Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
A Few Interesting Snakebite Articles
At this past year’s American College of Emergency Physicians Annual Scientific Assembly, which was held in San Francisco, I had a brief conversation with Dr. William Meggs, an expert in envenomation from snakebite. We discussed a number of topics and he shared with me some of the literature in which he was a contributor. Here are the highlights:
In “Pilot studies of pressure-immobilization bandages for rattlesnake envenomations” (Clinical Toxicology 2010;48:62-63), pressure-immobilization bandages were used in a pig model of rattlesnake (Crotalus atrox) envenomation. The pigs were injected with rattlesnake venom in a hind limb and then either received a pressure-immobilization bandage or no therapy, followed in 24 hours (in surviving pigs) with treatment with antivenin. All of the treated (pressure-immobilization bandage) pigs survived to reach 24 hours. All of the untreated pigs died at 13.68 ± 3.42 hours. Surviving pigs walked on the envenomed limb at 7 days. Widespread tissue death was seen in the untreated group; only local tissue death (around the bite site) was seen in the treatment group.
Based on this particular animal study, the pressure-immobilization technique certainly appears to be of value.
In “Pressure-immobilization bandages delay toxicity in a porcine model of eastern coral snake (Micrurus fulvius fulvius) envenomation” (Annals of Emergency Medicine 2005;45:603-608), pressure-immobilization bandages or no treatment were used to treat pigs after injection with eastern coral snake venom in a front limb. Four of the 5 pigs in the treatment group survived to 8 hours, while none of the pigs without treatment survived. Based on this study, we can also conclude that the pressure-immobilization technique appears to be of value.
In “Efficacy of North American crotalid antivenom against the African viper Bitis gabonica (Gaboon viper)” (Journal of Medical Toxicology 2010;6:12-14), a study was performed to determine the efficacy of North American crotalid antivenom in treating mice envenomed with venom of the African viper Bitis gabonica (Gaboon viper). The reason this was attempted is because envenomations by exotic snakes occur in countries like the U.S. where antivenoms to treat bites from these snakes may not be available. The results of the experiment showed that using this antivenom increased the time to onset of distress in envenomed mice. The authors concluded that humans envenomed by this particular African viper might benefit from being treated with North American crotalid antivenom. It should be noted that the venom and antivenom were mixed prior to injection into the mice. This is obviously not the case when humans are bitten by snakes – there is always a delay to the administration of antivenom. Nonetheless, the concept is intriguing and merits further consideration.
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