From: kjm@buc.edu.au (Kevin Moore)
Newsgroups: rec.backcountry
Subject: Re: [l/m 9/2/92] Snake bite: Distilled Wisdom (11/28) XYZ
Date: 14 Oct 92 04:15:43 GMT
Organization: Physics Department - Ballarat University College
NNTP-Posting-Host: 141.132.16.8

In article <1992Oct11.112023.12569@nas.nasa.gov> eugene@amelia.nas.nasa.gov
 (Eugene N. Miya) writes:

>TREATMENT:

	[deletia, It all looks pretty sound to me, but...]

>Try to slow the spread of the venom.  Use constricting bands above
>and below the site of the bite.  These should *not* be tight enough
>to cut off circulation, all you want to do is slow down the movement
>of the fluids under the skin.   Keep watching these bands, they should 
>not be on a swollen area and you may have to move them as swelling 
>increases.  To re-iterate:  *Do*not*cut*off*circulation*.  

>A more recent development for immobilizing the venom is to wrap the
>area snugly with fabric and immobilize the limb with a splint.  Any
>type of fabric, including elastic bandages, works well.  Just be
>sure it is not tight enough to cut off blood circulation and watch
>for swelling which might make it too tight.

If I may be permitted to put in a plug for this second method. It was 
originally developed by the Commonwealth Serum Laboratories in Australia, 
and is credited with a significant reduction in mortality rates for snake 
and spider bites in Australia. (I don't have figures to hand, but can look 
it up if sufficient interest is shown) Its major advantage is that any mug 
can get it right. Our snakes all have high levels of neurotoxins, and the 
main thing is to prevent their circulation via the lymph system.

Constricting bands and tourniquets are very definitely not recommended in 
Australia, as they require too much skill to apply correctly in an emergency 
situation and may either cause the loss of the limb or be ineffective. The 
same applies and more so to any attempt to remove the venom.

To apply the pressure-immobilisation bandage, you apply an elastic bandage 
(which we should all be carrying several of as a standard part of a first-
aid kit anyway) to the area of the wound (covering it to at least a foot 
either side)and then cover the limb, working towards the extreme of the limb 
first. If you have enough available, work back again along the limb until 
the entire limb is covered. The bandage should be firm, but not tight. To 
check for circulation, squeeze an exposed toe or finger on the limb. If the 
blood doesn't flow back when you release the finger, leaving a white patch 
which persists, then the bandage is too tight. The limb should be splinted, 
as muscle action facilitates lymphatic flow, and therefore venom mobility.

>The bitten limb should be immobilized, especially if bitten by an
>elapid such as a coral snake.  Treat it like a fracture.

Absolutely. For any snake. The limb should be splinted. Keep the victim 
calm, and moved as little as possible.

>You will not be able to remove very much of the venom, almost none
>in an elapid bite where the chewing will have dispersed it.  However,
>you should try if *all* of the following criteria are met:

In Australia, the recommendation is that you don't even try, but get that 
pressure-immobilisation bandage on immediately. 

	[deletia]

>There is some controversy over the idea of cutting into the flesh
>around the fang marks. 

Don't. Just don't. No controversy about it. It is far too dangerous for 
untrained operators. (And doesn't work very well anyway)


			 While this can facilitate removal of venom
>it is also very dangerous.  Unless you really know what you are
>doing you may do more damage than the snake did.  Muscles, nerves,
>and blood vessels may all be in the area and you can damage them,
>sometimes permanently.  Most classes I have attended do not
>recommend cutting.  MFM recommends it under certain conditions,
>namely:


>(MFM mentions cold therapy only to *strongly* advise against its use.
>It is *not* effective and, particularly in the case of a pit viper
>bite, will impede recovery.  Cold will restrict circulation already
>compromised by the damage to blood vessels.  Furthermore, the body's
>principle detoxifying mechanism appears to be the action of
>antibodies against the venom.  Lowering of the temperature retards
>access of antibodies to the toxins.  Cold therapy apparently was
>proposed on the assumption that the venom is an emzyme.  In fact
>most are peptides which cooling does not inactivate.)

>How about a "snake-bite kit?"  Obviously you want to be prepared for
>emergencies which are likely to happen but I don't think that
>necessarily means buying a kit and carrying it all the time.  Except
>for a suction device you should already be carrying everything you
>need in your standard first aid kit.  Snakebite is so rare that I
>don't think I would even bother with a suction device unless a bite
>by one of the "three nasties" is a reasonable probability.  Items 
>which ought to be in your first aid kit and are useful in case of 
>snake bite are:

>1.  A good antiseptic (eg. Betadyne) to cleanse the bite.

>2.  Elastic bandage or gauze ("cling") to use in making constricting
>bands or wrapping the area to immobilize the venom.

Two or three for every member of a group. You need four or five to do the 
pressure-immobilisation bandage properly on a leg. They don't weigh much, 
and are useful in other emergencies, as is the betadyne.

>3.  Splinting materials to immobilize the limb bitten.

You can usually improvise.
******************************************************************************
The reason is that the program was written in  	*	Kevin Moore
BASIC, a sort of computer baby-talk.            *     kjm@buc.edu.au
                              Richard Dawkins	*
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