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Terrestrial envenomations in pediatric patients: identification and management in the emergency department

Michael Levine1, Nathan Friedman2

  • 1Associate Professor of Emergency Medicine, University of California, Los Angeles, Los Angeles, CA.

Pediatric Emergency Medicine Practice
|August 17, 2021
PubMed

Insights

Most terrestrial animal bites and stings are minor, but children may face severe venom effects. This review covers epidemiology, pathophysiology, and management of venomous bites and stings, noting pediatric differences.

Area of Science:

  • Toxicology
  • Pediatrics
  • Dermatology

Background:

  • Most terrestrial animal bites and stings pose minimal risk to adults.
  • Children are more vulnerable to venomous effects due to smaller body mass, potentially leading to severe envenomation.
  • Understanding these risks is crucial for timely and appropriate medical intervention.

Purpose of the Study:

  • To review the epidemiology and pathophysiology of common terrestrial animal bites and stings.
  • To outline clinical presentations and provide evidence-based management guidelines.
  • To highlight age-specific differences in pediatric envenomation.

Main Methods:

  • Literature review of terrestrial animal envenomations.
  • Synthesis of epidemiological data and pathophysiological mechanisms.
  • Analysis of clinical presentations and treatment strategies.

Main Results:

  • Common venomous terrestrial animals include spiders, bees, wasps, fire ants, scorpions, snakes, and lizards.
  • Envenomation pathophysiology and general management share similarities between children and adults.
  • Pediatric patients may exhibit more severe reactions and require tailored treatment approaches.

Conclusions:

  • While many bites/stings are benign, venomous encounters require careful management, especially in children.
  • Recognizing subtle pediatric differences in envenomation is key for effective treatment.
  • This review provides a comprehensive guide for managing patients with terrestrial animal bites and stings.

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