Britt A, Burkhart K
Pennsylvania State University, Milton Hershey Medical Center, USA.
Am J Emerg Med. 1997 Sep;15(5):529-31. doi: 10.1016/s0735-6757(97)90202-3.
Most venomous snakes in the United States are of the Crotalidae family. Another family of snakes, the Elapidae, are not so common, but their bites may be a threat to zoo keepers and persons who have exotic snakes as pets. Because Elapidae envenomation is not common, signs and symptoms of such envenomation may not be recognized. Elapidae venom, because of a curare-like property, can produce respiratory compromise followed by death within 10 minutes. Antivenin, cholinesterase inhibitors, and mechanical ventilation are treatments to consider in such envenomations. Unlike Crotalidae antivenin, Elapidae antivenin may not confer protection against species not used in its preparation. Identification of the involved snake, by family and specie, should be an early priority. Correct management of the envenomated patient is dependent on the prompt administration of the most specific antivenin available when indicated.
美国大多数毒蛇属于蝰蛇科。另一类蛇——眼镜蛇科,并不那么常见,但它们的咬伤可能会对动物园饲养员以及将外来蛇类作为宠物的人构成威胁。由于眼镜蛇科蛇咬伤并不常见,此类蛇毒中毒的体征和症状可能无法被识别。眼镜蛇科蛇毒具有箭毒样特性,可导致呼吸功能障碍,随后在10分钟内死亡。抗蛇毒血清、胆碱酯酶抑制剂和机械通气是此类蛇毒中毒可考虑的治疗方法。与蝰蛇科抗蛇毒血清不同,眼镜蛇科抗蛇毒血清可能无法对未用于制备该血清的蛇种提供保护。尽早确定所涉及的蛇的科和种类应是首要任务。对蛇毒中毒患者的正确处理取决于在有指征时及时给予最具特异性的可用抗蛇毒血清。