Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia.
Emergency Department, Lyell McEwin Hospital, Adelaide, South Australia, Australia.
Emerg Med Australas. 2022 Apr;34(2):230-236. doi: 10.1111/1742-6723.13869. Epub 2021 Sep 23.
To describe the South Australian paediatric redback spider bite experience and to examine the hypothesis that redback antivenom (RBAV) treatment in children is clinically effective.
Retrospective chart review of all children under 18 years of age presenting to the EDs of the three major paediatric or mixed hospitals in Adelaide, South Australia, with a discharge diagnosis of redback spider envenomation between 1 January 2010 and 31 March 2020. The main outcome measures include: patient and bite demographics; presenting symptoms and signs; treatment provided; clinical effects at 2 h post RBAV administration on pain, diaphoresis, blood pressure, heart rate and systemic features; overall clinical impression of RBAV effectiveness and resolution of symptoms prior to discharge.
There were 256 patient encounters involving 235 patients. Latrodectism was described in one-third (34%) of the cases. Sixty-one patients received RBAV and in 57 (93%) patients the RBAV had good clinical effect. Two hours post RBAV administration, pain resolved in 71%, hypertension resolved in 62%, diaphoresis resolved in 43% and tachycardia resolved in 82%. There were no cases of urticaria or anaphylaxis and one case of serum sickness.
This retrospective review of redback spider envenomation in South Australian children over a 10-year period has demonstrated clinical effectiveness of RBAV in paediatric patients across all age groups, observed in both clinician perceived results and measurable outcomes. RBAV remains an effective treatment for redback envenomation in children.
描述南澳大利亚儿科红背蜘蛛咬伤的经验，并检验红背蜘蛛抗毒液（RBAV）治疗儿童具有临床疗效的假设。
对 2010 年 1 月 1 日至 2020 年 3 月 31 日期间，南澳大利亚阿德莱德的三家主要儿科或混合医院急诊科就诊的所有 18 岁以下被诊断为红背蜘蛛咬伤的儿童进行回顾性病历回顾。主要结局指标包括：患者和咬伤人口统计学特征；出现的症状和体征；接受的治疗；RBAV 给药后 2 小时疼痛、出汗、血压、心率和全身症状的临床效果；RBAV 有效性的总体临床印象以及出院前症状的缓解情况。
共有 256 例患者就诊，涉及 235 例患者。其中三分之一（34%）的病例描述为 Latrodectism。61 例患者接受了 RBAV 治疗，其中 57 例（93%）患者的 RBAV 疗效良好。RBAV 给药后 2 小时，疼痛缓解 71%，高血压缓解 62%，出汗缓解 43%，心动过速缓解 82%。无荨麻疹或过敏反应病例，1 例血清病。
本研究回顾性分析了 10 年来南澳大利亚儿童红背蜘蛛咬伤的情况，结果表明 RBAV 在所有年龄段的儿科患者中均具有临床疗效，这在临床医生的感知结果和可测量的结果中均得到了证实。RBAV 仍然是治疗儿童红背蜘蛛咬伤的有效方法。
