How to deal with a snake bite

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This article was written by Rob Timmings
Rob runs a medical/nursing education business Teaching nurses, doctors and paramedics. It’s well worth the read
#ECT4Health

3000 bites are reported annually.
300-500 hospitalisations
2-3 deaths annually.

Average time to death is 12 hours. The urban myth that you are bitten in the yard and die before you can walk from your chook pen back to the house is a load of rubbish.

While not new, the management of snake bite (like a flood/fire evacuation plan or CPR) should be refreshed each season.

Let’s start with a
Basic overview.

There are five genus of snakes that will harm us (seriously)
Browns, Blacks, Adders, Tigers and Taipans.

All snake venom is made up of huge proteins (like egg white). When bitten, a snake injects some venom into the meat of your limb (NOT into your blood).

This venom can not be absorbed into the blood stream from the bite site.

It travels in a fluid transport system in your body called the lymphatic system (not the blood stream).

Now this fluid (lymph) is moved differently to blood.
Your heart pumps blood around, so even when you are lying dead still, your blood still circulates around the body. Lymph fluid is different. It moves around with physical muscle movement like bending your arm, bending knees, wriggling fingers and toes, walking/exercise etc.

Now here is the thing. Lymph fluid becomes blood after these lymph vessels converge to form one of two large vessels (lymphatic trunks)which are connected to veins at the base of the neck.

Back to the snake bite site.
When bitten, the venom has been injected into this lymph fluid (which makes up the bulk of the water in your tissues).

The only way that the venom can get into your blood stream is to be moved from the bite site in the lymphatic vessels. The only way to do this is to physically move the limbs that were bitten.

Stay still!!! Venom can’t move if the victim doesn’t move.
Stay still!!

Remember people are not bitten into their blood stream.

In the 1980s a technique called Pressure immobilisation bandaging was developed to further retard venom movement. It completely stops venom /lymph transport toward the blood stream.

A firm roll bandage is applied directly over the bite site (don’t wash the area).

Technique:
Three steps: keep them still
Step 1
Apply a bandage over the bite site, to an area about 10cm above and below the bite.
Step 2:
Then using another elastic roller bandage, apply a firm wrap from Fingers/toes all the way to the armpit/groin.

The bandage needs to be firm, but not so tight that it causes fingers or toes to turn purple or white. About the tension of a sprain bandage.

Step 3:
Splint the limb so the patient can’t walk or bend the limb.

Do nots:
Do not cut, incise or suck the venom.
Do not EVER use a tourniquet
Don’t remove the shirt or pants - just bandage over the top of clothing.
Remember movement (like wriggling out of a shirt or pants) causes venom movement.

DO NOT try to catch, kill or identify the snake!!! This is important.

In hospital we NO LONGER NEED to know the type of snake; it doesn’t change treatment.

5 years ago we would do a test on the bite, blood or urine to identify the snake so the correct anti venom can be used.
BUT NOW...
we don’t do this. Our new Antivenom neutralises the venoms of all the 5 listed snake genus, so it doesn’t matter what snake bit the patient.

Read that again- one injection for all snakes!
Polyvalent is our one shot wonder, stocked in all hospitals, so most hospitals no longer stock specific Antivenins.

Australian snakes tend to have 3 main effects in differing degrees.

Bleeding - internally and bruising.
Muscles paralysed causing difficulty talking, moving & breathing.
Pain
In some snakes severe muscle pain in the limb, and days later the bite site can break down forming a nasty wound.

Allergy to snakes is rarer than winning lotto twice.

Final tips: not all bitten people are envenomated and only those starting to show symptoms above are given antivenom.

Did I mention to stay still.
~Rob Timmings
Kingston/Robe Health Advisory
#vrarescue #snakebite
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Reply By: Member - Jim S1 - Saturday, Sep 14, 2019 at 13:56

Saturday, Sep 14, 2019 at 13:56
Absolutely spot on Ivan, and great to be reminded of the correct procedures
Don't move - so important, but of course requires another person at hand, hopefully with a mobile phone and snakebite bandages ( the special ones with the rectangles which become squares when stretched to the right tension.

Cheers
Jim
AnswerID: 627698

Follow Up By: IvanTheTerrible - Saturday, Sep 14, 2019 at 15:24

Saturday, Sep 14, 2019 at 15:24
I thought it was a brilliant article as it explains the procedure in very clear and concise terms and also explains why you do it
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FollowupID: 901844

Reply By: Frank P (NSW) - Saturday, Sep 14, 2019 at 14:31

Saturday, Sep 14, 2019 at 14:31
Thanks Ivan. That will be printed and placed in the 1st Aid kit to be read with every kit inspection as a refresher.
AnswerID: 627699

Reply By: OzzieCruiser - Saturday, Sep 14, 2019 at 15:45

Saturday, Sep 14, 2019 at 15:45
Great article - thanks

However this is not quite true "Remember people are not bitten into their blood stream."

If this were so there would be no blood at the bite site and in the majority of cases there is.

While most of the poison is carried by the lymp system some is also carried by the circulatory system - however the treatment for the lymp system works equally as well for the circulatory system - lying down and keeping calm slows the circulation, the compression bandage treatment also acts on the blood vessels as well slowing or stopping the movement of venom so the recommended treatment works well.

My question is what do you do if you get bit on the arse :-( other than lie down and rest.
AnswerID: 627700

Follow Up By: OutBack Wanderer - Friday, Sep 20, 2019 at 10:15

Friday, Sep 20, 2019 at 10:15
I always laugh when I see this, now if we are talking about the buttocks, I see no difference to any other part of the body, it has fat, muscle, skin. You have to wonder sometimes I think the author is referring to getting bitten whilst sitting on a dunny and the old suck out the venom relates to this, but as for the arse, no problem

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FollowupID: 901963

Reply By: cookie1 - Saturday, Sep 14, 2019 at 17:27

Saturday, Sep 14, 2019 at 17:27
This bobs up regularly and it is good information

Just for clarity though, I am not sure he teaches Doctors - he is a extremely well qualified ICT/Emergency nurse.

"ECT4Health has offered educational programs to nurses, students and paramedics across Australia and New Zealand for some of Australia’s biggest organisations (Queensland Health, Ausmed Education, Primed, University of Queensland, NSW Health, and VicHealth, to name a few). "

A Snake handler has told us that the "wonder antivenin" has some serious side effects and they do prefer to give the correct antivenin specifically for the snake type.

https://www.nps.org.au/medicine-finder/polyvalent-snake-antivenom-concentrate-for-infusion

Apply the bandage, but draw a ring around the bite site so that they can simply cut that out in order to swab the site without releasing the bandage, and identify IF you have been envenomated, most bites are dry, and which snake it is.

That's what I was told by a Snake handler a few months ago

Cheers
AnswerID: 627701

Reply By: Member - shane r1 - Sunday, Sep 15, 2019 at 10:32

Sunday, Sep 15, 2019 at 10:32
Thanks Ivan
Yep the more info on snake bite the better
Here’s a link to the RFDS
RFDS snake bite advice
Also Bob Cooper survival has great info too.
Cheers
AnswerID: 627703

Reply By: IvanTheTerrible - Sunday, Sep 15, 2019 at 17:44

Sunday, Sep 15, 2019 at 17:44
Rob Timmings has been a nurse for more than 30 years. He resides in Toowoomba Queensland with his wife and two children. Rob’s background is in ICU/emergency, psychiatry and hyperbarics. He has worked in Brisbane’s largest trauma units, and in Queensland’s most remote farther reaches as a remote nurse.

Academically qualified with Cert IV teaching qualifications, a BHlthSc and a Masters Degree in Emergency Nursing, he has used his formal education in his first passion, teaching. Rob has been a full time nurse educator for 17 years, but regularly, takes a contract in the remote area or an emergency setting to keep his rural skills polished. Currently, Rob works clinically in a metropolitan acute cardiac /ICU, but his greatest passion is that he loves to teach nurses. ECT4Health has offered educational programs to nurses, students and paramedics across Australia and New Zealand for some of Australia’s biggest organisations (Queensland Health, Ausmed Education, Primed, University of Queensland, NSW Health, and VicHealth, to name a few). Rob started his interest in nurse education working for the Australian College of Emergency Nursing (ACEN) teaching the popular Trauma Nursing Core Course TNCC (ENA:USA between 2000 -2008).

In 2004, Rob co-developed the Queensland Health Rural nursing program called PACS and PEPEN. He is published in his research interest – Rural and Isolated Practice nursing (RIPERN), and in 2013, he was honoured by being voted one of Australia’s top 5 most Influential Nurses by Nursing Review. Rob is a clinically active nurse, a self confessed Emergency Junkie, and as an academic with casual appointments at USQ, he remains a passionate advocate for regional, rural and remote nursing education. Rob has a humorous fun presentation style, that is different from most. He is always on for a laugh. His Dad jokes are epic.
AnswerID: 627711

Follow Up By: Echucan Bob - Tuesday, Sep 17, 2019 at 10:17

Tuesday, Sep 17, 2019 at 10:17
Dad jokes! What about the old snake bite joke where two blokes are in the remote bush. One is bitten in a very delicate place. The other hikes back to the vehicle and radios RFDS who advise to suck the venom out or else the victim will die. He hikes back to the victim who asks “What did they say?” to which he replies “You’re gonna die!”
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FollowupID: 901892

Reply By: Rod W6 - Tuesday, Sep 17, 2019 at 20:44

Tuesday, Sep 17, 2019 at 20:44
An item as important as this should be placed permantley at the top of the forum page so its in ya face all the time and not let slide into the archives or where ever useful posts go.
AnswerID: 627742

Reply By: RobynR4 - Friday, Sep 27, 2019 at 20:28

Friday, Sep 27, 2019 at 20:28
Thank you Ivan.
Rob and my late dad must've 'learned from the same school' at some point.
My dad was a medic in the army for 10 years and also taught St Johns First Aid for a number of years. He hung around a lot of ambos during those years.

This first aid lesson sounded like it was coming out of my dad's mouth. Straight to the point. Explaining the reasons why. Reminding what not to do.

Dad was also great looking outside the square when it came to first aid. The one I love the most is the CPR technique on a big person. Don't think "Oh my goodness! He's a big front rower sort of bloke! I'm a quarter of his size! I'll never get one third compression without collapsing from exhaustion within a minute or so!!"...
Use your heel!
It doesn't matter how you do the compressions, as long as you make them effective! You have great muscles in your legs! Use them too!

Anyway...hopefully you don't have to use this and all your friends and acquaintances are healthy.
:)
AnswerID: 627895

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