Pediatric emergency medicine trisk 1999 1999

pain can persist for hours or even days and the emergency provider should provide adequate analgesia Treatment involves irrigating the wound with sterile saline The injured extremity is then immersed in very hot water (40° to 45°C [104° to 113°F]) for 30 to 60 minutes or until the agonizing pain is completely relieved Pain relief is best achieved with morphine 0.1 mg/kg IV, IM, or SC The patient should be monitored carefully for cardiotoxic effects and respiratory depression Antivenin is available only for the stings of the stonefish of Australia Catfish The catfish is a popular food and sport fish found in many lakes and rivers throughout the United States The venom apparatus consists of a number of spines located in the dorsal and pectoral fins The integumentary sheaths covering the spines contain venom glands The venoms are unstable, heat-labile compounds Injuries can be a combination of puncture wounds and lacerations, foreignbody reactions, and the effects of venom The spines may become imbedded in flesh, causing soft tissue swelling, infection, or foreign-body reaction The venom produces a local inflammatory response with local intense pain, edema, hemorrhage, and tissue necrosis Treatment involves irrigating the wound with sterile saline The injured extremity is then immersed in hot water (40° to 45°C [104° to 113°F]) for 30 to 60 minutes or until pain is relieved Pain relief is best achieved with morphine The wound should be explored, spines removed and debrided if needed Systemic antibiotics to cover gram-negative organisms are recommended Wounds may be closed by using a delayed primary closure TERRESTRIAL INVERTEBRATES Phylum Arthropoda The arthropods make up the largest phylum in the animal kingdom All arthropods have an exoskeleton with jointed appendages The phylum is divided into two subphyla: the Chelicerata, which includes scorpions, spiders, ticks, and mites, and the Mandibulata, which includes insects Scorpions There are 650 known scorpion species (class Arachnida), but only a limited number are dangerous to humans In the southwest United States, Centruroides sculpturatus is the potentially lethal inhabitant Although C sculpturatus and