[at-l] Snakebite Treatment

[thornel at attglobal.net (W F Thorneloe)]

With the rattler bite, onset of reaction to the toxin may be delayed. While 
it is true that only 50% of bites lead to envenomation, the severity of the 
adverse outcome dictates a need to seek rapid medical attention including 
hydration, telemetry and possibly anti-toxin. The risks of waiting and 
watching are excessive. Once you go into shock, your survival chances 
diminish rapidly.

The swelling around the bite indicates Bad Things happening. Among these 
are hemolysis - breakdown of blood. This leads to a variety of problems 
including renal failure and heart failure. The longer you wait to seek 
help, the more difficult your task becomes. If you are in the Southwest and 
get one of the neurotoxic rattlers, your time for rescue is further 
reduced. A tournaquet of any sort is a bad idea, as once it is released, a 
clot or a bolus of venom may be delivered straight to the heart. 
Immobilization and evacuation are the best initial strategies. This is a 
toxic exposure, not an allergic reaction to an insect sting.

I am a doctor and have studied up on this in med school, and Wilderness 
Medicine courses. We had a retired ER physician on the list who gave a 
wonderful review of this matter about a year ago (this is a recurrent theme).

The likelihood of snake bite is in younger people, most dangerous to 
children. The elderly also have more problems recovering from bites. Young 
men doing stupid things are the most commonly seen victims.

OrangeBug

At 08:08 AM 2/12/04 -0500, Arthur Gaudet wrote:

>If either of you are doctors and wish to give medical advice: I'm looking
>for the relative risk of death when faced with the decision I outlined.
>...
>If others are knowledgeable about these metabolic things I think an
>underlying question might relate to the swelling that occurs when bit. Once
>the area is swollen it seems likely that free circulation of the venom
>isn't possible or it's greatly reduced. That's the reason for waiting - let
>the area swell up and allow the reaction to be local rather than forcing a
>systemic reaction by doing something right away. Those who are bee bite
>sensitive know the difference between these reactions.