Bites, Snake Flashcards

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1
Q

Features

A

Most bites do not result in envenomation

tends to occur in;

  • snake handlers or
  • in circumstances where snake has a clear bite of the skin
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2
Q

First aid

A

Keep pt as still as possible.

Do not;

  • wash
  • cut or manipulate the wound
  • apply ice or use a tourniquet.

Immediately bandage the bite site firmly (not too tightly).

  • A wide crepe bandage is ideal
  • it should extend above the bite site for as high as possible, at least 15 cm
  • e.g. if bitten around the ankle, the bandage should cover the leg to above the knee
  • bandage can be cautiously removed when pt is safely under medical observation.

Splint the limb to immobilise it: a firm stick or slab of wood would be ideal.

Transport to a medical facility for definite treatment.

Do not give alcoholic beverages or stimulants.

A venom detection kit can be used to examine;

  • a swab of the bitten area or
  • a fresh urine specimen (the best) or
  • blood

Observe for symptoms and signs of envenomation.

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3
Q

Envenomation

A

Important early symptoms of snake bite envenomation include:

  • nausea and vomiting (a reliable early symptom)
  • abdominal pain
  • excessive perspiration
  • severe headache
  • blurred vision
  • difficulty speaking or swallowing
  • coagulation defects (e.g. haematuria)
  • tender lymphadenopathy

The greatest danger is;

  • respiratory obstruction
  • failure or catastrophic bleeding.

Do not give antivenom unless:

  1. linical signs of envenomation or
  2. biochemical signs;
  • positive urine, or
  • abnormal clotting profile
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4
Q

Treatment of envenomation

A

Monitor vital signs.

Set up a slow IV infusion of N saline.

Dilute the specific antivenom (1 in 10 in N saline) and infuse slowly over 30 mins via the tubing of the saline solution (may need 2 or more ampoules of antivenom).

Have on standby:

  • adrenaline
  • antihistamines
  • oxygen
  • steroids

Provide basic life support as necessary.

A test dose of antivenom is not recommended.

Be careful of prophylactic adrenaline in some situations, e.g. avoid with brown snakes and with coagulopathy).

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