Terrestrial Envenomations in Pediatric Patients: Identification and Management in the Emergency Department (Trauma CME and Pharmacology CME) | Points & Pearls -
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Terrestrial Envenomations in Pediatric Patients: Identification and Management in the Emergency Department (Trauma CME and Pharmacology CME)

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Points and Pearls Excerpt

  • Envenomation by Latrodectus mactans (black widow spiders) can result in significant pain and hyperadrenergic symptoms. Treatment should first be focused on ensuring adequate administration of opioids and benzodiazepines.
  • Use of Latrodectus antivenom is generally not considered first-line therapy because of the relatively high rate of immediate (anaphylactoid) or delayed (serum sickness) allergic reactions.
  • Because toxicity from Loxosceles (brown recluse) bites primarily manifests as necrotic dermal lesions, various soft-tissue infections are often incorrectly ascribed to envenomation from this spider.
  • Patients envenomated by a Loxosceles spider should be observed for necrotic lesions and systemic effects. Hemolysis should be treated with corticosteroids.
  • Massive hymenoptera envenomation can result in multisystem organ involvement. Treatment with corticosteroids is indicated even though the reaction is not IgE-mediated.
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Publication Information
Authors

Michael Levine, MD, FACEP, FACMT; Nathan Friedman, MD

Peer Reviewed By

Sing-Yi Feng, MD; Nicole Gerber, MD

Publication Date

September 2, 2021

CME Expiration Date

September 2, 2024

CME Credits

4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.
Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 0.5 Trauma CME and 1 Pharmacology CME credits.

Pub Med ID: 34403224

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CME Information

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