Bites and Stings from Venomous Animals: Routine Manual
De Andrade Nichioka, Sergio
PARDAL, Pedro Pereira de Oliveira & YUKI, Rubens Nobuo – Acidentes por animais peconhentos: manual de rotinas. Belem, Ed. Universitaria, 2000. 40 p. ilus.
Bites and stings from venomous animals remain an important public health problem in Brazil, both in rural (e.g. snake bites) and urban (e.g. spider bites and scorpion stings) areas. The Brazilian Ministry of Health publishes a manual (last published in 1998) on epidemiological and clinical aspects of bites and stings of medical interest. Although of good quality, the Ministry of Health’s manual relies mostly from the experience from southeastern Brazil, which is not necessarily directly applicable to other parts of the country. Drs. Pardal and Yuki’s manual tries to fill this gap for the Amazon region, a huge area so far little explored regarding injuries from venomous animals. Written by specialists from Para state, the manual consists mostly of flow charts and short texts, which should facilitate the reading by general practitioners and other health professionals working in isolated communities in the Amazon, for whom the manual was designed to help.
A careful reading of the text reveals a few flaws. For instance, the recommended dose of ranitidine for prevention of anaphylactic reaction following antivenom administration (by itself of debatable efficacy) is incorrect, and so it is the statement that the severity of bee stings depends on hypersensitivity and not on the number of stings (both can be important). The legends of the pictures of a stingray and a piranha have only the scientific name of the fish, assuming that the reader knows the animal, what cannot be taken for granted for a text written for the uninitiated. The manual would also benefit from larger pictures to make easier the recognition of the animals by the reader. In fact, the authors should consider substituting some of the pictures in the case of a second edition of their manual.
Although not perfect, Drs. Pardal and Yuki’s “Acidentes por Animais Peconhentos: manual de rotinas” will certainly be an important source of information for health professionals working in or traveling to the Amazon region, for whom it is strongly recommended.
This Manual is available from the first author at Hospital Universitario Joao de Barros Barreto, Rua dos Munducurus 4487, Guama, 66073-000 Belem, PA, Brazil.
Sergio de Andrade Nishioka, MD, PhD
Faculdade de Medicina
Universidade Federal de Uberlfandia
Copyright Instituto de Medicina Tropical de Sao Paulo May/Jun 2001
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