Respected All,

In continuation to our last post on “Snakebite Management”, today we will share with you some precautions in snakebite management case. Also, we will highlight the changes incorporated in 2010 guidelines for First Aid and ECC for immobilization (splinting) and control of bleeding.

Below are some of the precautions those should not be overlooked while administering first aid to snakebite patient. Also, consider snakebite a medical emergency and extensive care should be given to the patient.

DO NOT:

1:- Cut and/or Suck: Cutting into the bite site can damage underlying organs, increase the risk of infection, may start profuse bleeding BUT surely this cutting or sucking does not result in venom removal so don’t do it.

There are extractors available in local market to be used for suction BUT never ever try suction through mouth and considering to spit it out. Though the effectiveness of manual extractors is not confirmed by any research team.

2:- Use Ice: Ice does not deactivate the venom and may cause frostbite. Also this contradicts with the application of pressure bandage and is less beneficial.

3:- An Electric Shock: Have you ever heard of people talking about giving an electric shock (not controlled shock by an AED) to the bitten patient who is conscious! If you have heard the story then please find that person and tell him/her not to teach this to others as it could cause burns or electrical problems to the heart (and …. sudden death).

4:- Use Tourniquets: We used it before when were not aware of the affects but NOT NOW*. A tourniquet can provoke gangrene of the limb, failure to assess build up pressure on the limb and unproven benefits. These treatments are not effective BUT may be harmful so don’t practice them.

5*:- Use/Give Anti-Snake Venom: If you are not trained to do so or have no clinical support with you at your remote medical facility then DO NOT give it. An ASV must be administered only by an experienced and qualified doctor in a medical facility where emergency drugs exist to cope with the situation. The adverse reactions of certain snake serums can be more dangerous than the snake’s venom and can kill in a matter of minutes.

6*:- Use/Give Aspirin for Pain: For pain medication give Paracetamol and not Aspirin.

As promised please below for details on tourniquets from 2010 First Aid, CPR and ECC Guidelines.

2005 Guidelines:

The effectiveness, feasibility, and safety of tourniquets to control bleeding by first aid providers are unknown, but the use of tourniquets is potentially dangerous.

2010 Guidelines:

“Because of the potential adverse effects of tourniquets and difficulty in their proper application, use of a tourniquet to control bleeding of the extremities is indicated only if direct pressure is not effective or possible.

Specifically designed tourniquets appear to be better than ones that are improvised, but tourniquets should only be used with proper training.”

To Your Health, Safety and Prosperity,

Faisal Javed Mir & First Aid to Save a Life Pakistan

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