• Racun adalah zat atau senyawa yang masuk ke dalam tubuh dengan berbagai

cara yang menghambat respons pada sistem biologis dan dapat menyebabkan
gangguan kesehatan, penyakit, bahkan kematian.

• Gigitan binatang termasuk dalam kategori racun yang masuk kedalam tubuh
melalui suntikan. Gigitan binatang atau sengatan serangga dapat
menyebabkan nyeri yang hebat dan/ atau pembengkakan

• Gigitan dan sengatan berbagai binatang walaupun tidak selalu

membahayakan jiwa dapat menimbulkan rx alergi yang hebat dan bahkan
kadang-kadang dapat berakibat fatal.
Human Bites

Cat bites

Dog Bites
1. The main clinical problem with human bites is infection. Human saliva contains up to 1011
bacteria/mL, and plaque on teeth has an even greater bacterial concentration.
2. Organisms include Eikenella corrodens, Staphylococcus species, Streptococcus viridans,
Bacteroides species, and microaerophilic streptococci.
3. Treatment should include wound irrigation, joint irrigation if necessary, intravenous
antibiotics. In almost all instances human bites should not be closed except when on the
face.
4. Antibiotic treatment of human bite wounds involves the use of penicillin or ampicillin plus a
β-lactamase inhibitor (amoxicillin/clavulanic acid or ampicillin/sulbactam)
1. Cat bites often leave deeply penetrating wounds that are
heavily contaminated. These wounds may even penetrate
into underlying bone.
2. Organisms include Pasteurella multocida and Staphylococcus
species.
3. Antibiotic treatment also consists of penicillin plus a first-
generation cephalosporin or amoxicillin plus a β-lactamase
inhibitor.
1. Dogs can generate massive force with their muscles of mastication and can cause
extensive soft-tissue injury. Soft-tissue infection, however, is not as common in dog
bites, but prophylaxis is still recommended.
2. Infecting organisms include Pasteurella multocida, Bacteroides species, Streptococcus
viridans, Fusobacterium, and Capnocytophaga.
3. Antibiotic treatment again consists of penicillin plus a first-generation cephalosporin
or amoxicillin plus a β-lactamase inhibitor.
1. All animal wounds should be irrigated and cleansed with detergent.
2. The chance of an animal having rabies is increased if the animal was behaving
abnormally or if it was an unprovoked attack.
3. Dogs and cats may be observed for 10 days if they are healthy. Previously immunized animals
should be considered low risk.
4. Skunks, bats, raccoons, and other wild carnivores should be considered rabid.
5. Rodents, rabbits, and livestock rarely ever carry the rabies virus.
 There is a clinical consensus that wounds in the face should be closed primarily.
 Today, primary replantation and plastic surgical reconstruction with ear cartilage grafts can also be performed
successfully.
 For wounds on the limbs, the existing recommendations are still inconsistent. It is generally accepted that the usual 6-
to 8-hour time limit for primary suturing can be extended to 12 hours or longer.
 Multiple recent studies have shown that wound infection is no more common after primary
 suturing of bite wounds than with healing by second intention.
 Dog-bite wounds of the face can be primarily sutured even if several days old.
 Primary closure is contraindicated for puncture wounds, with deep inoculation of pathogens (typically cat bites), bite
wounds on the hands, and human bites (except on the face).
• Dari 14 famili ular, 5 diantaranya adalah ular berbisa.
• Di Amerika, setiap tahunnya terdapat 3-4 gigitan per 100.000 populasi. •
Berdasarkan laporan WHO, jumlah kasus gigitan ular berbisa di India
sebanyak 2 juta per tahun, dengan angka kematian antara 35.000
sampai 50.000 orang.
• Di Vietnam, jumlah korban gigitan ular sekitar 30.000 orang per tahun, di
antaranya pekerja di perkebunan karet sejak 1993 sampai 1998. •
Sedangkan, di Thailand selama 1985-1989 jumlah korban gigitan ular
berbisa antara 3.377 sampai 6.038 orang per tahun. Begitu juga di
Myanmar, pada 1991 terdapat 14.000 kasus gigitan ular dengan 1.000
kematian. •
• Hingga kini Indonesia belum memiliki data pasti jumlah kasus gigitan ular
berbisa.
Local signs of
envenoming
(a) Fang marks 2.5 cm
apart inflicted by a
large Russell’s viper in
Sri Lanka
(b) Persistent local
bleeding from fang
marks 40 minutes after
a bite by a
Malayan pit viper
(c) Swelling, blistering
and bruising following
a bite by a Malayan pit
viper
(d) Blistering with early
necrosis at the site of a
monocellate cobra bite.
• Pemeriksaan laboratorium biasanya menunjukkan peningkatan jumlah neutrofil,
limfopenia, koagulopati dengan PT dan PTT memanjang, serta penurunan jumlah
fibrinogen. Kadar kreatinin kinase serum normal pada hari pertama dan kedua
setelah perawatan. Mioglobin plasma dan kadar kreatinin mempunyai korelasi yang
kuat. Pada pemeriksaan urinalisis dapat terjadi proteinuria (83%), serta hematuria
mikroskopik (50,9%). Hemoglobinuria dan mioglobinuria umumnya dapat dideteksi
dan dapat terjadi leukosituria (56,4%).
Polivalent Anti Bisa Ular Dapat Digunakan Pada
Gigitan:
1. Cobra
2. Ancistrodon (ular tanah)
3. Bungarus fasciatus (ular weling)
4. Bungarus candidus (ular weling)
Cobra termasuk jenis neurotoksik yang hebat,
sedangkan Ancistrodon termasuk haemolisis
yang hebat. Untuk yang lainnya termasuk jenis
campuran.
Fire Ants

Spiders

Bees and Wasps

1. The red fire ant (Solenopsis invicta) is an aggressive species that tends to inflict
multiple bites.
2. The bites are usually limited, but near-fatal cases have been documented.
Anaphylaxis is the major problem with their bites.
3. The bite has a characteristic appearance with an initial vesicle followed by a sterile
pustule.
4. The venom is unique in that it consists of 95% nonprotein alkaloid.
5. The treatment is mechanical scrubbing with soap and water to remove the venom.
Anaphylaxis is treated in the standard fashion.
1. Two common species are dangerous to humans.
2. The brown recluse spider (Loxosceles reclusa) has three pairs of eyes and a
violinshaped carapace on its body.
• There is minimal pain at the site, but a hemorrhagic blister commonly develops and
progresses to necrosis.
• Systemic symptoms are mild.
• Treatment is supportive. If started early, dapsone may prevent ulceration.
3. The black widow spider (Lactrodectus macrotans) has a black body with a red
hourglass on its underbelly.
• Its bite causes a systemic reaction, which has a rapid onset and up to 5% mortality.
• Treatment is supportive and an antivenin is available for severe cases.
• Dantrolene, calcium, and methacarbamol are second-line agents.
1. The most important consequence of bee and wasp stings is anaphylaxis. In fact, this is
responsible for more deaths than all other venomous animal bites and stings
2. Bees leave a stinger in the wound, which kills the bee. The stinging apparatus should
be scraped with a knife to remove it.
3. Individuals with a known sensitivity should wear a warning bracelet and carry an
epinephrine antianphylaxis kit for injection.
TERIMA KASIH