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Extractors
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by SouthernWolf on December 25, 2007
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Is it a good idea to carry the extractor type snake bite kits out in the field while hiking and such... or are they a waist of time and space?
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RE: Extractors
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by Cro on December 25, 2007
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Kevin, the answer is yes and no, LOL !
If you search the Experts section here, you will find many lively discussions on this subject over the last few years. Rathar than keep on whipping an old dead horse, try searching on the subject here first!
Many folks are very quick to quote Dr. Sean Bush, and say that the Extractor is of no use, however, even Dr. Bush`s own research proved that the Extractor did remove venom from a bite wound if it was applied VERY QUICKLY following a bite.
I have talked with many venomous keepers who used Extractors immediatly after a bite, and they tell me that they feel that it did remove venom, and did keep them from having to go to a hospital. They "rode out" their bites over several days.
Most of the research shows that after 3 minutes, it is probably not worth the trouble to use an Extractor on a bite. However, if you can use it IMMEDIATLY following a bite, it will probably remove some venom, and sure will not hurt. Your main concern would be getting to medical treatment. You can apply an Extractor as you walk to your car, or wait for medical transport.
There are some instances where venom can pool in adapose (fat) tissue, and not be taken into circulation for quite a while. In a case like that, an extractor might remove quite a lot of venom from the pooled area. Some of the studies conducted by researchers other than Bush suggest that venom can be removed for up to 20 minutes following a bite.
Some studies suggest that an Extractor might apply too much suction on a fang wound channel, and thus collapse the chanel and block the venom from being removed. I have taken some blunt tip syrynges, and modified them to fit the tip of an extractor cup. That way, the blunt tipped needle can be inserted into the fang wound chanel until it bottoms out, then suction can be started. That way, if there is a pool of venom, it might very well be sucked out.
Other folks here will be quick to say that there was some tissue damage where an Extractor was used. And they quote Bush again. Well, if there is some necrosis in the tissue where an Extractor was used, it means that the Extractor did pull venom from the wound that would have gone into circulation, and that venom did minor damage to the tissue where it was concentrated. I think it is far better to hold the venom near the bite area where it can be treated with anti venom, instead of allowing it to spread. That is kind of why they invented the compression bandage for treating Elapid bites.
Just so you don`t think I am "Bush Bashing," it is just that I do not agree with the conclusions that he published from his own research. He owes his livelyhood to pushing big pharma, and the extremely expensive antivenoms that the hospitals use. He is not about to indorse anything that is contrary to that.
Just some of my views on this subject.
Best Regards and Merry Christmas.
JohnZ
Personally, I keep an Extractor in my snake room where it can be put into use within seconds following a bite. I also keep one in my back pocket when field herping.
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RE: Extractors
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by LarryDFishel on December 25, 2007
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To beat the horse just a little...
>>I think it is far better to hold the venom near the bite area where it can be treated with anti venom, instead of allowing it to spread.
In most cases in the U.S., I think I disagree. If there is not enough venom to cause irreversable organ damage or death before being treated with antivenom, all you are doing is keeping tissue destroying venom concentrated in a small area where it can do permanent damage rather than allowing it to be diluted by several gallons of blood. In fact I believe you would also be PREVENTING antivenom from acting on the venom by keeping it out of the bloodstream.
>>That is kind of why they invented the compression bandage for treating Elapid bites.
Yes, for venom that does little local damage and will probably kill you before you reach a hospital, it makes a lot of sense. But we don't have taipans here...
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RE: Extractors
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by GREGLONGHURST on December 26, 2007
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Larry's argument is the reason for not using a tourniquet. By allowing the venom to flow throughout the bloodstream, you are in fact diluting it, as well as allowing its treatment with antivenin. I can see where the extractor may well cause the same problems as a tourniquet.
Dr. Findlay Russell states in his fine tome Snake Venom Poisoning that he had treated many snakebites, but never had to perform an amputation on a victim unless the victim's first-aid had included use of a tourniquet.
~~Greg~~
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RE: Extractors
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by Cro on December 26, 2007
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One thing that was often done in the past with the old Wyeth Crotalidae Polyvalent Antivenom was to inject it directly proximal to a bite, and follow the swelling with many other proximal injections. This was to help against venom that was still concentrated in the area of the bite. This was in addition to the IV AntiVenom that was used to help treat the venom in circulation.
No one can seem to answer if this is still being done with the CroFab type of AntiVenom, or if any scientific research has been done with radio tagged venoms to document their rate of spread, and if localized AV injection are of use.
I agree with Larry and Greg that if venom is heald proximal to the bite for a long time, or by using a tourniquet or constrictor band for a long period of time that it has the potential to cause local tissue damage. If it will be hours before AntiVenom can be started, that could be a large problem. However, if AntiVemom is started soon after a bite, it might be that the concentration of venom in a smaller area would outweigh allowing it to circulate to other body areas and damage other organs. There is no doubt that it would become diluted, but how much damage would it cause?
There is need for a great deal more research on venom components and how venoms spread. The article that I posted in the Venomous News Items states that Massasauga Rattlesnake venom contained three-finger toxin-like transcripts, a family of poisons thought only to occur in another family of snakes (Elapidae). Should we be using constrictor bands as used in Elapids to prevent the spead of these cobra like toxins that are contained in the venom of pit-vipers?
Should be fun to watch what the researchers come up with next.
Best Regards and Happy New Year.
JohnZ
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RE: Extractors
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by LarryDFishel on December 26, 2007
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AV is still occasionally injected at the bite site, mostly by doctors who fail to read the instructions. It is certainly not accepted practice. I'm not personally familiar with research that says it doesn't work, but it was once common practice and is no longer done. There is USUALLY a reason for such changes in medical practice.
I don't think anyone seriously believes that you are likely to die from the paralytic effects of Sistrurus venom before reaching a hospital, so there's not much reason to use a constriction band.
Now with a big C. horridus or C. ademanteus, it could be something to consider, but you're basically deciding to sacrifice the limb with no proof yet that a constriction band would help much. Tough call.
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