poisonous snake bite

[mikie]

i actually was also told that, but idk

I've heard that as well, but I think that's more for the rugged outdoorsman/MacGyver-style

You won't see me sucking the venom out of any patients arm!

 

[Jon]

I've heard that as well, but I think that's more for the rugged outdoorsman/MacGyver-style

You won't see me sucking the venom out of any patients arm!

You are right - that would suck!

 

[mikie]

...that would suck!

Was the pun intended?

 

[paramedix]

Part of treatment would be possible hospitalization. So make sure the hospital you transport your patient to can accept and handle the patient and that they have the necessary RX or they can get it fast.

We have only a few hospitals that can really help with RX in our area.

 

[Free-B-EMT]

I've always been told just to have the pt calm down, and do nothing else, but the logical thing to me would be to apply a tourniquet and ice...what do u guys think?

I actually had a call involving a bite from an Eastern Timber Rattlesnake. The patient found the snake lying in the road and wanted to save it from being hit by traffic. He grabbed it by the tail and it swung around and bit him on the hand. After throwing the snake off the side of the road, the patient went home. He did not call for help until four hours later when the pain became so intense he could no longer stand it. We found him lying in bed, in intense pain, with his arm swollen to approx. twice its normal size and badly discolored. We called for ALS but they were unavailable so we transported to the local ED without treatment. I happened to get this same patient on an unrelated call about four months after the snake bite incident. He showed no signs of having any problems related to the snake bite at all.
I don't know if this incident is typical or not but from my experience it does not seem that we need to be too concerned about treating in the field. There is time to get them to the hospital for proper treatment.

 

[mikie]

What would you do?

So here's a question...

How would you transport the pt? What treatment would you provide (BLS, ILS, ALS)? Lights and sirens?

For me...Try to find out what kind of snake it was. I would consult MedControl first, probably tx patient in position of comfort, maybe some O2 via nasal cannula (never hurts!). Unless MedControl states otherwise, probably immobilize location of bite (remove jewelry, etc), keep it level, place over the bite a 4x4 or some sterile dressing (prevent any more infection). If pt is in a decent amount of distress, lights & sirens (I don't know the extent of the bite and how fast it can spread, so err on the side of caution).

Consult poison control (depending on tx time)?

Anyway, just my 2c. Let's hear some others!

 

[Jon]

I think first order of buisness, after ensuring scene safety, would be consulting medical command and discussing the situation.

If the bite is possibly poisionious, Medical Command may want the Pt. going downtown to the City (30-60 minutes by ground 10-15 by air) if Medical Command feels the patient needs more care than they can get at the local hospital... Additionally... if anyone would have antivenin, I'd guess it is the city.

As for treatment... treat symptoms as needed.. place Pt. on oxygen, monitor vitals, and be prepared for the patient to crash.

 

[LucidResq]

I would be calling med control and poison control very early so if needed they could get started on collecting antivenin. I've heard that often no one hospital has enough antivenin to fully treat a snakebite, and that they have to call around to gather enough. The hospital may not even have the antivenin and you may need to transport to a specific hospital.

If the snake was dead and on scene, I'd pick it up with a stick and put it into a secure container to bring along. Gather as much information as possible about the snake and the bite.

Immobilize the bitten part and the joints above and below it. Trace around any marked area of erythema/edema with a pen, with the time written next to it (hospitals like to track the progression of the swelling). Keep the bitten part level with the heart and transport. Maybe place them on a nasal cannula. Full set of vitals taken often, and the regular physical assessments and history.

I think they key thing would be keeping the pt. calm and still. A snake bite would freak anyone out but an increase in HR is only going to make the situation worse.

 

[Jeremy89]

...If the snake was dead and on scene, I'd pick it up with a stick and put it into a secure container to bring along. Gather as much information as possible about the snake and the bite....

I hear a snake has the capability to bite hours after it is 'dead'...something to do with muscle spasms or something. If it were me, I wouldn't go near the thing. I can look at a bloody trauma scene with no problem but the site of a snake sends chills down my spine... :wacko:

 

[mikie]

If the snake was dead and on scene, I'd pick it up with a stick and put it into a secure container to bring along. Gather as much information as possible about the snake and the bite.

That's good thinking as well as marking the area with the pen/marker! I would probably (I guess depending on your location) have dispatch call animal control and THEY can transport it.

I don't need a snake in the back of the ambulance and suddenly it wakes up...I'm not going to check its pulse on scene to confirm its death (assuming I don't see any blunt trauma...but still, I must have missed snake A&P in my basic class )

 

[LucidResq]

If I had a camera I'd probably take a few pictures of it instead of bringing it along. I wonder how/if you can check a pulse on a snake, not that I would want to try.

 

[JPINFV]

^
You do it very carefully.