Difference between revisions of "AY Honors/First aid/Snake bite"

Latest revision as of 11:50, 8 September 2021

First aid

Snakebite first aid recommendations vary, in part because different snakes have different types of venom. Some have little local effect, but life-threatening systemic effects, in which case containing the venom in the region of the bite by pressure immobilization is highly desirable. Other venoms instigate localized tissue damage around the bitten area, and immobilization may increase the severity of the damage in this area, but also reduce the total area affected; whether this trade-off is desirable remains a point of controversy.

Because snakes vary from one country to another, first aid methods also vary. As always, this article is not a legitimate substitute for professional medical advice. Readers are strongly advised to obtain guidelines from a reputable first aid organization in their own region, and to be wary of homegrown or anecdotal remedies.

However, most first aid guidelines agree on the following:

Protect the patient (and others, including yourself) from further bites. While identifying the species is desirable in certain regions, do not risk further bites or delay proper medical treatment by attempting to capture or kill the snake. If the snake has not already fled, carefully remove the victim from the immediate area. If possible, take a photograph of the snake (many cell phones are equipped with cameras). If you do not know what type of snake it is, someone else might be able to identify it from the photo. A poor photo is better than no photo.
Keep the victim calm. Acute stress reaction increases blood flow and endangers the patient. Keep people near the patient calm. Panic is infectious and compromises judgment.
Call for help to arrange for transport to the nearest hospital emergency room, where antivenin for snakes common to the area will often be available.
Make sure to keep the bitten limb in a functional position and below the victim's heart level so as to minimize blood returning to the heart and other organs of the body.
Do not give the patient anything to eat or drink. This is especially important with consumable alcohol, a known vasodilator which will speed up the absorption of venom. Do not administer stimulants or pain medications to the victim, unless specifically directed to do so by a physician.
Remove any items or clothing which may constrict the bitten limb if it swells (rings, bracelets, watches, footwear, etc.)
Keep the victim as still as possible.
Do not incise the bitten site.

Many organizations, including the American Medical Association and American Red Cross, recommend washing the bite with soap and water. However, do not attempt to clean the area with any type of chemical. Australian recommendations for snake bite treatment strongly recommend against cleaning the wound. Traces of venom left on the skin/bandages from the strike can be used in combination with a snake bite identification kit to identify the species of snake. This speeds determination of which antivenin to administer in the emergency room.^&

↑ Chris Thompson. "Treatment of Australian Snake Bites". Australian anaesthetists' website. http://www.usyd.edu.au/anaes/venom/snakebite.html.

[1] Chris Thompson. "Treatment of Australian Snake Bites". Australian anaesthetists' website. http://www.usyd.edu.au/anaes/venom/snakebite.html.

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-In a snakebite situation, every reasonable effort should be made to kill or at least to positively identify the culprit, since treatment of a nonpoisonous bite is far simpler and  less dangerous to the victim than treatment of a poisonous bite.
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+===First aid=== <!--T:1-->
+Snakebite first aid recommendations vary, in part because different snakes have different types of venom. Some have little local effect, but life-threatening systemic effects, in which case containing the venom in the region of the bite by pressure immobilization is highly desirable. Other venoms instigate localized tissue damage around the bitten area, and immobilization may increase the severity of the damage in this area, but also reduce the total area affected; whether this trade-off is desirable remains a point of controversy.
-Snake venom is a complex mixture of enzymes, peptides, and other substances.  A single injection can cause many different toxic effects in many areas of the body. Some of these effects are felt immediately while the action of other venom components may be delayed for hours or even days. A poisonous bite should be considered a true medical emergency until symptoms prove otherwise.
+<!--T:2-->
+Because snakes vary from one country to another, first aid methods also vary. As always, this article is not a legitimate substitute for professional medical advice. Readers are strongly advised to obtain guidelines from a reputable first aid organization in their own region, and to be wary of homegrown or anecdotal remedies.
-The venom is stored in sacs in the snake’s head. It is introduced into a victim through hollow or grooved fangs.  An important point to remember, however, is that a bitten patient has not necessarily received a dose of venom. The snake can control whether or not it will release the poison and how much it will inject. As a result, while symptoms in a poisonous snakebite incident may be severe, they may also be mild or not develop at all.
+<!--T:3-->
+However, most first aid guidelines agree on the following:
-It is essential that you be able to quickly diagnose a snakebite as being envenomated or not. Usually enough symptoms present themselves within an hour of a poisonous snakebite to erase any doubt.  The victim’s condition provides the best information as to the seriousness of the situation. The bite of the pit viper is extremely painful and is characterized by immediate swelling and excess fluid about the fang marks, usually within 5 to 10 minutes, spreading and possibly involving the whole extremity within an hour. If only minimal swelling occurs within 30 minutes, the bite will almost certainly have been from a nonpoisonous snake or from a poisonous snake that did not inject venom.
+<!--T:4-->
+#Protect the patient (and others, including yourself) from further bites. While identifying the species is desirable in certain regions, do not risk further bites or delay proper medical treatment by attempting to capture or kill the snake. If the snake has not already fled, carefully remove the victim from the immediate area. If possible, take a photograph of the snake (many cell phones are equipped with cameras). If you do not know what type of snake it is, someone else might be able to identify it from the photo. A poor photo is better than no photo.
+#Keep the victim calm. Acute stress reaction increases blood flow and endangers the patient. Keep people near the patient calm. Panic is infectious and compromises judgment.
+#Call for help to arrange for transport to the nearest hospital emergency room, where antivenin for snakes common to the area will often be available.
+#Make sure to keep the bitten limb in a functional position and below the victim's heart level so as to minimize blood returning to the heart and other organs of the body.
+#Do not give the patient anything to eat or drink. This is especially important with consumable alcohol, a known vasodilator which will speed up the absorption of venom. Do not administer stimulants or pain medications to the victim, unless specifically directed to do so by a physician.
+#Remove any items or clothing which may constrict the bitten limb if it swells (rings, bracelets, watches, footwear, etc.)
+#Keep the victim as still as possible.
+#Do not incise the bitten site.
-The aim of first aid for envenomated snakebites is to reduce the circulation of blood through the bite area, delay absorption of venom, prevent aggravation of the local wound, maintain vital  signs, and transport the victim as soon as possible to a medical treatment  facility.  Other aid will be mainly supportive:
+<!--T:5-->
+Many organizations, including the American Medical Association and American Red Cross, recommend washing the bite with soap and water. However, do not attempt to clean the area with any type of chemical. Australian recommendations for snake bite treatment strongly recommend against cleaning the wound. Traces of venom left on the skin/bandages from the strike can be used in combination with a snake bite identification kit to identify the species of snake. This speeds determination of which antivenin to administer in the emergency room.<ref>{{cite web |url=http://www.usyd.edu.au/anaes/venom/snakebite.html |title=Treatment of Australian Snake Bites |author=Chris Thompson |work=Australian anaesthetists' website |accessdate=}}</ref>
-#Apply a constricting band (i.e., rubber tubing, belt, necktie, stocking) above and below  the bite.  Each band should be approximately 2 inches from the wound, but NEVER  place  the  bands on each side of a joint.  If only one constricting band is available, place it above  the  wound.  It should be tight enough to stop the flow of blood in the veins, but not tight enough to shut off the arterial blood supply. The victim’s pulse should be palpable  below the band.
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-#If the victim cannot reach a medical treatment facility within 30 minutes of the time of the bite, and there are definite signs of poisoning, use a sterile knife blade to make an  incision about 1/2 inch (13 mm) long and 1/4 inch (6 mm) deep over each fang mark on the long axis of the extremity.  This  technique  is done  only  on  the  extremities,  not  on  the head or trunk. Apply suction cups to help remove  some  of  the  injected  venom.  Suction by mouth is recommended only as a last resort, because the human mouth contains so many different bacteria that the bite  could  become  infected.  Incision  and suction later than 30 minutes from the time of  the  bite  is  not  recommended.
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-#Check the pulse and respiration frequently. Give  artificial  ventilation  if  necessary.
-#Calm and reassure the victim, who will often be excited or hysterical. Keep the victim lying  down, quiet, and warm. '''DO NOT''' give  alcohol  or  any  other  stimulant  to drink.
-#Treat  for  shock.
-#Use a splint to immobilize the victim’s affected extremity, keeping the involved area at  or  below  the level of the heart.
-#Cover   the   wound   to   prevent   further contamination.
-#Give  aspirin  for  pain.
-#Telephone the nearest medical facility so that  the  proper  antivenin  can  be  made available.
-#Transport the victim (and the dead snake) to a medical treatment facility as soon as possible. All suspected snake bite victims should be taken to the hospital, whether they show signs of envenomation or not.