[Risks posed by venomous animals -- accidents due to snakebite envenomation].

Abstract

In regions where poisonous animals are widely distributed, the management of injuries due to these animals is part of the routine medical care. Personnel e. g. deployed for humanitarian aid missions in these areas have to be prepared to face these challenges as well. Beside this group zoo personnel and snake charmers here in Europe are also endangered. The most common form of animal poisoning is due to snake bites. There are approximately 600 different species of poisonous snakes, commonly found in the warm climatic regions. But poisoning from spiders, scorpions and some marine animals can also be life threatening. There are different kinds of snake venoms, which result into different clinical presentations depending on the components of the venom. The venom may be cytotoxic, hematotoxic, neurotoxic, rhabdomyolytic, cardiotoxic, renotoxic or may cause an autoimmune reaction by complement activation. In the management of injuries following animal poisoning, besides the first aid measures taken, the injured is supposed to be managed according to the poison component in the venom with specific antivenin treatment and supportive therapeutic care. There are mono- and polyvalent antivenins available. Noneffective first-aid measures or measures which can cause further trauma must always be avoided. In general adapted behaviour in the field can prevent envenomation. Education on preventive measures with the aim of behaviour change are central components for pre-deployment preparations.