An irritable infant and the runaway redback: an instructive case.

The envenomation syndrome of Redback spider bites, lactrodectism, is distinctive. However diagnosis can be difficult due to an atypical presentation. We describe the case of a 1 year old boy with irritability, diaphoresis and reduced oral intake, in whom a diagnosis was made of redback spider bite. Successful resolution of symptoms was achieved following treatment with antivenom. The symptoms and management of redback spider bites is discussed.

The hidden menace of non-equine horses.

An emergency department audit of horse-related injury presentations alerted researchers to a hitherto uninvestigated source of childhood harm: non-equine horses. A search for the term "horse" in the database of the South Australian Injury Surveillance and Control Unit was performed for presentations of horse-related injuries to a paediatric emergency department of an Australian tertiary teaching hospital over a 5-year period. After all equine-related episodes were extracted, the remaining presentations were herded together and conclusions were jumped to. When legitimate science and research technique failed, poetic licence was prevailed upon.

Paediatric and adolescent horse-related injuries: does the mechanism of injury justify a trauma response?

OBJECTIVE: To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries. METHODS: A retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003. RESULTS: A total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1-17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations. CONCLUSION: Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.