Gefahren durch Gifttiere - Unfälle mit Giftschlangen

Zusammenfassung

In den Verbreitungsgebieten von Gifttieren ist die Versorgung der Verletzungen durch diese ein Teil des klinischen Alltags der medizinischen Versorgungseinrichtungen. Für in diesen Gegenden exponiertes Personal während z. B. Hilfseinsätzen sollten ebenfalls Vorkehrungen für das Management solcher Verletzungen getroffen werden. Außerhalb dieser Gebiete sind Zoopersonal und Terrarienbesitzer gefährdet. Die weitaus meisten Verletzungen werden durch Giftschlangen verursacht, die mit ca. 600 giftigen Arten insbesondere in den warmen Klimazonen verbreitet sind. Aber auch Vergiftungen durch Spinnen, Skorpione und giftige Seetiere können lebensbedrohlich sein. Schlangengifte bestehen aus einer Vielzahl von Einzelkomponenten, die speziesabhängig ein breites Spektrum von unterschiedlichen Gifteffekten und damit ein buntes klinisches Bild erzeugen können. Es werden lokal-proteolytische, autopharmakologische, hämatologische, neurologische, muskuläre, kardiale und renale Gifteffekte unterschieden. Beim Management von Gifttierverletzungen sind, abhängig von der Hauptgiftwirkung und neben den Ersthelfermaßnahmen, supportive Therapiemaßnahmen und spezifische Antiveninbehandlungen differenziert anzuwenden. Mono- und polyvalente Antivenine stehen zur Verfügung. Nicht wirksame oder schädigende Erste-Hilfe-Maßnahmen müssen vermieden werden. Durch angepasstes Verhalten lassen sich Gifttierverletzungen in aller Regel vermeiden. Aufklärung und Maßnahmen zur Verhaltenssteuerung gehören zu den zentralen Präventionsmaßnahmen vor dem Einsatz in Verbreitungsgebieten von Gifttieren.

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.

Schlüsselwörter

Gifttiere - Giftschlangen - Gifteffekte - Antivenin - Kompressions-Immobilisations-Verband

Key words

Venomous animals - venomous snakes - snake envenomation - antivenom - toxinology - compression-immobilisation method

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