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Tuesday, December 14 2010

Cell phone most important tool in snake bite kit

By Cindy Steinle
Tue, December 14 2010 at 10:19

The most important item in your snake bite emergency kit may well be your cell phone. In a recent medical journal article, Dr. Cyrus Rangan, director of toxics and epidemiology at the Los Angeles County Department of Health Services, tells snake bite victims to skip icing, tourniquets, sucking venom and all the other old wives' tales. A call to 911 will be your best bet.

In women, such bites are mostly on the foot, the result of accidentally stepping on or near the snake. "Ninety percent of the time men get bitten on the hand because they're doing something dumb," said Dr. Rangan. He told the story of a man who kissed a rattler on the mouth – and got bitten – in two separate incidents.

[....]

Besides calling a pharmacy to make sure it has the appropriate antivenom in stock, Dr. Rangan said, appropriate first aid includes immobilizing the patient and elevating the bitten extremity above the heart.

[....]

Surgical intervention is rarely needed. Some necrotic tissue debridement might be called for, but fasciotomy is rarely indicated and is the largest contributor to comorbidity, he added.

For the full article, click here.

I'm interested to hear what the experts in treating these injuries say. I know the Florida Snakebite Institute is very vocally against fasciotomy.

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First of all, it is the the ER's responsibility to contact there pharmacy to ensure antivenin is available...Not the patient's!
2nd, Prior to reaching the emergency dept, the bitten extremity should be kept below the level of the heart. Once in the ER, it should be elevated to encourage movement into the circulation which acts to dilute the venom. Take the analogy of adding sugar to a glass of water and then a picture. Which is more concentrated?
and finally, Fasciotomy is only recommended once antivenin has been given, elevation has been achieved, and Mannitol has been administered. Then and only then if compartment pressures are elevated-should a fasciotomy be considered. Surgical debridement in many cases can be done outpatient after coagulation issues have been corrected.

#1 Joe Venom on 2010-12-17 01:44 (Reply)

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