnde nociceptive e leɗɗe kapilaar ngam saabaade ɓuuɓri terɗe mikroo-leaka mawɗe, ɓuuɓɗe. Ɓoornude bannge ɓuuɓɗo e junngo ɓuuɓngo platypus ina nannga peptideeji tooke ɗii e nokku, ina ɓeyda mette ɗe ɓuuɓnata tawo, ina addana kadi bonnude ƴiye iskemiik.
6. So tawii Platypus gorko ina jokki e ɓuuɓde e junngo walla e koyngal e ɓuuɓol mum caggal, wallu teddeendi ɓanndu daaba oo, ɓuuɓna koyɗe mum caggal ɗee no feewi ngam ittude ɓuuɓol gonngol e nder mum ngol. Woto meeɗ ɓuuɓnude walla ɓuuɓnude junngo maa e doole ngam woɗɗitaade platypus; daaba oo ina taarii koyɗe mum caggal e junngo walla e junngo yeeso, ina riiwta ɓuuɓri ndii fof, ndi 1,5 santimeeteer, ina fadi ɗum no ɓuuɓri nii, ina ɓuuɓna gonɗi luggiɗɗi e nder ƴiye e ƴiye.
7. **So tawii ko ɓuuɓri Platypus : lootde no feewi e saabunde e ndiyam laaɓɗam, ittaa denndaangal cirƴam, waktuuji, e ɓuuɓri ɗoon e ɗoon, fooftina tergal ngal e nder ɓuuɓri, mbaɗtaa heen ɓuuɓri coofndi walla ɓuuɓri ɓuuɓndi (fotaani ɓuuɓnude junngo ngo ɓuuɓnata). e nder hojomaaji 30 haa 90 kadi maa waylu kala cirƴam waɗta ɗum turniket taƴoowo koppi.
8. To suudu safrirdu : ɗaɓɓu ɗoon e ɗoon CSL Funnel-Web Spider Antivenom (ampoule 2 haa 4 IV) HADDE ittude PIB ngam kala mboros Funnel-Web mo alaa maale ; ngam spur Platypus, ɗaɓɓu ɗoon e ɗoon ɓuuɓri diiwaan (0,5% bupivakain/ropivakain) sabu morfin e opioiduuji gonɗi e nder ƴiiƴam ina mbaawi waasde haɓaade hiperalgesia platypus.

Lekki kuulal: Ostarali Funnel-Web / Ɓoggi Mouse vs Platypus gorko vs Ɓoggi Redback triage¶

flowchart TD
    A["Ostarali Tookeeji Bite walla Spur"] --> B{"Hol daaba baɗɗo tooke ɗee?"}
    B -->|Large shiny black spider with massive downward fangs: Funnel-Web (Atrax / Hadronyche) or Mouse Spider (Missulena)| C["EMERGENCIE NEUROTOXIQUE MENANCES : Jokkude ñawɗo oo haa laaɓa cer ; noddu 000 JOONI"]
    B -->|Webbed semi-aquatic mammal in eastern Australian river/creek drove hind ankle spur into hand/leg| D["Ɓoornugol gorko (Ornitorhynchus anatinus) Ɓoornugol ƴiiƴam"]
    B -->|Small black spider with red stripe on abdomen in dry shed/garden: Redback Spider (Latrodectus hasselti)| E["Latrodektism : WOTO mbaɗtu PIB ; waɗde pack cooyɗo ɓuuɓɗo; opitaal ngam ñawndude ñawu / Antivenom Redback"]
    C --> F["Waɗde bannge ɓuuɓɗo (PIB) e dow ɓuuɓri e tergal fof + Rigid Splint ; WOTO loot nokku bite"]
    F --> G["Suudu wuurtinde ED e nder safrirde : Jogaade PIB haa IV naati & CSL Funnel-Web Antivenom Spider (2 haa 4 fiiluuji) ina hesɗi"]
    G --> H["Infuse Antivenom + PEEP Ventilateur ngam ɓuuɓri ƴiiƴam + Atropine ngam ɓuuɓri ƴiiƴam + ɓuuɓri ƴiiƴam"]
    D --> I["WOTO MEƊƊU waɗde PIB walla turniket; ɓuuɓna spurs e nofru; ittu denndaangal cirƴe/waktuuji ɗoon e ɗoon; lootiree ndiyam e saabunde"]
    I --> J["Immobiliseede tergal e nder sling; waɗde kompaas coofɗo; jolngo to Hospitaal ED ngam hiperalgesi 10/10 mo safraaka"]
    J --> K["Kuutoragol suudu safrirdu : Blok nerf diiwaan (Bupivakayin Plexus Brachial) + Oksijen Nitrous/Ketamin + Ndiyam gaañanɗe & Antibiotik"]

Njiylawu hoore-e-hoore: Ɓoornugol Funnel-Web vs Ɓoornugol Mouse vs Ɓoornugol Platypus Spur gorko vs Ɓoornugol Redback¶

Sabu jamirooje ballal gadanal Ostarali (Laamuuji ANZCOR 9.4.2 e 9.4.8) ina ɗaɓɓi karallaagal mbayliigu luurondirngal fawaade e daaba, seerndude banngeeji ɗii ina tiiɗi :

Funnel-Web (Atrax & Hadroniche) e Ɓowɗi (Missulena) Ostarali : Patofisiyoloji e Teknik PIB¶

1. Ko waɗi Sidney e Funnel-Webs hoɗɓe e leɗɗe ko caɗeele safaara¶

35+ sifaaji ɓowɗi gonɗi e Ostarali (Galle Atracidae, ɓiɗɓe leɗɗe Atrax e Hadronyche) ina nguuri e laddeeji ɓuuɓɗi, e ŋore, e kaaƴe gonɗe e saraaji gure, e ŋore ɓuuɓɗe e nder geec fuɗnaange-rewo gila e fuɗnaange-rewo Queensland, Fuɗnaange-rewo Galles Atrax robustus, tawaa ko e nder 160 kiloomeeteer (100 kiloomeeteer) hakkunde Sidney) haa Viktooriya, Tasmani, e ŋoral Flinders to Ostarali worgo. - Ko waɗi worɓe njilluuji e ndunngu/duuɓi ina njuuma: E nder jammaaji ngulɗi, ɓuuɓɗi caggal toɓo mawngo (Novembre haa Abriil), worɓe mawɓe Sydney Funnel-Webs ina njalta e ɓulli mum en silk-lined ngam njillu ngam yiylaade rewɓe, ina keewi naatde e cuuɗi ɓuuɓɗi, e nder cuuɗi ɓuuɓɗi, walla e nder cuuɗi ɓuuɓɗi, walla e nder cuuɗi ɓuuɓɗi pooli (to ɓe mbaawi nanngude ɓuuɓri henndu e nder ƴiye reedu maɓɓe, ɓe nguura e nder ndiyam e nder poolgu nguu fotde waktuuji 24 haa 36, ɓe ɓuuɓna kala ƴettuɗo ɗum en ina cikka ɓe njippiima).Gorko Atrax robustus tooke ɗee ɓuri 5 haa 6 laabi tookeede primates to veles delta-atrakotoksin-Ar1 (robustoksin). Ko ɓuri ɗum semmbe ko Ɓoornugol leɗɗe gonɗe e Fuɗnaange e Fuɗnaange (Hadronyche formidabilis e Hadronyche cerberea) to NSW e Queensland, ko kañum en ngaddata tooke mawɗe e nder ko ina ɓura 50 e nder teemedere e ɓuuɓri. - Mekanik ƴiye paraksiyal: Ina wayi no ƴiye Araneomorf hannde ɗee (hono rewɓe jommbaajo walla orb-weavers) ɗe ƴiye mum en ɓuuɓnata banngeeji no pinsi nii (diaxial), ƴiye Mygalomorph (Atrax, Hadronyche, Missulena totoɓɓere paraxille dow ina njogii paraxilve toɓɓere) gooto e maɓɓe fof no piɗtaali ɓiɗɓe leɗɗe**. Ngam riiwtude ɗeen ƴiye milimeeteeruuji 5, ƴiye funeeɓe ina ummoo e koyɗe mum caggal, ina ɓuuɓtoo les laabi keewɗi, ina heewi ɓuuɓde haa nde foti ɓuuɓde walla ɓuuɓde.

2. Henndu otonomiiru fasaaji ɗiɗi, wiyeteendu Delta-Atrakotoksin¶

So delta-atracotoxin naatii e cirkulaasiyoŋ ɓalndu, maale ɗee ina puɗa e nder hojomaaji 10 haa 30 e sukaaɓe (e daartol ina wara e nder hojomaaji 15 e nder cukalel tokosel hade antivenom) e hojomaaji 15 haa 90 e mawɓe :

1. Faas 1: Henndu ɓuuɓndu (Hojomaaji 10 haa waktuuji 4):
2. Maandeeji ƴiiƴam: Ɓuuɓri ƴiiƴam (piloerection) e ɓuuɓri ƴiiƴam nokkuuji e nokku ɗo ƴiiƴam ɗam woni ɗoo ina yaawi yahrude yeeso haa ɓuuɓri e ɓuuɓri saraaji hunduko e hunuko (parestesi perioral), ɓuuɓri yiyteende nanndundi e ɓowɗi e ɗemngal (ɓuuɓri fasciculations linguistiques), facial, facial fascikulaaji ƴiye.
3. Kolinerjik (Parasympathetic) Ƴeewirde : Ƴellitaare asetilkolin mawnde ina addana ɓuuɓri ropy keewndi (sialorrhea), ɓuuɓgol (lacrimation), ɓuuɓgol ɓuuɓngol (diaphoresis), ɓuuɓgol ɓuuɓngol e nder reedu, ɓuuɓgol ɓuuɓngol e ɓuuɓgol ɓalndu, ɓuuɓgol ɓuuɓngol e nder reedu.
4. Kiriis Adrenerjik (Simpatitik) e Edema Pulmonaari: Yaltinde norepinefrin e epinefriin e nder sahaa gooto ina addana takikardiya mawɗo, hipertension arterielle maligne (ina heewi ɓurde 200/120 mmhacrani Hg,moral), edema pulmonaire (ɓuuɓri kapilaar neurogenic kawriindi e ŋakkeende ɓuuɓri ɓalndu nano), hebbinde laawol henndu ngol ndiyam ɓuuɓɗam pinɗam, addana ɗum hipoksiya e komaa tiiɗɗo.
5. Fase 2: Ɓooygol katekolamin e ɓuuɓri ɓernde (waktuuji 4 haa 24):
6. So tawii ñawɗo oo wuurii e Fase 1 tawa alaa antivenom, jokkere enɗam presynaptic ina ustoo desorɗe mum katekolamin tawa asidosis e stunning myocardial ina naata e mum.

================================================================================
   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. Wuurtinde e nder safrirde e porotokol antivenom mboros CSL¶

1. Waɗde PIB e nokku mum Haa Resuscitation Hesɗi:
2. So ñawɗo oo arii e suudu safrirdu tawa PIB ina woni e nokku mum, WOTO ɓuuɓtu bannge oo e nder triage. So tawii bolol mawngol delta-atrakotoksin ina nanngaa e limfatik tergal, yaltinde bannge oo ko adii nde ina addana neɗɗo ɓuuɓde ɗoon e ɗoon, bonnde, ɓuuɓnde e nder hojomaaji 5.
3. Sosde laabi IV ɗiɗi mawɗi, jokkondirde e ƴeewndo ECG/BP/SpO2 jokkondirngo, peewnude kaɓirɗe ɓuuɓnugol ƴiiƴam, e jogaade 2 ampoule CSL Funnel-Web Spider Antivenom ƴettaaɗe e sara leeso hade maa ittude PIB.
4. Njuɓɓudi Antivenom Ɓoornugol CSL Funnel-Web:
5. Pewniraa ko e IgG ɓowɗi hiperimmune laaɓtuɗo, umminaaɗo e tooke Atrax robustus gorko (ina waawi huutoreede no feewi e denndaangal kullon Atrax, Hadronyche, e Missulena, tawi noon ko famɗi fof ko ina addana ɗum ɓuuɓde so yerondiraama e tooke pucci).
6. Doseeji: Kala maale tooke gonɗe e ɓalndu (ɓuuɓri perioral, ɓuuɓri ɗemngal, ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam), ɓuuɓna 2 ampoule (250 unités) ɓuuɓnaaɗe e 100 mL saline normale IV e nder hojomaaji 15 haa 20. So tawii ko tooke tiiɗɗe (edema pulmonaire, komaa, hipertension tiiɗnde), fuɗɗoro-ɗaa ko 4 ampul IV ɗoon e ɗoon, mbaɗtaa ampul 2 kala hojomaaji 15 haa denndaangal maale otonomik e neuromuskulaar ɗee njuumta.
7. Ballal gonngal e laawol weeyo e hemodinamik:
8. Waɗde oksijen toowɗo, CPAP, walla ɓuuɓri endotrakeal tawa ina waɗi ɓuuɓri toowndi (PEEP, 10 haa 15 cmH2O) ngam ɓuuɓri ƴiiƴam.
9. Hokkude atropin IV (0,6 haa 1,2 mg IV; 0,02 mg/kg e sukaaɓe) ngam yoorde ƴiiƴam kolinerjik ɓuuɓɗam e ɓuuɓri ƴiiƴam.
10. Safrude hipertension Fase 1 baawɗo warde nguurndam e vasodilatatooruuji juutɗi, titrateeɗi (hono nitroprusside sodium walla phentolamine), e WOTO MEƊƊI waɗde beta-bloqueurs juutɗi, baawɗi saabaade alfa-vasokonstrikaasiyoŋ mo alaa ko haali e ñawɗo oo e nder ɓalndu mum, e nder ɓalndu mum Faandaare 2 ko hipotension.

Platypus gorko (Ornithorhynchus anatinus) Ɓooygol ƴiiƴam : Patofisiyoloji e toppitagol ɓuuɓri ƴiiƴam¶

1. Anatomi system tooke crural e doole jibinannde sahaa¶

Platypus (Ornithorhynchus anatinus), gonɗo e maayooji ndiyam laaɓɗam, billaaji, e ɓulli ummortooɗi Queensland haa les, rewrude e New South Wales, Victoria, e Tasmani, ina jeyaa e kullon ladde tooke seeɗa e dow Leydi. - Mo jogii tooke: Ɓiɓɓe platypus gorko e debbo fof ina njibinaa e ɓuuɓri rudimentary hind-ankle, kono ɓuuɓri debbo ina reggondira e hitaande adannde nguurndam. Ko platypus gorko mawɗo tan ina jogii ƴiye keratinous calcaneal (ankle) ɓuuɓɗe, ɓuuɓɗe, ɓuuɓɗe (fotde 12 haa 15 milimeeteer [0,5 haa 0,6 inch] njuuteendi) gonɗe e dow ƴiye tarsal accessoire dillooje e dow bannge nder leg kala. - Hipertrofi Sesoŋal Gland Crural: Kala spur ɓuuɓɗo ina jokkondiri e ɓuuɓri ƴiiƴam tiiɗndi e gland tooke crural gonɗo e ɓalndu toowndu. Sabu platypuss worɓe ƴellitiima tooke mum en ko adii fof ngam hare leydi worɓe e worɓe e nder dumunna jibinannde ndunngu (Août haa Oktoobar to Ostarali), ƴiye crural ina mawna no feewi, ina njaltina tooke ɓurɗe heewde (fotde mililiteruuji 4 e kala winter) e nder dumunna la. - No aadee heɓirta spurred: Fotde envenomations aadee fof ina waɗa so liɗɗi moƴƴo ina etoo uddude platypus gonɗo e nder lure liɗɗi walla e nder laylaytol yabby ngol rewaani laawol, walla so liggotooɗo ladde ina ɓuuɓna daaba oo gila les. Platypus gorko ina taarii koyɗe mum ɗiɗi caggal ɗee e junngo, e wuttulo, walla e wuttulo ñawɗo oo, ina riiwta ƴiye ɗiɗi ɗee fof e nder mum no kalifaandi nii, ina fawi heen no feewi, ina pompa tooke crural laabi keewɗi e nder dermis e muscle luggiɗnde.

2. Hol ko waɗi tooke Platypus ina addana neɗɗo ɓuuɓri gonndi e morfin, e lebbi ɓuuɓɗi¶

Nanduɗo e tooke mboɗeeri walla tooke mboros funnel-web ɗe ƴellitii ngam warde jawdi e yaawre rewrude e paralisis respiratoire walla coagulopathy, tooke platypus gorko ƴellitii ngam waɗde wumre, waasde waawde mette e worɓe luulndiiɓe: 1. Koktel Peptiid keeriiɗo: Anndugol poroteyiin e genomik tooke Ornitorhinkus crural hollitii ko famɗi fof 83 binndi tooke ceertuɗi e nder galleeji poroteyiin 13, tawi ɓuri heen heewde ko peptideeji nay nannduɗi e tooke ornitorhinkussLPD-type,v peptideeji natriuretik), faktor mawnugol nerve (NGF), hialuronidaas, proteaseeji serin nannduɗi e kallikrein, e isomeraas peptiid L-to-D (mo waylata asid L-amino to N-terminus vDLPs e peptiideeji asid-king to ɓuuɓgol e proteaseeji aadee haa ɗi keddoo e golle e nder ñawu nguu balɗe haa jonte). 2. Kuutoragol nociseptoruuji toowɗi e reentaade morfiin: Peptideeji tooke platypus ina uddita laabi kationuuji toowɗi e dow nociseptoruuji C-fibre e A-delta gonɗi e ɓalndu neɗɗo (DRG), ina njiyloo histamin e bradykinin ina njaltina, ina njuɓɓina nerwel gonngal e ɓalndu, ina njuɓɓina nerwel g. Sabu ngool firo nociceptive ina rewi e modulaasiyoŋ jaɓɓotooɗo mu-opioid, seriiji ñawbuuli ina kollita wonde hay morfin, petidin (meperidine), walla fentanil ina addana neɗɗo ballal ŋakkungal, ina addana ñawɗo oo ɓuuɓde e nder 10/10 gonɗo e ɓuuɓde e ɓuuɓde opioid. 3. Kuurse kilinik (Hiperaljesi akut, allodini, edema, e atrofi juutɗo): - Hojomaaji 0 haa 60: Nafoore ɓuuɓnde, ɓuuɓnde e punndiiji ɗiɗi spur ɗii, ina ɓuuɓtoo haa dow junngo ngoo fof haa yettoo aksilla e ɓalndu. Edema ɓuuɓɗo, eritematous, mo alaa ko ɓuuɓnata, ina ɓuuɓna koppi, junngo, e wuttulo haa fotde laabi ɗiɗi mawneeki no woorunoo e nder waktu gooto. - Balɗe 1 haa 14: Allodynia mekanik e nguleeki luggiɗnde (hay so henndu ɓuuɓndu walla ɓoggol ina memi ɓalndu ina addana neɗɗo mette muusɗe) e ŋakkeende golle ɓuuɓgol/ɓuuɓgol koppi. - Aset 2 haa Lebbi 3: So tawii alaa neurotoksisite hakkundeejo walla coagulopathy, ñawɓe ina keewi heɓde hiperestesi duumotooɗo, nafoore muusnde, e ɓuuɓri ɓalndu ɓuuɓndi (atrophie) e nder ɓalndu junngo e junngo yeeso (mediated by venom myotoxic dis e fijirde junngo ngam sellude.

3. Ballal gadanal e porotokol safrirde ngam tooke Platypus¶

1. Ballal gadanal ladde (Ko foti waɗeede e ko foti waɗeede):
2. Safely unhook the spurs: Wallit platypus mbele ina waasa ŋoŋɗude e junngo maa, kadi ɓuuɓna koyɗe mum caggal ɗee no feewi haa yaasi ngam ittude spurs gonɗi e nder mum ɗii tawa aɗa ɓuuɓna ɓanndu maa.
3. WOTO MEƊƊU waɗde bannge ɓuuɓɗo (PIB) walla turniket: Kuulal ANZCOR 9.4.8 ina haɗi PIB e laaɓal ngam ɓuuɓnude ɓuuɓri platypus sabu nanngude vDLPs e proteaseeji gonɗi e asid amino D e junngo ina ɓeyda ɓuuɓri e ɓuuɓri.
4. Loowde e De-ring Ɗoon e ɗoon: Loowde punndi spur e saabunde e ndiyam laaɓɗam, ɓurtu kala cirƴam, waktuuji, e jokkere enɗam e nder hojomaaji 2 gadani ɗii hade ɓuuɓri coktirgal ɗi, fooftina junngo e nder sling ballitoowo, e waɗde cool compress wppe a in).
5. Analgesia opitaal (Standard kaŋŋe blok nerve diiwaan):
6. So a arii e departemaa cafrirɗo, rokku ɗoon e ɗoon **Oksijen Nitrous / Oksijen (Entonox) 50:50 ina foofa walla Ketamin IV mo doosgal mum famɗi (0,1 haa 0,3 mg/kg IV) + fentanil IV titrated ngam waɗde ponto.
7. Waɗde Blok Nerve Régional Immédiate : Safaara gooto ɓurɗo moƴƴude ngam ittude haa laaɓa cer ɓuuɓri pltypus e nder hojomaaji 5 haa 10 ko blok nerve regional guidé par ultrasound ɓadiiɗo nokku edematous (hono blok fraklakulaar, supravikulaar, walla inaxillaire, brachillaire walla blokeeji nerfuuji hakkundeeji, ulnaaruuji, e radial) kuutortooɗi 0,5% bupivakayin walla 0,5% haa 0,75% ropivakain (ina heewi waɗeede e kateter nerfuuji perineural jokkondirɗi fotde waktuuji 48 haa 72 infusion ñawɗo).
8. Ƴeewndo ñawanɗe, Rajo-graafi, e Profilaksi Antibiotik:
9. So tergal ngal ɓuuɓtii haa laaɓi gila e bolol nerwel diiwaan oo, keɓaa rajo-rajo (rayooji X) ngam ittude tippudi spur keratin walla ɓuuɓri periosteal keɓtinaandi, e ɓuuɓnude no feewi laabi punndi luggiɗɗi ɗii e saline normal sterile (woto **suture punndi ndii udditaa).
10. Hesɗitin ** ngonka tetanus (Tdap/Td)** e rokkude antibiyotikaaji baawɗi huutoraade ndiyam laaɓɗam Aeromonas hydrophila e leɗɗe ɓalndu (hono **siprofloksasin 500 mg PO laabi ɗiɗi ñalawma kala tawa ina ɓeydee heen amoksisiliin-klavulanaat walla flukloksaasilin to5 jolngo e terapi gollorɗo juuɗe nde ɓuuɓri ɓuuɓndi ustii ngam haɗde ɓuuɓri ɓalndu duumiindi e ɓuuɓri jokkondire.

Limooje emergency diiwaan e porotokolle agence¶

• Ostarali (New Wales, Kunislannde, Viktooriya, Tasmani, Ostarali Fuɗnaange, ACT):
• Noddu 000 ɗoon e ɗoon ngam kala mboros ɓaleejo mawɗo walla tooke platypus tiiɗɗe (walla 112 ummoraade e telefoŋ cinndel mo alaa signal).
• Jokkondir e Nokku humpito tookeeji Ostarali to 13 11 26 (waktuuji 24 e ñalawma e nder Ostarali fof) ngam jokkondirde e cafroowo safroowo oo to bannge safaara tooke ngam CSL Funnel-Web Spider Antivenom doseeji walla porotokolle analgesia diiwaan platypus.
• Rewrude e Laabi ANZCOR 9.4.2 (Tooke: Ɓooygol Ɓoggi) ngam Ɓoggi Funnel-Web e Mouse (PIB + splint) e Laabi ANZCOR 9.4.8 (Tooke: Karallaagal Immobilisation de Pression) ngam ustude tiiɗnaare PIB e Redback e nder Platy
• Leydi Selannde: Noddu 111 ngam heɓugo jaalorgal e noddugo Centre lesdi Nuwel Selannde ngam nyawndorɗe tookeeji haa 0800 764 766.
• Dental Dowlaaji Dentuɗi, Dental Orop, Dental Dowlaaji Amerik, e Kanadaa (Kollirɗe Zooloji e Eksotik): Noddu 999 (UK), 112 (UE), walla 911 (Amerik/Kanada), e jokkondirde e Dental Tookeeji Amerik e 1-800-222-1222) walla **NPBA.U Kala zoo, laboratuwaar wiɗto, walla nokku ƴeewndo doosɗe jogiiɗo Atrax / Hadronyche mboros funnel-web Ostarali ina foti jogaade CSL Funnel-Web Spider Antivenom mo timmaani e nokku mum walla e opitaal toɗɗaaɗo e nokkuuji mborosaaji e jannginde gollotooɓe e nder Immobilisation de pressure ko yaawi.

Naamne keewɗe naamneede¶

Hol ko waɗi aɗa ɓoornoo bannge ɓuuɓɗo e dow ƴiye Funnel-Web, kono ALAA e dow ƴiye Platypus spur walla Redback?¶

Ɓoornugol Sydney walla Tree-Dwelling Funnel-Web ina waɗa delta-atrakotoksin, woni tooke neurotoksin jaawɗo warde, rewata e ƴiye limfatik haa e nder ƴiiƴam, ina addana neɗɗo ɓuuɓri ƴiiƴam e ɓuuɓri ɓernde e nder hojomaaji 15 haa 60, tawi alaa ko addanta almo tissust nokku oo. Ɓoornude bannge ɓuuɓɗo (PIB) e ɓuuɓnude tergal ngal ina haɗa ɓuuɓri limfatik, ina nannga tooke neurotoksin e nder tergal ngal e nder kisal haa nde CSL Funnel-Web Antivenom rokketee e nder safrirde ndee. E ko feewti heen, tooke Platypus gorko e tooke mboros Redback ina kuutoroo e nokkuuji ngam saabaade mette mawɗe e ɓuuɓri ƴiiƴam (tawa alaa ko bonnata neurotoksisite waroowo jaawɗo) ; ɓuuɓnude PIB tiiɗɗo e dow spur Platypus ina nannga peptideeji ɓuuɓɗi e junngo, ina ɓeyda ɓuuɓde e ɓuuɓde no feewi.

Hol no mbaawir mi anndude so tawii mboros ɓaleejo to Ostarali ina haani Bandage Immobilisation de Pression ?¶

Laabi ballal gadanal Ostarali (Laabi ANZCOR 9.4.2) ina kuutoroo kuulal koyngal, daɗngal nguurndam, ina wiyee "Big Black Spider" : so tawii won e nder Ostarali (haa teeŋti e saraaji fuɗnaange walla fuɗnaange-rewo e ŋoral) ina ɓuuɓtoo e ŋoral ɓalewal hakkundeewal haa mawngal, niɓɓiɗngal walla jalbowal immediat it5 ko wayi no Funnel-Web walla Mouse Spider baawɗo warde e waɗde Bandage Immobilisation Pressure e splint rigid e noddude 000. Aɗa sokli haalde Funnel-Web so wonaa Mouse Spider walla Trapdoor Spider e nder ladde, sabu waɗde PIB ko nguurndam timmuɗam e Fu- of.

Mbele mboros Funnel-Web ina waawi wuurde e les ɓuuɓri caggal galle, ina ɓuuɓna ma?¶

Oho. E nder jammaaji ɓuuɓɗi, toɓooli e ndunngu, ɓowɗi Funnel-Web worɓe njirlotooɗi ina keewi fadde e nder ɓulli caggal galle. Sabu reedu majji ina waɗi gaasaaji ɓuuɓɗi, ɗi ndiyam ɓuuɓnataa, ɗi njiylotoo ko filmo henndu e saraaji ɓuuɓri foofaandu majji (ɓuuɓri deftere), mboros Funnel-Web ina waawi wuurde e nder ndiyam ɓuuɓɗam fotde waktuuji 24 haa 36. Hoto meeɗ ƴettude ƴiiƴam ɓalejam "ronkaama" e dow poolgu walla e boowal skimmer e juuɗe ɓole ; huutoroo sahaa kala laylaytol juutngol walla pinngi.

Mbele platypus gorko e debbo fof ina njogii ɓuuɓri tooke?¶

Alaa, ko platypus gorko mawɗo tan woni tooke. Ɓiɓɓe platypus gorko e debbo fof ina njibina ɓuuɓri tokosiri, kono ɓuuɓri debbo ina ɓuuɓta hade mum yettaade hitaande wootere. Ko gorko oo tan heɓata ɓuuɓri keratin ɓuuɓndi, 1,5 santimeeteer e nder koyɗe ɗiɗi ɗee kala, jokkondirɗe e ɓuuɓri tooke ɓalndu (crural glands), ɗi ɓuuɓnata, ɗi ngadda tooke ɓurɗe mawnude e sahaa jibinannde ndunngu (Août haa Oktoobar) ngam haɓaade worɓe luulndiiɓe.

Hol ko waɗi morfiin gonɗo e nder ƴiiƴam haɗataa mette gonɗe e ƴiiƴam platypus gorko?¶

Tooke platypus gorko ina waɗi ko wayi no peptideeji nannduɗi e defensin (ko isomerase asid amino D dartinata ɗum en ngam enzim aadee waawa ustude ɗum en), peptideeji natriuretik, e faktoruuji mawnugol nerwooji ɗi njiylotoo fiɓnde nerwooji ɓuuɓɗi periferik (sensorpitooji e nociseptoruuji e nociseptoruuji) e nder juuɗe mum en jaɓɓotooɗe. Rajooji safaara ina kollita wonde hay doosɗe toowɗe morfiin gonɗe e nder ƴiiƴam ina mbaawi haɗde 10/10 ɓuuɓri ɓuuɓndi e ɓuuɓri toɓɓere ɓurtunde (allodynia). E nder ɗuum, safrooɓe ina mbaɗa « bloc nerveux régional » (ina mbaɗa bupivakayin e saraaji junngo walla e nerves plexus brachial) ngam haɗde e ɓanndu, maale ñawu nguu yahde dow junngo haa ngaandi.

Mbele ina woodi tooke ngam haɓaade mboros platypus?¶

Alaa, alaa ko waawi haɗde tooke platypus, kadi alaa maayɗeele aadee meeɗi winndeede e spur platypus. Safaara opitaal ina teskaa e anestetik nerve block regional ko yaawi (ina heewi e kateter jokkondirɗo balɗe keewɗe), oksidaa nitrous walla ketamin mo doosgal mum famɗi, ndiyam ɓuuɓɗam, tetanus e antibiotik, e fijirde juuɗe ngam safrude ɓuuɓri e ɓuuɓri gonndi e ɓuuɓri ndi waawataa weeks to lewru.

Fuɗɗoode e ardorde laawɗunde¶

• Goomu wuurtinde Ostarali (ANZCOR, Ostarali e Nuwel Selannde): Kuulal ANZCOR 9.4.2 (Tookeeji: Ɓoornugol mboros) e Kuulal ANZCOR 9.4.8 (Tookeeji: Karallaagal ustude ɓuuɓri).
• Laabi safaara: Tookeeji e Tookeeji (eTG Complete, Ostarali) & AVRU: Njuɓɓudi tooke mboros (Atrax / Hadronyche), CSL mboros mboros mouse, e mboros platypus.
• Jaaynde safaara Ostarali (MJA): Tookeeji mborosaaji gonɗi e nder weeyo (Isbister e woɗɓe, MJA) e Tookeeji mborosaaji gonɗi e nder weeyo : Njuɓɓudi mborosaaji diiwaanuuji (Fenner, Williamson, & Myers, MJA).
• Seqirus / CSL Behring (Ostarali): Kabaruuji geɗe ngam haɓde e mborosaaji mborosaaji (IgG mboros laaɓtuɗo).
• Wiɗtooji tagoodi e geɗel gootel: Peptideeji nannduɗi e defensin e isomeraas peptideeji L-to-D e nder tooke mboros oo (Whittington e woɗɓe; Torres e woɗɓe).

Ardiiɓe jokkondirɓe¶

• Debbo ɓaleejo e ɓaleejo vs ɓaleejo Recluse triage mboros mboros
• Tick e spider ina njiya ballal gadanal
• Ɓoornugol mboddi e emergency reptile tooke
• Skorpiyon, centipede, e artropodeeji tooke ina njuuma
• Limooje emergency e leydi