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Old 07-29-2006, 17:41   #6
medicerik
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Join Date: Jul 2004
Location: National Capital Region
Posts: 17
There was a conference back in 1997 or 1998 sponsered by the Wilderness Medical Society entitled Tactical Management of Wilderness Casualties in Special Operations (PM me with an email address if you want a copy of this publication). Dr. Otten from the University of Cinncinati discussed a hypothetical case of a snake bite during a twelve man patrol with the helicopter extrication point at least six miles away.

He makes three points initially:
1) 30 percent of snake bites from poisonous snakes do not involve any envenomation. He suggests doing whatever possible to keep the person calm as initial complaints from the patient could very well be from a panic attack.
2) Intravenous bites with envenomation are almost universally fatal no matter what you do.
3) Subcutaneous bites with envenomation, although still potentially fatal, give you some time before you have to intervene with antivenom

Treatment wise, he suggests:
1) elevation and compression. although he specifically states that for most types of envenomation, there is no evidence this works, for the Australian eliped snake, this has been shown to be as effective as antivenom. You can do this with a field dressing and an ace bandage.
2) he, and the physicians who discuss the case, also mention that most other suggested prehospital treatments for envenomation probably do not work.
3) supportive treatment to the best of your abilities while awaiting extrication

Erik
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