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)
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.
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.
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.
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
Download the AVRU fact sheet here
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