Myatt Toby, Nguyen Brian J, Clark Richard F, Coffey Christanne H, O'Connell Charles W
University of California San Diego School of Medicine, La Jolla, California.
Department of Emergency Medicine, University of California San Diego, San Diego, California; Division of Medical Toxicology, University of California San Diego, San Diego, California.
J Emerg Med. 2018 Aug;55(2):213-217. doi: 10.1016/j.jemermed.2018.04.035. Epub 2018 May 24.
Stingray injuries result in thousands of emergency department visits annually.
This study aimed to assess the complication rate and outcome of field treatment with hot water immersion.
This was an on-site, prospective, observational study. Subjects were enrolled after having been stung by a stingray. A trained researcher obtained the following information: age, sex, health conditions and medications, and wound description. The efficacy of hot water immersion on pain was recorded. Patients were contacted on postinjury days 3, 7, and 14 for follow up.
Twenty-two subjects were included. No obvious foreign bodies were observed in wounds. Ten subjects were treated with hot water immersion and povidone-iodine, 12 with hot water immersion alone. Ongoing symptoms or complications were noted at the 3-day follow-up in 6 of 22 subjects (27.3%). One subject was diagnosed with cellulitis on post-sting day 8 and was treated with antibiotics. Ongoing symptoms or complications were reported more commonly in patients treated with hot water and povidone-iodine compared with those treated with hot water alone (p = 0.056). There was a significant difference in wound size between those with and without ongoing symptoms at the 3-day follow-up (p = 0.0102). No wounds <1 cm developed any complications. Average duration of water immersion was 73.6 min (range 35-145 min). The mean pain score pretreatment was 7.36 and posttreatment was 2.18, with an average decrease of 5.18 (95% confidence interval 4.22-6.15).
Stingray injuries responded well to hot water immersion for pain control. Skin and soft tissue infection was diagnosed in 1 of 22 patients (4.55%).
每年有数千人因黄貂鱼蜇伤前往急诊科就诊。
本研究旨在评估热水浸泡现场治疗的并发症发生率及治疗效果。
这是一项现场前瞻性观察性研究。研究对象为被黄貂鱼蜇伤后入组。一名经过培训的研究人员收集了以下信息:年龄、性别、健康状况及用药情况,以及伤口描述。记录热水浸泡对疼痛的缓解效果。在受伤后第3天、第7天和第14天对患者进行随访。
纳入22名研究对象。伤口中未观察到明显异物。10名研究对象接受了热水浸泡加聚维酮碘治疗,12名仅接受热水浸泡治疗。22名研究对象中有6名(27.3%)在3天随访时出现持续症状或并发症。1名研究对象在蜇伤后第8天被诊断为蜂窝织炎并接受了抗生素治疗。与仅接受热水浸泡治疗的患者相比,接受热水浸泡加聚维酮碘治疗的患者更常出现持续症状或并发症(p = 0.056)。在3天随访时,有持续症状和无持续症状的患者伤口大小存在显著差异(p = 0.0102)。伤口<1 cm的患者未出现任何并发症。平均浸泡时间为73.6分钟(范围35 - 145分钟)。疼痛评分预处理时平均为7.36,治疗后为2.18,平均下降5.18(95%置信区间4.22 - 6.15)。
黄貂鱼蜇伤采用热水浸泡控制疼痛效果良好。22名患者中有1名(4.55%)被诊断为皮肤和软组织感染。