Tuesday, Mar 17, 2015 at 15:59
No disrespect to the family of Dane, but given this discussion about snakes it seems a timely opportunity to talk about snake bite treatment/safety advice and I'd like to refer your attention to our article -
Snake Bite Treatment
Most snake venom reaches the blood stream via the lymphatic system. Research has shown that very little venom reaches the circulation, even after several hours, if the Pressure Immobilisation Technique is applied immediately and maintained.
At the 2010 ExplorOz National Gathering, our guests were treated to a workshop by snake expert and
outback survival instructor Bob Cooper who has incredible real-life experiences. The article I've linked above summarises the technique he demonstrated at the workshop and has been compiled with his (and the RFDS) recommendations. If you read this article you'll note there is some linked
Forum Posts in the Discussion tab at the bottom from 2012 that debates the specific Pressure Immobilisation Technique (PIT) suggested in the article, and upon reading that post again today (Thread
98984, I followed some of the suggested links from those posters. The main authority quoted was the ARC (Australia Resuscitation Council) guidelines for Pressure Immobilisation Technique (Guideline
9.4.8). If you read this you'll actually see that it in fact agrees with the techniques outline in our article. Some quotes from the ARC guidelines:
"There is insufficient evidence to determine which technique or method of bandage application is most effective in the field"... "Furthermore
whilst commencing the encircling bandage distally and moving proximally may improve
comfort and tolerance of the bandage, it may act to increase venom movement. Starting proximally and working distally may further minimise venom movement but may cause distal oedema /fluid retention and make the bandage too uncomfortable for prolonged use. Training (using manometer
feedback) has been shown to improve the pressure achieved with PIT, and the use of elasticised bandages may also improve the pressure obtained in PIT application." in minimizing venom absorption.
Attendees at Bob's snake workshop might recall that he discussed this too. The ARC guidelines also confirm the advice in our article about using elastic bandages and
where to start the bandaging. "If on a limb, apply a broad pressure bandage over the bite site as soon as possible.. Elasticised bandages (10-15cm wide) are preferred over crepe bandages, if neither are available, clothing or other material should be used."
But don't get caught up on the bandaging technique - its the immobilisation that is the critical component to staying alive. You must keep the victim and limb completely at rest.
Again quoted from the ARC "Bring transport to the victim if possible. If they are unable to obtain urgent help to come to them, then apply local pressure if possible,
immobilisation is contraindicated and they should move themselves to seek urgent help".
Furthermore, all snake bites should be considered venomous. Some bite victims do not immediately present with symptoms and unfortunately some have "walked" a short distance to get help and have died as a result.
As the circumstances are all too real for many in our audience it serves as a reminder that we must be vigilant of outback travel risks and always think through worst case scenarios. We should always be considering our risks and refreshing our
first aid skills.
My most sincere condolences to Dane's family.
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Follow Up By: Les - PK Ranger - Thursday, Mar 19, 2015 at 20:20
Thursday, Mar 19, 2015 at 20:20
That is all VERY good and up to date info Michelle.
Can I add, practicing PIT bandaging on ones self (and loved ones willing to sit around for an hour) is VERY worth while doing.
This was a regular activity during many a snake catching training session, so people had an idea of just how tight to apply bandages to themselves and others.
Too loose and it's not effective, too tight and you risk harming the limb by affecting circulation.
The overwhelming nature of bandaging someone up is to do the wrapping too tight, compression bandages are pretty
well named.
It's important to leave bandages on for a good while (hence the hour mentioned above) as it takes a bit of time for circulation to be affected sometimes.
Splinting is fairly easy with a few triangular bandages and a stout stick.
Remember, besides snake bite, PIT is the
first aid for Funnel Web
Spider and Blue Ring Octopus.
You don't use it for other
spider bites, jelly fish, stone / Lion fish, or other stings like fire ants or scorpions.
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