Snake bite first aid with the Setopress bandage

Snake Bite First Aid and the Setopress bandage 

A practical approach to diagnosis and Snakebite first aid with the Setopress

Snakebite first aid treatment – What to do if you are bitten by a Snake?

Snakebite first aid treatment was published in a clinical article in the Medical Journal of Australia and it is interesting to look at its findings so we can understand envenomation from snakebite in Australia and better provide better first aid management of snake bites.

Snakebite is a potential pre-hospital care medical emergency for paramedics, first aiders or first responders to an envenomation event, even though patients may initially appear well. This article by International Paramedic College talks about using a marker to achieve good compression with the Pressure Immobilisation Bandage (PIB)

While snake envenoming is rare, it is potentially life-threatening. Interestingly the article states that “Most snakebites will not result in significant envenoming and do not require anti-venom” (Isbister 1989)

Dry bites, whereby no venom is released, are painful and cause localised redness and swelling.

If the bite is venomous, other symptoms may include a stinging or burning sensation on the skin and feelings of nausea, dizziness, anxiousness and confusion. In severe cases, the bite may result in paralysis or coma.

Are all snake bites venomous bites

If someone is bitten by a snake, you won’t know if it’s a dry bite or a venomous bite – so to be safe, always treat any bite as a venomous bite.

The various venomous snake groups each cause a characteristic clinical syndrome, or set of medical signs and symptoms and when you combine this with local geographical distribution information you can determine the probable snake involved and appropriate anti-venom to use. The Snake Venom Detection Kit may assist in regions where the range of possible snakes is too broad to allow the use of monovalent anti-venoms.

However, while the clinical evidence base on pressure bandaging in snakebite is limited a review of 96 subjects, 78 from the health field and 18 from the general public concluded that the PIB was poorly applied by both groups. (Canale ,2009)

How much pressure is just right? –  PIB and the “Goldilocks Effect”

Snake venom is carried in the lymphatic system and not in the bloodstream, as many mistakenly believe. That’s why the main aim of snake bite first aid is to reduce lymphatic flow by applying continuous firm pressure over the affected limb. This is known as the Pressure Immobilisation Technique (PIT) but what the “Goldilocks measure” is how much pressure is just right.

Snakebite First aid?

1 bandage is long enough for an entire limb

The Australian Venom Research Unit (AVRU) has recently recommended the Setopress High Compression Bandage for use as a Pressure Immobilisation Technique (PIT) for the treatment of all Australian Snakes, Funnel Webbed Spiders, Blue Ringed Octopus and Cone Shell stings.

While the Setopress High Compression Bandage has long been popular with high-risk groups, the visual application guide makes it easy for the general public to apply the Setopress bandage consistently and correctly.
Offering two compression options, the Setopress bandage has brown rectangles printed on one side, and green rectangles on the other.

When stretched correctly the rectangles become squares which provide over 30mmHg (brown square) and 20mmHg (green square) of pressure.

The optimal pressure recommended by the AVRU at the University of Melbourne is slightly firmer at 40mmhg for an arm and 55mgHg for a leg.

Apply the correct tension for snake and spider bites

However, when you apply this bandage it gives you a great marker of how firm an effective PIB should be, making it easier to feel and use the visual guide to apply the correct amount of pressure needed for effective application of the PIB.

Unlike other bandages, you only need one, as the Setopress is 3.5m long un-stretched. This is long enough to treat even the longest of limbs. Being able to completely bandage a limb is a must with snakebite as is effectively splinting the limb and laying the patient down to minimise any movement.

What should I do to treat snake bite?

  • DRS ABCD – is the initial step in the management of all first aid emergencies. If you don’t know what it means get yourself along to a reputable first aid course ASAP.
  • Retreat – away from the snake if you necessary
  • Calm the patient – lay them down and keep them still, the recovery position may be useful to protect their airway.
  • Remove rings and bracelets – and any restrictive objects from the bitten limb because swelling may occur and cause harm by restricting blood flow.
  • Remain with the person – who has been bitten until help arrives. If you have no choice but to leave them then return as quickly as possible.
  • Mark the bite site – by using a pen to circle the area of the bandage over the bite site

Snakebite first aid- What things you should never do after a Snake Bite?

  • Never try to catch or kill the snake as you may get bitten
  • Never give Alcohol, tea, stimulants, food or medications without medical advice
  • Never wash the wound, apply hot or cold packs, cut the wound, use ligatures or tourniquets., apply electric shocks and do not suck the wound or use suction from any device.
  • Never allow the patient to walk or run after a snake bite
  • Never remove the Pressure Immobilisation Bandage unless advised by medical personnel.
  • Never ignore the urgency of obtaining medical assistance in favour of reliance on traditional medicines or home remedies

 Be prepared

Only a handful of people die from a venomous snakebite in Australia each year. Knowing what to do if bitten by a snake and giving proper first aid is essential in keeping those numbers down and reducing them even further.

Book a first aid course and buy yourself a Setopress bandage from suppliers like International Paramedic College who can take the time to show you how to apply the PIB correctly and immobilise the limb.

The Australian Venom Research Unit (AVRU) at Melbourne University recommends the Pressure Immobilisation Bandage

Down load the AVRU fact sheet here

References:

Isbister, G. K., Brown, S. G., Page, C. B., McCoubrie, D. L., Greene, S. L., & Buckley, N. A. (2013). Snakebite in Australia: a practical approach to diagnosis and treatment. Med J Aust199(11), 763-8.

Welton, R. E., Williams, D. J., & Liew, D. (2016). Injury trends from envenoming in Australia, 2000‐2013. Internal medicine journal.

Canale, E., Isbister, G. K. and Currie, B. J. (2009), Investigating pressure bandaging for snakebite in a simulated setting: Bandage type, training and the effect of transport. Emergency Medicine Australasia, 21: 184–190. doi: 10.1111/j.1742-6723.2009.01180

Queensland Ambulance Service Clinical Practice Guidelines accessed February 2017. from https://ambulance.qld.gov.au/docs/clinical/cpg/CPG_Snake%20bite.pdf