Hoʻopiʻi ka Scorpion, centipede, a me arthropod venomous i ke kōkua mua¶

Hāʻawi nā ʻāhiʻo ʻaneʻi ʻawaʻawa i nā ukana kemika ikaika me ka hoʻohana ʻana i nā mea kaua anatomic kūikawā: hahau ka moʻo huelo ʻawaʻawa i kahi aculeus i kau ʻia ma luna o ke kua, hoʻopaʻa ke centipede nunui i kāna mea i pepehi ʻia me ka hoʻohana ʻana i nā wāwae mua i hoʻololi ʻia i kapa ʻia ʻo forcipules, a hoʻopaʻa ʻia nā ʻanuʻu ahi i lawe ʻia me nā manamana e pivot a hoʻokomo i ka piperidine alkaloids. ʻOiai ʻo ka hapa nui o nā arthropod i nā pākeke olakino e hoʻopuka i ka ʻeha wela a me ka pehu liʻiliʻi, hiki i kekahi mau moʻo huelo neurotoxic ke hōʻeha koke i ke ola olakino no nā pēpē, nā keiki liʻiliʻi, a me nā poʻe ʻelemakule, ʻoiai hiki i nā ʻuā ahi a me velvet ant stings hiki ke hoʻoulu i ka anaphylaxis systemic a i ʻole nā ​​maʻi ʻili lua koʻikoʻi.

ʻO ka hoʻomaopopo ʻana i ka ʻokoʻa lapaʻau ma waena o kahi kīʻaha neurotoxic maikaʻi ʻole, kahi necrotic cytolytic blister, a me ka piʻi wikiwiki ʻana o ka pediatric cholinergic storm e hiki ai i nā mea hoʻopakele ke hāʻawi koke i ka hoʻomaha ʻeha i manaʻo ʻia, pale i nā lāʻau lapaʻau ʻino, a loaʻa i nā poʻe maʻi kiʻekiʻe i ka antivenom a me ka mālama koʻikoʻi ma mua o ka ulu ʻana o ka hanu.

E hana i kēia i kēia manawa¶

1. E neʻe aku mai kahi pūnana aku a holoi i nā mea kolo i koe me ka maluhia. E ʻanuʻu ma kahi o 5 a 10 mau mika (16 a 33 kapuaʻi) ka mamao mai nā puʻu ʻanuʻu ahi i hoʻopilikia ʻia, nā puʻu wahie, a i ʻole nā ​​māwae pōhaku wao nahele. Inā e hū mai ana nā ʻanuʻu ahi ma ka ʻili a i ʻole ka lole, e pulupulu me ka lima lima a i ʻole ka lole ma mua o ka holoi ʻana me ka wai, no ka mea, ʻo ka pulu ʻana i nā ʻanuʻu ahi e hoʻomāhuahua i ka nahu a me ka nahu pinepine.
2. E kelepona koke i kāu helu ulia pōpilikia no ke keiki i u ʻia e ka moʻo huelo ʻawaʻawa a i ʻole kekahi mea e hōʻike ana i nā hōʻailona ʻōnaehana. Kāhea i ka 911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ka European Union, 999 ma United Kingdom, 000 ma Australia, a i ʻole e nīnau i ka papa kuhikuhi o helu pilikia. E kāhea pū i kāu kikowaena Poison Control Center (1-800-222-1222 ma ʻAmelika Hui Pū ʻIa) no ke alakaʻi ʻana i nā ʻano ʻano a me ka hoʻonohonoho ʻana i ka lāʻau lapaʻau.
3. Wehe koke i nā apo a pau, nā wati, nā kūpeʻe lima, a me nā kāmaʻa paʻa mai ka lālā i hoʻopilikia ʻia. ʻO ka nahu ʻana o ka centipede, ka ʻū a ka moʻo huelo ʻawaʻawa, a me nā ʻūhā ahi he nui hiki ke hoʻoulu koke i ka lymphatic brawny a me ka pehu vascular i loko o 15 a 30 mau minuke. ʻO ka waiho ʻana i ke apo metala ma ka manamana lima pehu hiki ke hoʻopaʻa i ke kahe koko a hoʻoulu i ka ischemia kikohoʻe.
4. E holoi mālie i ke kopa a i ʻole ka nahu me ke kopa malū a me ka wai e kahe ana. E hoʻomaʻemaʻe i nā ʻili a me ka lepo me ka holoi ʻole ʻana. Inā loaʻa nā pseudopustules ant ahi a i ʻole nā ​​lauoho anuhe, e mālama mau i nā ʻōpala a ʻaʻole loa e pahū a ʻomi paha.
5. E noi i ka pulupulu maloʻo i uhi ʻia i ka lole no 10 a 15 mau minuke i ka manawa (a i ʻole ka hoʻopaʻa ʻia ʻana i ka wai mahana no ka nahu ʻana o ka centipede). No ka maʻi ʻana o ka moʻo huelo ʻawa a me ke ahi, ʻo ka ʻeke maloʻo i ʻōwili ʻia i kahi kāwele maloʻo e hoʻolōʻihi i ka ʻā ʻana a hoʻopaʻa i nā hopena o ke aʻalolo. No nā centipede nunui (Scolopendra), ʻo ka hoʻoinu ʻana i ka nahu i loko o ka wai mehana hiki ke ʻae ʻia ma 40 a 43 degere Celsius (104 a 109 degere Fahrenheit) no 20 a 30 mau minuke e kōkua i ka hoʻopau ʻana i nā mea ʻawaʻawa-labile protein a hoʻomaha i ka vasospasm kūloko.
6. E noho mālie, mālie, a nānā pono i ka mea i hoʻopilikia ʻia no ke ala ea a i ʻole ka pilikia neurological. E hoʻomaha i ka ʻāʻī ma kahi kūlana kūʻokoʻa ʻoluʻolu ma lalo a i ʻole ma lalo iki o ka pae o ka puʻuwai no ka maʻi neurotoxic scorpion, a i ʻole e hoʻokiʻekiʻe iki ʻia no ka pehu ʻole neurotoxic. Inā loaʻa i ka mea maʻi kahi epinephrine auto-injector a hoʻomohala i nā hives, ʻoʻoleʻa ka ʻāʻī, wīwī, a noni paha, e hoʻokomo koke i ka epinephrine i loko o ka ʻūhā waena o waho.

ʻO ka lāʻau hoʻoholo pilikia no nā arthropod ʻawaʻawa¶

flowchart TD
    Start["Suspected Scorpion, Centipede, or Venomous Arthropod Sting"]
    Scene["Move to Safety and Remove Constricting Jewelry<br/>Wash gently with soap and water"]
    Anaphylaxis{"Signs of Systemic Anaphylaxis?<br/>(Wheezing, stridor, tongue swelling, hives, hypotension)"}
    Epi["Inject Epinephrine Auto-Injector into Outer Thigh<br/>Call Emergency Medical Services Immediately<br/>Position flat with legs elevated (or upright if short of breath)"]
    Species{"Identify Culprit Arthropod Class and Clinical Syndrome"}
    Scorpion["Scorpion Sting<br/>(Electric burning pain, tap test positive, minimal local swelling)"]
    Centipede["Giant Centipede Bite<br/>(Two paired puncture marks, intense localized burning, erythema, swelling)"]
    FireAnt["Fire Ant / Velvet Ant / Blister Beetle / Puss Caterpillar"]
    NeuroCheck{"Neurotoxic Red Flags or Pediatric Patient?<br/>(Child under 10, roving eyes, drooling, slurred speech, muscle spasms, tachycardia)"}
    ScorpionALS["Call EMS Immediately for Antivenom Transport<br/>1. Suction oral secretions and position on side if drooling<br/>2. Apply cool cloth compress (NO ice immersion, NO tourniquets)<br/>3. Monitor breathing for respiratory fatigue"]
    ScorpionMild["Mild Local Scorpion Pain in Adult<br/>1. Apply wrapped cool pack 10 minutes on / 10 minutes off<br/>2. Call Poison Control and monitor for 4 to 6 hours<br/>3. Verify tetanus immunization status"]
    CentipedeCare["Centipede First Aid Protocol<br/>1. Clean paired puncture wounds thoroughly<br/>2. Test warm water (40 to 43C / 104 to 109F) or cool pack for pain relief<br/>3. Monitor for chest pain, lymphangitis, or secondary cellulitis"]
    OtherCare["Fire Ant / Caterpillar / Beetle Care<br/>1. Tape-strip venomous caterpillar spines immediately<br/>2. Keep fire ant pustules and cantharidin blisters intact<br/>3. Apply cool compresses and watch for allergic reaction"]

    Start --> Scene
    Scene --> Anaphylaxis
    Anaphylaxis -->|Yes| Epi
    Anaphylaxis -->|No| Species
    Species -->|Scorpion| Scorpion
    Species -->|Centipede| Centipede
    Species -->|Ant / Caterpillar / Beetle| FireAnt
    Scorpion --> NeuroCheck
    NeuroCheck -->|Yes: High Risk or Systemic Signs| ScorpionALS
    NeuroCheck -->|No: Isolated Local Pain Only| ScorpionMild
    Centipede --> CentipedeCare
    FireAnt --> OtherCare

Ka hoʻohālikelike ʻana i nā arthropod terrestrial nui¶

ʻO ka ʻike ʻana i ka arthropod culprit ma kāna ʻano hoʻohālikelike anatomical a me ka hōʻike hōʻike kino koke e kōkua i ka poʻe pane mua e noʻonoʻo inā he neurotoxicity ʻōnaehana ka hoʻoweliweli, ʻeha ʻeha o ka ʻiʻo kūloko, a i ʻole anaphylaxis maʻi.

ʻO Scorpion envenomation: pathophysiology a me ka hoʻonaʻauao lāʻau¶

Ma kahi o 2,500 mau ʻano moʻo huelo ʻawaʻawa i wehewehe ʻia ma ka honua holoʻokoʻa, ʻoi aku ka liʻiliʻi ma mua o 50 no ka ʻohana pilikia olakino Buthidae hiki ke hoʻoulu i ka envenomation kanaka. Eia nō naʻe, ma nā ʻāina maloʻo, subtropical, a me nā ʻāina wela ma waena o ʻAmelika ʻĀkau a me ʻAmelika Hema, ʻApelika ʻĀkau, ka Middle East, a me India, ʻoi aku ka nui o ka scorpion stings no ka 1.2 miliona mau kuʻi a ʻoi aku ma mua o 3,000 mau make i kēlā me kēia makahiki, ka hapa nui o nā keiki ma lalo o 10 mau makahiki.

He lula morphological pono o ka manamana lima: pincers versus huelo¶

ʻOiai ʻaʻole pono e hoʻāʻo ka poʻe hele wāwae a me nā mea hale e mālama i kahi moʻo huelo ʻawaʻawa e nānā pono iā ia, ʻike nā mea olaola āpau a me nā mea ʻona ʻona pilikia i kahi kūʻai kūʻai kūpono e pili ana i ka anatomy scorpion.

• ** ʻO nā pine wiwi a me kahi huelo mānoanoa a ikaika:** ʻO nā Scorpions nona nā pedipalps lahilahi, palupalu, like me tweezer-like me ka metasoma (huelo) kaumaha, hilinaʻi nui i nā neurotoxins kemika ikaika e hoʻokuʻu koke i ka mea pio. Ma kahi kokoke i nā moʻo huelo Buthid make a pau, e like me ka mea make (Leiurus), nā moʻo huelo momona (Androctonus), a me nā moʻo huelo ʻili (* Centruroides *), e kaʻana like i kēia ʻaoʻao slender-claw.
• ** ʻO nā ʻuala nui, like me ka ula a me ka huelo lahilahi:** ʻO nā Scorpions i lako me nā pedipalps mānoanoa, puʻupuʻu, ʻokiʻoki (e like me ka emperor scorpion Pandinus imperator a i ʻole ka moʻo huelo huluhulu wao nahele nui Hadrurus arizonensis) e lanakila ai i nā mea pio me ka ikaika o ka pōʻino o ke kanaka.

Pehea ka hoʻouka ʻana o ka ʻili a me nā neurotoxins Buthid i ka ʻōnaehana nerve¶

ʻO nā mea make i hana ʻia e Centreroides, Tityus, Leiurus, a me Hottentotta aia nā polypeptides neurotoxic haʻahaʻa-molekala-kaumaha e hoʻopaʻa pono ʻia i nā kahawai sodium-gated-volt (\(\text{Na}^+\)) ma nā axonal membranes o nā aʻalolo somatic peripheral a me ka ʻōnaehana nerve autonomic:

1. Alpha-toxins e hooloihi i ka manawa hoopau o na auwai sodium, e pale ana i ka membrane nerve mai ka repolarizing ma hope o ka puhi ana a me ka paa ana i ka neuron i loko o ka moku'āina o ka hoʻokuʻu uila.
2. ʻO Beta-toxins hoʻololi i ka paepae hoʻāla uila i hiki i nā aʻalolo naʻau a me nā kaʻa ke ahi koke i nā hiki hoʻomaha maʻamau.
3. ** ʻO ka pāpaʻa (\(\text{K}^+\)) channel blockers** hoʻopaneʻe hou aku i ka hoʻihoʻi hou ʻana o ka neuronal, e hoʻonui ana i ke kī hou ʻana o kēlā me kēia aʻalolo i hoʻoikaika ʻia.

ʻO kēia depolarization neuronal mau ʻole e hoʻoulu i ʻelua crises overlapping e pili ana i ka ʻano ʻāina:

• North American Bark Scorpion Syndrome (Centruroides sculpturatus / C. exilicauda, me Mekiko C. limpidus a me C. noxius): Ke kumu nui nei i ka haunaele neuromuscular a me cranial nerve storm i hui pu me ka parasympathetic (cholinergic) keu. ʻIke koke ka poʻe i ka ʻeha ulia, ʻeha a me ke kani ʻana o ka lālā a puni ka waha, nā ʻiʻo o ka ʻiʻo i makemake ʻole ʻia, nā neʻe ʻāhiu ʻāhiu e like me ka hopu ʻana i ka wā e ala ana ka mea maʻi, nalowale ka hui pū ʻana o ka pharyngeal muscle, salivation frothy frothy, blurry vision, and conjugate or dysconjugate neʻe opsoclonus).
• ** Ka Honua Kahiko a me ʻAmelika Hema Autonomic Cardiovascular Storm (Leiurus, Androctonus, Parabuthus, Hottentotta, a me Tityus serrulatus):** ʻOiai e hoʻoulu ai kēia mau mea ʻawaʻawa i ka ʻehaʻeha neurological koʻikoʻi, hoʻomaka lākou i ka piʻi nui ʻana o parasympathetic acetylcholine, hoʻoulu i ka maʻi ʻana o ka maʻi maʻi. ka wela, ka luaʻi, a me ka priapism i nā kāne ʻōpio) i ukali wikiwiki ʻia e ka nui, ka lōʻihi o sympathetic catecholamine flood (epinephrine a me norepinephrine). ʻO kēia ʻino catecholamine ke kumu o ke kiʻekiʻe kiʻekiʻe, supraventricular a ventricular tachycardia, toxic myocarditis, acute ventricular failure, a me ka neurogenic pulmonary edema e hoʻoweliweli ana i ke ola, kahi e hoʻopiha ai ka wai ʻulaʻula i nā māmā. ʻO nā ʻano ʻano Tityus ma Pasila a me Trinidad (ʻo ia hoʻi ʻo Tityus trinitatis) kaulana nō hoʻi no ka hoʻoulu ʻana i ka maʻi maʻi hemorrhagic pancreatitis.

ʻO ke kauka "Tap Test" no Centreroides nā ʻuʻu ʻawaʻawa¶

ʻAʻole e like me ke kuʻi pi, ka nahu nalo, a i ʻole ka nahu ʻana o ka spider, ʻo kahi maʻi ʻo Arizona bark scorpion (Centruroides sculpturatus) e waiho ** ʻaneʻane ʻaʻohe māka ʻike ʻia ma ka ʻili**. ʻAʻohe ʻulaʻula ʻulaʻula, ʻaʻohe wahi ʻānai, a ʻaʻohe pehu o ka ʻiʻo, he mea paʻakikī loa ka ʻimi ʻana i ka wahi o ke kuʻi ʻana ma kahi pēpē uē a ʻōpiopio ʻaʻole hiki ke ʻōlelo.

Hoʻohana nā kauka ulia pōpilikia i ka Tap Test no ka hoʻopaʻa ʻana i kahi envenomation neurotoxic Centreroides: paʻi mālie i ka pūnaewele i manaʻo ʻia me ka manamana lima hoʻokahi e hoʻoulu koke i ka hoʻihoʻi ʻana i ka uila a me ka pana ʻana i nā paresthesias ma waho o nā ʻāpana āpau i ka pā māmā. Ma muli o kēia hyperesthesia mechanical loa, hiki i ka nānā ʻana i ke keiki mai ke poʻo a ka wāwae ma ke kaomi māmā ʻana i nā lima, nā wāwae, nā lima, a me nā wāwae hiki ke kuhikuhi pinepine i ka wahi kikoʻī ʻike ʻole ʻia.

Ka helu ʻana i ke kino o ka envenomation scorpion (Papa I a i IV)¶

Hoʻokaʻawale nā kauka ulia pōpilikia a me nā kikowaena hoʻomalu lāʻau ʻawaʻawa neurotoxic i loko o ʻehā mau māka lapaʻau e hoʻoholo ai i ka mea hiki ke mālama ʻia me ka analgesia a me ka nānā ʻana me ka mea e koi koke i ka intravenous scorpion antivenom:

ʻO ke kōkua mua i kēlā me kēia ʻanuʻu no ka maʻi ʻawaʻawa¶

1. E hōʻoia i ka palekana o nā hiʻohiʻona a nānā i nā hōʻailona neurotoxic Grade III/IV: E hoʻoneʻe i ka mea maʻi mai kahi a lulu i ka moena a i ʻole nā kāmaʻa. Inā he keiki a keiki paha ma lalo o 10 makahiki ka mea i hōʻeha ʻia, a i ʻole he kanaka makua me ka maʻi cardiopulmonary, e kelepona koke i nā lawelawe lapaʻau pilikia. E makaʻala no ka kaʻoniʻoni ʻana o ka maka, drooling nui, haʻiʻōlelo slurred, a me ka ʻāʻī ʻana o nā lālā.
2. E pale i ke ea inā hoʻomaka ka drooling a i ʻole ka paʻakikī o ka ʻai ʻana: E kau i kahi keiki e kulu ana a i ʻole ʻāwīwī i ke ** kūlana hoʻihoʻi hope** ma ko lākou ʻaoʻao i hiki ke kahe ʻana o ke kohu ma waho o ka waha ma mua o ka hoʻoulu ʻana i ka laryngospasm a i ʻole aspiration, a me ka pā a puni.
3. E holoi i ka wahi hoʻopaʻa ʻana a wehe i nā mea i hoʻopaʻa ʻia: E holoi mālie i ka ʻili me ke kopa a me ka wai anuanu, a wehe koke i nā apo, nā wati, a me nā kāmaʻa.
4. E hoʻomoʻi i ka ʻauʻau hau: E kau i kahi lole ʻoluʻolu, pulu a i ʻole kahi ʻeke hau i ʻōwili ʻia i loko o kahi kāwele maloʻo ma luna o ka wahi hoʻopaʻa no 10 a 15 mau minuke i ka manawa. Mai hoʻokahe i kahi lālā i loko o ka wai hau, a pale aku i nā tourniquet, ʻokiʻoki, a i ʻole nā ​​mea hoʻoheheʻe.

Nahu centipede nunui (Scolopendra): ʻo ka pathophysiology a me ka hoʻōla wela¶

ʻO Centipedes (Class Chilopoda) he mau arthropod predatory elongated me hoʻokahi mau wāwae ma kēlā me kēia māhele kino. ʻOiai ʻo nā centipedes hale liʻiliʻi (Scutigera coleoptrata) a me nā centipedes pōhaku kīhāpai he mau āwae nāwaliwali e ʻaʻaʻole i ʻō i ka ʻili o ke kanaka, ʻo ka ʻūhā a me ka wao nahele ** ulu nui nā centipedes o ka genus Scolopendra** i ka lōʻihi o 15 a 30 kenimika (6 a 12 iniha) a hoʻopakele i kekahi o nā mea ʻeha loa i loko o ka holoholona. Aia nā ʻano mea kaulana i ka centipede wao nahele nunui (Scolopendra heros) o ʻAmelika Hema komohana a me Mekiko, ka Vietnamese a i ʻole ka Pākīpika giant centipede (Scolopendra subspinipes) i loaʻa ma ʻĀsia, Hawaiʻi, a me Australia, a me ka Mediterranean banded centipede (Scolopendra cingulata).

Anatomical mechanical: forcipules a me "track marks"¶

Ma keʻano loea, ʻaʻole nahu ka centipede me ka waha ʻoiaʻiʻo a ʻaʻole hoʻi e kuʻi me ka huelo. Akā, ua hoʻololi hou ʻia nā mea hoʻohui o kona ʻāpana kumu kino mua i ʻelua o nā pine nui nui, ʻāwīwī, ʻāwīwī i kapa ʻia ʻo forcipules (a i ʻole toxicognaths) i hoʻonoho ʻia ma lalo o ke poʻo. Ke hoʻoweliweli a paʻa ʻia paha i loko o nā lole, e hoʻokuʻu ka centipede i nā forcipule ʻāwili ʻelua i loko e like me ka ʻelua o nā ʻīpi caliper, e waiho ana i kahi ʻano ** ʻeha maʻi paʻa ma waena o 3 a 10 millimeters (0.12 a 0.4 iniha) kaʻawale**, hele pinepine ʻia me kahi lālani ʻelua o nā wāwae hele wāwae e paʻa ai ka ʻili o ka holoholona.

Ma muli o ka kuhi hewa pinepine ʻana o ka poʻe e kū ana i kēia mau hōʻailona o ka nahesa ʻawaʻawa, he mea nui ka nānā ʻana i ke ākea a me ka ʻili a puni: ʻo ka nui o nā pū centipede e kahe liʻiliʻi ke koko, e hoʻololi koke i ka ʻulaʻula a i ʻole ka poni ʻulaʻula, a e ulu wikiwiki a paʻa ka pehu kūloko i loko o nā minuke.

ʻO ka hana biochemical o ka ʻawaʻawa centipede¶

ʻO Scolopendra venom he mea hoʻolalelaʻi paʻa biochemically a me ka cocktail predatory i hoʻolālā ʻia e hoʻopau i nā iniseti, nā moʻo, a me nā mea momona liʻiliʻi i loko o kekona:

• Biogenic amines a me nā mea hoʻoponopono ʻeha: ʻO ka manaʻo kiʻekiʻe o histamine, serotonin (5-hydroxytryptamine), a me acetylcholine e hoʻomaka koke i ka depolarization nociceptor a me ka permeability vascular kūloko.
• Ssm Spooky Toxin (SsTx): He peptide toxin ikaika loa i hōʻike ʻia i loko o Scolopendra subspinipes e ālai ana i ka KCNQ (\(\text{K}_\text{v}7\)) voltage-gated potassium channels, e hoʻoulu ana i ka arterial vasospasm, hypertension, coronary artery constriction, a me ka hanu.
• Cytolytic enzymes: Phospholipase \(\text{A}_2\), hyaluronidase, acid and alkaline phosphatases, a me metalloproteases e wawahi iho i na membrane cell a me extracellular matrix, e hooulu ana i ka eha, ka pohu, lymphangitis, a me ka necrosis o ka ili papapaa i kekahi manawa ma na wahi o ka poka.

ʻO ke kōkua mua ʻanuʻu no kahi nahu centipede nunui¶

1. E hoʻokuʻu i ka centipede me ka palekana: E hoʻohana i ka lāʻau a i ʻole ka pūlima no ka hoʻokuʻu ʻana i ka centipede i hoʻopili ʻia i hoʻokahi neʻe wikiwiki ma mua o ka hopu ʻana me nā manamana lima ʻole.
2. E holoi maikaʻi i nā pū i hui ʻia: E hoʻoinu i ka ʻeha ma lalo o ka wai paipu maʻemaʻe no kekahi mau minuke a holoi mālie me ke kopa maʻemaʻe e wehe ai i ka maʻi bacteria (Staphylococcus, Streptococcus, Pseudomonas, a me Clostridium tetani).
3. E hoʻohana i ka lāʻau wela wela:
4. Ka hoʻokomo ʻana i ka wai mahana (40 a 43 degere Celsius / 104 a 109 degere Fahrenheit): ʻO ka hoʻoinu ʻana i ka lima a me ka wāwae i nahu ʻia i loko o ka wai mehana hiki ke ʻae ʻia i hoʻāʻo ʻia ma 40 a 43 degere Celsius (104 a 109 degere Fahrenheit) no 20 a 30 mau minuke. E ho'āʻo mua i ka mahana o ka wai e pale i ka wela.
5. Ke ʻano ʻē aʻe o ka hoʻopaʻa maʻalili: Inā hoʻonui ka wai mehana i ka ʻāʻī ʻana, a i ʻole ma hope o ka pau ʻana o ka wai mehana 20 mau minuke mua, e hoʻopili i kahi puke anuanu i uhi ʻia i ka lole no 10 a 15 mau minuke i ka manawa.
6. E hoʻokiʻekiʻe iki i ka lālā a nānā i nā pilikia: E hoʻopaʻa i ka ʻaoʻao i hoʻopilikia ʻia ma luna a i ʻole ma luna iki o ka pae puʻuwai. E ʻimi i ka lāʻau lapaʻau ulia pōpilikia inā loaʻa ka ʻeha o ka umauma, paʻa ka ʻāʻī, mimi ʻeleʻele ʻeleʻele, ʻili necrosis, a i ʻole e laha ana i nā ʻulaʻula (lymphangitis), a hōʻoia i ke kūlana o ka pale ʻana i ka maʻi tetanus.

ʻO nā ʻanuʻu ahi, nā ʻenetu velvet, nā ʻanuʻu ʻawaʻawa, a me nā nalo ʻōhū¶

Ma waho aʻe o nā moʻo huelo ʻawaʻawa a me nā centipedes, ʻehā pūʻulu o nā arthropods terrestrial e kipa pinepine ai i ka keʻena ulia pōpilikia no nā ʻeha dermal, ʻeha nui, a i ʻole ka puʻuwai maʻi maʻi.

1. Nā ʻanuʻu ahi i lawe ʻia mai (Solenopsis invicta a me Solenopsis richteri)¶

Ke hoʻopilikia ʻia kahi puʻu ʻanat ahi, ʻōpuʻu nā mea hana i nā wāwae o ka mea i pepehi ʻia ma mua o ke kani ʻana i ka manawa like. Hoʻopaʻa kēlā me kēia anene i ka ʻili me kāna mau ʻāʻī a pivots i kona ʻōpū i loko o ka pōʻai, e u ana i 5 a 8 mau manawa i ke ʻano rosette. ʻAʻole like me ka ʻawaʻawa meli, 95 pākēneka o ka mea ʻawaʻawa ahi ahi he mau ʻalkaloids piperidine hiki ʻole i ka wai (solenopsins) i hui pū ʻia me kahi hapa 5 pakeneka o nā protein allergenic. Ma loko o 6 a 24 mau hola, pepehi nā cytotoxic solenopsins i nā keʻokeʻo keʻokeʻo kūloko, e hoʻololi ana i kēlā me kēia wīla ʻulaʻula i kahi ʻano sterile white cloudy pseudopustule.

• Ka protocol kōkua mua no nā ʻuu ʻana o ke ahi:
• E holoi maloʻo ma mua o ka holoi ʻana: ʻO ka pulupulu ʻana i nā ʻanuʻu ahi i hoʻopaʻa ʻia e hoʻopaʻa paʻa iā lākou a hoʻomau i ke kani ʻana. E paʻi koke iā lākou me ka lole maloʻo a i ʻole ka lima lima lima mua, a laila holoi me ke kopa a me ka wai a kau i nā mea hoʻomaloʻo maloʻo.
• ʻAʻole e paʻi a ʻokiʻoki paha i nā pustules keʻokeʻo: ʻAʻole paʻa nā pustules ahi i ka wā e mau ana ka ʻili o ka ʻili. ʻO ka ʻoki ʻana a i ʻole ka popping iā lākou e hoʻokomo i ka maʻi bacteria Staphylococcus a me Streptococcus i loko o ka ʻiʻo necrotic, e hoʻoulu ai i ka cellulitis bacterial koʻikoʻi a i ʻole sepsis. E uhi i nā pustules paʻa me kahi kāʻei maʻemaʻe a palahalaha ma luna o 7 a 10 mau lā.

2. ʻO nā ʻanuʻu Velvet (Famili Mutillidae)¶

ʻOiai ko lākou inoa, ʻo nā ʻōleʻa ʻeleʻele he mau ʻēheu wahine ʻēheu ʻole i uhi ʻia me ka lauoho ʻulaʻula, ʻalani, a ʻeleʻele paha. Hoʻolako ʻia me kahi exoskeleton paʻakikī ʻē aʻe a me kahi stinger lōʻihi, agile, nā ʻano like me ka Eastern velvet ant (Dasymutilla occidentalis, i kapa ʻia ʻo "cow killer") e hāʻawi i kahi ʻūhā pahū i helu ʻia ma kahi kokoke i ka piko o ka Schmidt Sting Pain Index. ʻO ka mea pōmaikaʻi, ʻaʻohe o nā neurotoxins ʻōnaehana a i ʻole nā ​​​​enzymes e luku ana i ke kino. E holoi i ka pūnaewele me ke kopa a me ka wai, e hoʻopili i kahi ʻeke maloʻo i uhi ʻia i ka lole i loko o 10-15 mau minuke, a e nānā i nā hopena maʻi maʻamau.

3. ʻEnuhe ʻino (Lepidopterism / Erucism)¶

Uhi ʻia nā enuhe ʻino i nā ʻāwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīwīw. ʻO ka palaki ʻana i ka enuhe e paʻi ai i nā haneli o nā spines microscopic i piha i ka ʻawaʻawa i loko o ka ʻili.

• ** ʻAno pilikia nui:**
• Puss caterpillar (Megalopyge opercularis, a i ʻole "asp"): Ua like me ka hulu gula-ʻulaʻula a hinahina paha. Haʻalele kona mau spines i ** nā kiko ʻulaʻula hemorrhagic e like me ka ʻāpana** a hoʻoulu i ka ʻeha nui e ʻā ana i loko o ka ʻāʻī a i ʻole ka ʻāʻī lymph nodes, nā ʻiʻo ʻiʻo, a me ka paʻa o ka umauma.
• Enuhe Silkworm Pilikia o ʻAmelika Hema (Lonomia obliqua a me Lonomia achelous): ʻEnuhe kumu lāʻau kamaʻāina nona nā mea ʻawaʻawa prothrombin activators a me nā enzyme fibrinolytic. ʻO nā kumu pili ** lethal consumptive coagulopathy** i loko o nā hola a hiki i nā lā, e alakaʻi ana i ke kahe koko, hematuria, a me ka hemorrhage intracranial make e koi ana i ka hoʻokomo koke ʻana i ka halemai o anti-lonomic serum (SALon).
• Polokia kōkua mua: Hoʻokiʻekiʻe i ka enuhe me nā pū, a laila e hana koke i ka Adhesive Tape Stripping ma ke kaomi ʻana i ka cellophane paʻa a i ʻole ka lipine lipine ma luna o ka wahi hili a ʻili pinepine ʻia me nā ʻāpana hou e unuhi i nā spines i hoʻokomo ʻia. E holoi mālie me ke kopa a me ka wai, e hoʻopili i nā ʻeke maloʻo, a e ʻimi i ka lāʻau lapaʻau pilikia no ka ʻeha ʻeha nui a i ʻole kekahi hui ʻAmelika Hema Lonomia.

4. ʻO nā pīkoi pohihihi (Famili Meloidae a me Oedemeridae)¶

Hoʻopuka nā ʻūhā poha i ka cantharidin, he terpenoid vesicant, mai ko lākou mau ami wāwae (reflex bleeding) i ka wā e palaki ai a i ʻoki ʻia i ka ʻili. ʻAʻole ʻeha ka hoʻopili ʻana i ka wā mua, akā i loko o 2 a i 24 mau hola, hū aʻe nā ʻōpū nui i piha i ka wai (bullae) ma ka epidermis. Mai paʻi i ka namu ma ka ʻili ʻole; Holoi mālie, holoi koke me ke kopa a me ka wai i ʻole e hamo ʻia ka cantharidin i loko o nā maka, a e mālama mau i nā ʻōhū ma lalo o kahi lole maʻemaʻe.

ʻO nā moʻolelo ʻino a me nā hana ʻino e pale aku ai¶

Hoʻohana pinepine ka poʻe i manaʻo maikaʻi i nā lāʻau lapaʻau kuʻuna a i ʻole nahesa i loaʻa i ka arthropod stings e hōʻeha nui ana i ka luku ʻana i nā ʻiʻo a i ʻole nā ​​mea ʻona kino:

Kāohi i nā wahi endemic¶

Ma nā ʻāina wao nahele, ka wela, a me nā ʻāina subtropical kahi e ulu ai nā moʻo huelo ʻawa, nā centipedes nunui, a me nā ʻanuʻu ahi, nā hana maʻalahi i kēlā me kēia lā e pale i ka hapa nui o nā mea ʻino i loko a me ka pō.

• Luliluli i nā kāmaʻa a pau, nā lole, a me nā kāwele ma mua o ka hoʻohana ʻana: E hoʻohuli mau i nā kāmaʻa a me nā kāmaʻa i luna a paʻi i nā kuʻekuʻe wāwae ma mua o ka hoʻokuʻu ʻana i kou wāwae i loko, a lulu i nā kāwele ʻauʻau a i ʻole nā lole i waiho ʻia ma ka papahele a i ʻole ka moena hoʻomoana.
• Huki i nā moena a me nā moena mai nā paia aku a hoʻohana i nā pahele wāwae ipu aniani: Piʻi nā Scorpions i ka stucco, pōhaku lepo, a me ka pā maloʻo me ka maʻalahi, akā ʻaʻole hiki iā lākou ke piʻi i ke aniani maʻemaʻe. Ma nā ʻāpana moʻo huelo ʻōpala, e hoʻoneʻe i nā moena pēpē ma kahi o 15 kenimika (6 ʻīniha) ka mamao mai nā paia, e hoʻopaʻa pono ʻaʻole e kau nā pākeʻe ma ka papahele, a hoʻokomo i nā wāwae ʻehā i loko o nā ipu aniani ākea ākea.
• Nānā i nā wahi moe i ka pō me kahi kukui ʻeleʻele ultraviolet (UV): Loaʻa i nā moʻo huelo ʻawaʻawa nā beta-carboline a me 4-methyl-7-hydroxycoumarin pūhui i loko o ka papa hyaline o kā lākou exoskeleton cuticle e **fluoresce ʻulaʻula neon uliuli-'ōmaʻomaʻo ma lalo o 365 a 395 nanometer UV kukui ʻeleʻele hiki ke hiki ke ʻike ʻia.
• E hoʻohana i nā kāmaʻa wāwae paʻa a me nā mīkina lima ʻili ma waho: Mai hele wāwae ʻole ma waena o nā lau i ka ʻāina ant ahi a i ʻole velvet ant teritori, a e hoʻohana mau i nā mīkina lima ʻili mānoanoa ke hoʻoneʻe i ka wahie, ka hoʻohuli ʻana i nā pōhaku patio, a i ʻole ke ʻoki ʻana i nā lau mānoanoa kahi e peʻe ai nā anuhe a me nā centipedes.

Kōkua ke alakaʻi kōkua mua iā ʻoe e hoʻokele i nā minuke koʻikoʻi o ka envenomation, akā ʻaʻole hiki ke hoʻololi i ka hoʻomaʻamaʻa pilikia lima. E noʻonoʻo e lawe i kahi kōkua mua i hōʻoia ʻia a me ka papa CPR ma o kāu hui Red Cross a i ʻole Red Crescent Society, St John Ambulance, a i ʻole kahi lāʻau lapaʻau o ka wao nahele i hiki iā ʻoe ke hoʻomaʻamaʻa i ka hoʻonohonoho ʻana i ke ea, ka hoʻohana ʻana i ka epinephrine auto-injector, a me ka loiloi pilikia me kahi kumu.

Nīnau pinepine¶

Nānā ʻia nā kumu¶

• Na Center for Disease Control and Prevention (CDC, United States) & National Institute for Occupational Safety and Health (NIOSH, United States): Venomous Insects and Scorpions: Clinical Guidance, Prevention, and First Aid Management.
• World Health Organization (WHO, International): Rabies and Envenoming: He mea i mālama ʻole ʻia i ka Public Health Issue and Global Management Guidelines for Scorpion Stings.
• Ahui ʻAmelika Hui Pū ʻIa o Poison Control Center (AAPCC / America's Poison Centers, ʻAmelika Hui Pū ʻIa): Nā Kūkākūkā Kūkākūkā e pili ana i nā hōʻike no ka mālama ʻana i waho o ka hale maʻi o Bark Scorpion (Centruroides) Stings.
• Food and Drug Administration (FDA, United States): Ke kuhikuhi ʻana i ka ʻike a me ka ʻikepili no ka hoʻāʻo ʻana i ke kino no Centruroides (Scorpion) Immune F(ab')2 (Equine) Intravenous Antivenom.
• Wilderness Medical Society (WMS, ʻAmelika Hui Pū ʻIa): Nā Kūlana Hoʻomaʻamaʻa Kauka no ka Kāohi ʻana a me ka mālama ʻana i nā Envenoma e nā Arthropods Terrestrial, Centipedes, Fire Ants, a me Lepidoptera.
• Ministry of Health of Brazil (Ministerio da Saude, Brazil): Manual de Diagnostico e Tratamento de Acidentes por Animais Peconhentos: Escorpionismo (Tityus) a me Erucismo por Lonomia.
• International Federation of Red Cross and Red Crescent Societies (IFRC, International): International First Aid, Resuscitation, and Education Guidelines: Bites and Stings.

Nā alakaʻi pili¶

• ʻO ka nalo, ka nalo, a me ka hornet
• Nahu a me ka nahu o ka spider
• ʻO nā hopena maʻi koʻikoʻi a me ka anaphylaxis
• Nahu nahesa i ke kōkua mua
• ʻO ka iʻa iʻa a me ke kuʻi ʻana o ke kai
• Nā helu pilikia a me ka hoʻouna honua