TyMilsom

There is some debate as to the best method of first aid treatment to venomous bites. I thought I would look about to see what was available by searching the net. Surprisingly, in this modern age, there are still recomendations to use tornique's, and use wound incisions etc....

I did come across this one below, which I like as it endorses lymphatic preassure bangages. It is Australian in origin, and so focuses on Elapid envenomations, however I think the advise is generally sound for all incidents.




First Aid for Snake Bites:

Do NOT wash the area of the bite!

It is extremely important to retain traces of venom for use with venom identification kits!

Stop lymphatic spread - bandage firmly, splint and immobilise!

The "pressure-immobilisation" technique is currently recommended by the Australian Resuscitation Council, the Royal Australasian College of Surgeons and the Australian and New Zealand College of Anaesthetists.

The lymphatic system is responsible for systemic spread of most venoms. This can be reduced by the application of a firm bandage (as firm as you would put on a sprained ankle) over a folded pad placed over the bitten area. While firm, it should not be so tight that it stops blood flow to the limb or to congests the veins. Start bandaging directly over the bitten area, ensuing that the pressure over the bite is firm and even. If you have enough bandage you can extend towards more central parts of the body, to delay spread of any venom that has already started to move centrally. A pressure dressing should be applied even if the bite is on the victims trunk or torso.

Immobility is best attained by application of a splint or sling, using a bandage or whatever to hand to absolutely minimise all limb movement, reassurance and immobilisation (eg, putting the patient on a stretcher). Where possible, bring transportation to the patient (rather then vice versa). Don't allow the victim to walk or move a limb. Walking should be prevented.

The pressure-immobilisation approach is simple, safe and will not cause iatrogenic tissue damage (ie, from incision, injection, freezing or arterial torniquets - all of which are ineffective).

See the AVRU site for more details of bandaging techniques.

Bites to the head, neck, and back are a special problem - firm pressure should be applied locally if possible.

Removal of the bandage will be associated with rapid systemic spread. Hence ALWAYS wait until the patient is in a fully-equipped medical treatment area before bandage removal is attempted.

Do NOT cut or excise the area or apply an arterial torniquet! Both these measures are ineffective and may make the situation worse.