Patients bitten by typically experience significant pain, substantial swelling, and potentially blister formation. The appropriate dosage and efficacy of FHAV for alleviating local tissue injury remain uncertain. Between 2017 and 2022, 29 snakebite patients were identified as being bitten by . These patients underwent point-of-care ultrasound (POCUS) assessments at hourly intervals to measure the extent of edema and evaluate the rate of proximal progression (RPP, cm/hour). Based on Blaylock's classification, seven patients (24%) were classified as Group I (minimal), while 22 (76%) were classified as Group II (mild to severe). In comparison to Group I patients, Group II patients received more FHAV (median of 9.5 vials vs. two vials, -value < 0.0001) and experienced longer median complete remission times (10 days vs. 2 days, -value < 0.001). We divided the Group II patients into two subgroups based on their clinical management. Clinicians opted not to administer antivenom treatment to patients in Group IIA if their RPP decelerated. In contrast, for patients in Group IIB, clinicians increased the volume of antivenom in the hope of reducing the severity of swelling or blister formation. Patients in Group IIB received a significantly higher median volume of antivenom (12 vials vs. six vials; -value < 0.001) than those in Group IIA. However, there was no significant difference in outcomes (disposition, wound necrosis, and complete remission times) between subgroups IIA and IIB. Our study found that FHAV does not appear to prevent local tissue injuries, such as swelling progression and blister formation, immediately after administration. When administering FHAV to patients bitten by , the deceleration of RPP may serve as an objective parameter to help clinicians decide whether to withhold FHAV administration.
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http://dx.doi.org/10.3390/tropicalmed8050246 | DOI Listing |
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Department of Orthorpedics and Sports Medicine, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat sports injuries, but evidence-based medical guidance for their standardized and rational use is lacking. This guideline working group identified clinically important issues, obtained the full opinions of patients and clinical staff, and discussed them with the expert group. Based on evidence from the literature, the "clinical practice guidelines for topical NSAIDs in the treatment of sports injuries" were formulated following the methods and principles of international guidelines.
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Department of Respiratory and Critical Care Medicine, Anyue County People's Hospital, Anyue, China.
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Department of Paediatrics, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China.
Simulation-based training in mental health is increasingly recognised as an effective tool within nursing education. This systematic review and meta-analysis aimed to evaluate the effectiveness of various simulation modalities, including standardised participants (SPs), role-plays, virtual reality (VR), mannequins and voice simulations, in improving educational outcomes for nursing students. A comprehensive literature search was conducted to identify studies evaluating the impact of mental health simulation on nursing education.
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