Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
What is appropriate first aid for poisonous snake bites?
If someone is bitten by a poisonous snake, the bitten
area should be immobilized and the victim transported to a hospital as quickly
as possible. The bitten area should be washed with soap and water. A wide
constriction bandage (tourniquet) may be applied two to four inches upstream of the
bitten area (if on an extremity) so long as the pressure is not too tight (one
or two fingers should be able to slide under the band). Overly tight tourniquets
should never be used as these can block arterial blood flow to the affected area and worsen tissue damage.
Incising (cutting) and suctioning the bite area has not
been shown to be beneficial, but a venom extractor (found in commercial snake
bite kits) may be helpful if it
is applied to the area within five minutes of the bite and left in place for 30
minutes. A 2004 study of mock venom extraction using a suction device, however, questioned the validity of venom extractors and suggested that their use is unlikely to be effective.
Ice or cooling packs should never be applied to the area as these may result
in greater harm, and incisions of the bitten area are also potentially harmful
and have no benefit.
Most importantly, any victim of a venomous snake bite should be evaluated in
an emergency medical care facility as soon as possible.
How are poisonous snake bites treated?
Treatment of poisonous snake bites involves thorough cleansing of the wound
and observation of the victim to determine whether symptoms suggestive of
evenomation develop over time. In most cases of poisonous snake bites, an
antivenin (also called antivenom) is given,
preferably by intravenous administration. For rattlesnake, cottonmouth, and
copperhead (pit viper) bites, Antivenin (Crotalidae) Polyvalent (ACP) equine
(horse)-derived antivenin was the standard treatment in emergency
departments for many years. ACP, however, is known to cause a number of
potentially severe allergic reactions because of its equine origin. In 2000 the
U.S. FDA approved the sheep-derived antivenin CroFab which appears to have a lower incidence of associated allergic reactions, although clinical trials comparing the two have not been performed.
References: Juckett, G and Hancox JG.
Venomous Snakebites in the United States: Management Review and Update. American
Family Physician 65(7), 2002.
FDA
Consumer Magazine. For Goodness Snakes- Treating and Preventing Poisonous Snake
Bites. Revised 2002.
Lavonas EJ; Gerardo CJ; O'Malley G; Arnold TC; Bush SP; Banner W Jr; Steffens M; Kerns WP 2nd. Initial experience with Crotalidae polyvalent immune Fab (ovine) antivenom in the treatment of copperhead snakebite. Ann Emerg Med 2004 Feb;43(2):200-6.
Alberts MB; Shalit M; LoGalbo F. Suction for venomous snakebite: a study of "mock venom" extraction in a human model. Ann Emerg Med 2004 Feb;43(2):181-6.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include severe burns, muscle trauma, coma, seizures, electrolyte imbalance, medications (statins), viruses, bacteria. Treatment of rhabdomyolysis depends on the cause.
Compartment syndrome is a condition in which swelling and an increase in pressure within a limited space presses and compresses blood vessels, nerves, or tendons that run through the compartment. There are two types of compartment syndrome, acute compartment syndrome is treated with surgery (fasciotomy) and chronic compartment syndrome, which is treated with rest and modality to the affected limb. Symptoms of compartment syndrome include pain, change in sensation, change in color, paralysis, or numbness in the affected limb.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
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