Comment: Snake Bite Treatment

The snake bite first aid procedures in this article are not correct. We have produced Snake Bite First Aid Instructions based on advice from leading CLINICAL Toxinologist Prof. Julian White and they are available from www.workingwithwildlife.com.au under our references section.
Bandaging MUST be started at the extremity of the limb to reduce new lymphatic flow generation and continued as far up the limb as possible. An elasticized bandage is not recommended - use a Heavy Weight CREPE Bandage 10cm wide by 2.3m long. Our advice is to keep 3 of these in a handy first aid kit or get on of ours which is specifically designed for snake bite treatment.
There is so much wrong information about Snake Bite First Aid being publicized, no wonder the public get confused.
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Reply By: mikehzz - Tuesday, Feb 14, 2012 at 08:58

Tuesday, Feb 14, 2012 at 08:58
Rather than tell us, have you told that very reputable organization the RFDS on which our article is based? If better information has come to hand then their information needs to be updated for sure so that their isn't a conflict between the two.
AnswerID: 477717

Follow Up By: Julian C - Tuesday, Feb 14, 2012 at 09:09

Tuesday, Feb 14, 2012 at 09:09
Hi MIke

Need to tell the people who publish the incorrect info so that you know that it is not quite right.

Certainly the RFDS need to know current best practice and I will be contacting them directly.

When you based your article on RFDS info, did you get it from their website or did you talk with a toxinologist at the RFDS?

Did you see our FREE first aid sheet on our website?

Regards

Julian
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Follow Up By: mikehzz - Tuesday, Feb 14, 2012 at 09:16

Tuesday, Feb 14, 2012 at 09:16
Sorry, I have nothing to do with compiling the article. By we, I meant Exploroz members and visitors who read the article. Cheers
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Follow Up By: TerraFirma - Tuesday, Feb 14, 2012 at 11:04

Tuesday, Feb 14, 2012 at 11:04
Quote Julian "When you based your article on RFDS info, did you get it from their website or did you talk with a toxinologist at the RFDS? " End Quote

In all due respect Julian this is not an appropriate question to the readers of these forums. Did someone speak to the toxicologist is also a silly question imo. You would be far better off approaching the managers of these forums and advising them off your concerns and asking them to make a correction and better still, perhaps publishing up to date qualified information. You may understand snake bite treatment but your approach leaves a lot to be desired.


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Follow Up By: Julian C - Tuesday, Feb 14, 2012 at 11:38

Tuesday, Feb 14, 2012 at 11:38
Hi Terra Firma

You are obviously a lot more experienced with these forums and understand how they work a lot more than I.

The approach was not intended to offend anyone.

Just wanted to find out EXACTLY where the info came from and I assumed Mike was involved with the story as he said "us" and i took that to mean the owners of this site.

Apologies.
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Follow Up By: TerraFirma - Tuesday, Feb 14, 2012 at 12:55

Tuesday, Feb 14, 2012 at 12:55
Hi Julian, Understand your concerns with regards to correct treatment, you did not offend me, just picked up on some undertones if you like. I would recommend you contact David or his partner who I'm sure would be more than willing to publish the correct procedures on this site in a highlighted manner where everyone could read so your message is most effective.
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Follow Up By: Julian C - Tuesday, Feb 14, 2012 at 13:15

Tuesday, Feb 14, 2012 at 13:15
Hi Terra Firma

Thanks for that. Will do.

Again, thanks for your help.

Regards

Julian
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Reply By: Rob! - Tuesday, Feb 14, 2012 at 09:37

Tuesday, Feb 14, 2012 at 09:37
It's disapointing that some people advertise their onw websites by taking a cheap shot at others.

Maybe Julian is right, but it is strange that he didn't contact medical authorities first to let them know about this.
AnswerID: 477721

Follow Up By: Julian C - Tuesday, Feb 14, 2012 at 09:58

Tuesday, Feb 14, 2012 at 09:58
Advertise, nothing could be further from my mind. Interested in only getting the right info to people and when I see wrong info I let the publisher and the source know.

No cheap shot. What if someone followed the advice and then died. I am sure that the family would want to know why the wrong information was given.

It is nothing new for wrong information to be disseminated that results in confusion and possible lost lives.

Don't you think it is important for people to get the right info from reputable sources?
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Reply By: Rob! - Tuesday, Feb 14, 2012 at 10:07

Tuesday, Feb 14, 2012 at 10:07
Julian,

No offence intended but your private website (and the internet generally) is hardly a reputable source. It is common for websites to use some reputable persons' name to give them credibilty even though this person may not endorse this.

... so unless you can provide a link to a website that ends with ".gov.au" or of a well respected university, then people will give your suggestion as much credibilty as the emails they receive which start with "FW:"

R.
AnswerID: 477728

Follow Up By: garrycol - Tuesday, Feb 14, 2012 at 10:21

Tuesday, Feb 14, 2012 at 10:21
Sorry Julian but I do not know you - how do I know your bona-fides. Your tone implies most on here know you but I don't.

You should include something that advises who you are and what your qualifications are to make such claims. Not disputing your qualifications just do not know what they are.

I have not seen the article you refer to or the RFDS info - however I have always been taught that the bandage (any wide bandage) should start at the extremity starting a little further out from the bite.
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Follow Up By: Julian C - Tuesday, Feb 14, 2012 at 11:33

Tuesday, Feb 14, 2012 at 11:33
Fair enough.

I am new to this forum and only intended to provide the most accurate information I can find through experts in the field of clinical toxinology. Yes there are always two sides to any story.

The information I base our first aid instructions comes from advice by Assoc. Prof Julian White who is based at the Royal Adelaide and Womens and Childrens Hospitals here in Adelaide.

I am aware of the history of the development of snake bite first aid by the CSL and the AVRU that uses that info.

Personal conversation with Prof White confirmed that it is imperative to stop or slow down NEW lymphatic generation and subsequent flow to reduce the lymphatic flow and venom distribution within the body.

If you do not bandage the fingers and toes first, while you are bandaging the limb, there will be lymphatic flow which could have been prevented.

My qualifications are less relevant as I am following advice from one of the worlds and Australia's most respected clinical toxinologists.

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Reply By: Motherhen - Tuesday, Feb 14, 2012 at 10:23

Tuesday, Feb 14, 2012 at 10:23
Without taking the time to read your references right now, i have found slight variations in how the bandaging is to be applied in different publications and first aid courses - but the end result is the same. This was discussed at length in a thread not so long ago.

I have relied on the advice of the Australian Venom Research Unit, where the technique was developed by Professor Struan Sutherland. Pressure-immobilisation was initially developed to treat snakebite, but it is also applicable to bites and stings by some other venomous creatures.

The AVRU did not give me permission to place a printable chart on my website, but only to give links to the page on AVRU, so that people see the article in its entirety, and where it will always be up to date. They also list the other bites and stings where pressure bandaging is to be used and those where it should not be used.AVRU First Aid for Snake Bite

Many other organisations including Government health sites also rely on AVRU as the ultimate authority.

Motherhen

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Follow Up By: Member - Duncan W (WA) - Tuesday, Feb 14, 2012 at 11:12

Tuesday, Feb 14, 2012 at 11:12
Well Mother I learnt something today. Good link you have provided there and one to bookmark.
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Follow Up By: Motherhen - Tuesday, Feb 14, 2012 at 11:28

Tuesday, Feb 14, 2012 at 11:28
Thanks Dunc :)

I am putting a lot of time into building a website with accurate information and good links to help travellers tour safely and in the manner that they choose in this great land. I also give another link to a chart giving the same information provided by AVRU but in a format more easily able to be printed and carried in the first aid box. Safety is just one important aspect of travel.

Mh
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Reply By: Bush Wanderer - Tuesday, Feb 14, 2012 at 11:10

Tuesday, Feb 14, 2012 at 11:10
I did my St John remote area first aid course last week.....it was the same as mentioned in the article. It was also the same 12 months ago with St John.
So maybe St John and RFDS are wrong ?
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Follow Up By: Bush Wanderer - Tuesday, Feb 14, 2012 at 11:19

Tuesday, Feb 14, 2012 at 11:19
St John with CPR recommend 30 compressions and 2 breaths. An emergency nurse that I know at RPH states that they don't do breaths anymore...just compressions.
St John possible may be out of date, or have a different opinion on how this should be done.
Techniques do seem to change over the years, sometimes completely different to how they were performed before.
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Follow Up By: olcoolone - Tuesday, Feb 14, 2012 at 13:36

Tuesday, Feb 14, 2012 at 13:36
The people who govern and set the standards "The Australian Resuscitation Council" still recommends 30 compressions and 2 breaths and this is what all training organisations train to, this is the standards and it has not changed from this.

Emergency nurses and doctors can be very wrong in their actions.... in a clinical environment they have at their disposal much more equipment and use different techniques.

We did our senior first aid training mid last year and the advised us to the new way of CPR as stated above.

A link to their site.
http://www.resus.org.au/
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Follow Up By: energy marty - Wednesday, Feb 15, 2012 at 13:26

Wednesday, Feb 15, 2012 at 13:26
all training organisations? My partner has just renewed her first aid certificat and in the course by accredited tariners they were taught no breaths - just compressions...
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Follow Up By: energy marty - Wednesday, Feb 15, 2012 at 13:27

Wednesday, Feb 15, 2012 at 13:27
pardon my spelling...
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Follow Up By: Bush Wanderer - Wednesday, Feb 15, 2012 at 13:57

Wednesday, Feb 15, 2012 at 13:57
Australian Medical Association talks about an American study for COPR as opposed to CPR....more people survived with Compression Only CPR as opposed to traditional CPR with 2 breaths.

Just another spin on this from Australias foremost authority.

I suppose as long as you do something, you give the patient a chance.
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Follow Up By: Rockape - Monday, Feb 20, 2012 at 20:30

Monday, Feb 20, 2012 at 20:30
olcoolone,
not having a go at you but I have worked pretty remote and I will stick by what any emergency nurse or flying doctor tells me.

To the lovely emergency nurse Joe Moss or now Mrs Joe Brown. Thank you from someone you know well and to your flying doctor mate Nigel.

RA.
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Reply By: Bazooka - Tuesday, Feb 14, 2012 at 13:08

Tuesday, Feb 14, 2012 at 13:08
Seems like the bandaging advice has been refined in recent times. The site below also refers to the AVRU website (link out of date) but its own advice (similar to the EO article) now conflicts with AVRU.

http://www.anaes.med.usyd.edu.au/venom/snakebite.html

The following official advice from NT Health actually RECOMMENDS THE USE OF ELASTICISED BANDAGES because they remain firm over longer periods and the pressure they generate is closer to the optimal. It dates from 2009 but appears to be current best practice in the NT.

http://remotehealthatlas.nt.gov.au/0912_snakebite_bandages_communique(2).pdf

There is a link in this PDF to a study which states, inter alia:
"PB [pressure bandaging] was poorly done by the general public and health professionals. Crepe bandages rarely generated optimal pressures compared with elasticized bandages, but training did improve participants' ability to apply elasticized bandages. PB recommendations should be modified to specify appropriate bandage types."

Obviously in practice you do the best you can with whatever you have.
AnswerID: 477746

Follow Up By: Julian C - Tuesday, Feb 14, 2012 at 13:30

Tuesday, Feb 14, 2012 at 13:30
Hi Bazooka

I am aware of the study where they used elasticized bandages and I need to point out that they used them on the leg only.

Personal conversation with Assoc. Prof. Julain White (Clinical Toxinologist) confirmed that the study showed that they were more effective on the leg but on the arm (much smaller limb) would provide TOO MUCH pressure as the bandage tightens over time and this would hasten the spread of venom as the patient tries to remain comfortable. This study could be expanded in future to include the arm and it would be extremely interesting to see the outcome.

Until that happens, Prof. White recommends that Heavy Weight Crepe Bandages be used - 10cm wide x 2.3m long.

So why don't we use the elastic bandages on a leg and the HC on the arm?

This is the problem - How do you get people to remember which to use where.

It is known that if someone is given options in a particular situation, it causes confusion followed by inactivity and that is not an option for snake bite FA.

Oh how nice it would be if we could all agree on one method.

Regards

Julian
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Reply By: ExplorOz - David & Michelle - Wednesday, Feb 15, 2012 at 12:56

Wednesday, Feb 15, 2012 at 12:56
Thank you all for the discussion on this subject, stimulated by our Snake Bite treatement article. Julian, just to clarify.... when you submit comments or questions into our published articles, a copy is sent to us (site operators) and a copy posted to the Forum - for exactly this type of reason.

The immediate response from site users is often very productive. The initial antagonist replies you received were because our Forum can often be misused by companies wishing to inappropriately use our Forum to promote their own websites, and your initial comment was a bit abrupt which seems to have stirred up our loyal site users. Self-promoting businesses are not accepted here because the site is fully funded by paying advertisers/members. Our loyal/regular audience is strong - with over 12 years of operation their feedback and input has been very influential in the development of the site rules/structure/content so it's the collective "we" you are talking to.

We have decided to keep this post visible in the Forum, as it ensures people reading the comment in the article have access to view this additional information/discussion.

Michelle Martin
Content Director
David (DM) & Michelle (MM)
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AnswerID: 477837

Follow Up By: watery - Monday, Feb 20, 2012 at 18:07

Monday, Feb 20, 2012 at 18:07
About two weeks ago my wife was bitten by a western brown snake on our farm at Maya, which is about 70kms from the nearest hospital, she was bitten on her foot, I used elastic bandages and started over the bite and bandaged her whole leg leaving her toes exposed for circulation monitoring straight away, we arrived at the hospital 3/4 of an hour after the bite, the flying doctor flew her to Perth, she arrived at the Perth hospital 3 hours after the bite , I was told I done every thing right by the top WA snake bite doctor, they removes the bandages 8 hours after the bight, a little bit of venom was detected after the removal of the bandages, she didn't need antivenene, and is all well now, cheers Peter.
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Reply By: Member - Rich - Monday, Feb 20, 2012 at 21:22

Monday, Feb 20, 2012 at 21:22
So what is the correct way?

Rich
AnswerID: 478264

Reply By: get outmore - Monday, Feb 20, 2012 at 22:33

Monday, Feb 20, 2012 at 22:33
Last thing anyone needs is to be paralysed by fear as to what the correct amount of breaths to comperssions or compressions only is it - which way do you bandage????



get in go hard as per your training and knowledge

your patiant will have a far far better chance than someone standing around trying to sort through any conflicting info
AnswerID: 478277

Reply By: SDG - Monday, Feb 20, 2012 at 23:10

Monday, Feb 20, 2012 at 23:10
In my cupboards I have a wooden (and a plastic)cylinder.
Upon opening the cylinder in two there is a medal wire looking piece that has a blade as sharp as a scapel on it's end.
The other end has what appears to be gunpowder.
The instructions say (basically) cut, suck, put powder on wound and light.



You mean to tell me this is no longer valid?


Techniques sure have changed over the years.






PS.
I know this is not the current technique BEFORE someone thinks i'm serious.
AnswerID: 478281

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