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RE: Fasciotomy questions
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by SwampY on October 9, 2008
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I've heard the following quote from a non-medical person who knows his bushmasters well... "There has never been a single documented case of someone losing a limb from compartment syndrome associated with a snakebite"...
Can anyone here provide examples that support or refute his statement?
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RE: Fasciotomy questions
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by GREGLONGHURST on October 10, 2008
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In his classic "Snake Venom Poisoning", Dr. Findlay Russel states that of the hundreds of snakebites he treated in his career, the only ones that resulted in amputation had used a tourniquet as part of the first aid treatment.
During treatment for a cottonmouth bite, the attending physician, a hand surgeon, told me he was going to make some longitudinal incisions in my forearm to relieve the pressure. I told him the procedure was called a fasciotomy, which let him know he was not dealing with some dumbass, and then told him that I would check myself out of the hospital before allowing that. He back-pedaled rapidly & decided to monitor the internal pressure. Lo & behold, there did not seem to be a problem. I was released a couple of days later, arm still so swollen my tee shirt sleeve made noise going on, but I have had no problems since. In fact, there is no scarring at all, even from the fang punctures.
I firmly believe that fasciotomy as snakebite treatment is unnecessary. Every time. Period.
~~Greg~~
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RE: Fasciotomy questions
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by Cro on October 10, 2008
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So, we have a population of doctors in this country who are almost all nit-whits when it comes to treating snake bites, and in their use of fasciotomy.
How do we fix the problem ? How do we educate folks who think of themselves as "minor level Gods who know everything ?"
If you change how snake bite treatment is covered in medical school, we might see a change in about 10 or 15 years, as those doctors make it into practice ?
Or, perhaps we contact Hollywood, and arrange an episode of "House" where all of the dweeb doctors want to do a fasciotomy on a snake bite victim, and House comes in to save the day, and the patient's arm, (which we watch swell to the size of a watermelon throughout the show) by his continued refusal to let the other doctors do the surgery. That way, half of the population in the country would suddenly know that a fasciotomy is not needed, because they saw it on "House," and the real doctors would have to change their evil ways !
Seriously though, how does one change the thought process of doctors across the nation ? Once they learn something wrong, it is almost impossible to fix the problem.
Best Regards John Z
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RE: Fasciotomy questions
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by toddg on October 10, 2008
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I imagine it’s a liability issue, if a fasciotomy is not performed and a patient loose a limb, it’s the Dr. House wannabe behind. If the fasciotomy is performed, {even with the horrible scarring and prolonged recovery} the afflicted limb is then saved and VIOLA!
No lawsuit.
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RE: Fasciotomy questions
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by Cro on October 10, 2008
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Except for one minor problem, if what Chad stated above is true:
"There has never been a single documented case of someone losing a limb from compartment syndrome associated with a snakebite."
If that is the case, then the potential for a lawsuit from permanant damage and crippling caused by nerve damage from the fasciotomy is much more likely.
And there are hundreds and hundred of recorded cases where a fasciotomy caused that type of permanant damage and crippled folks.
What is much more likely, that surgeons get paid to cut. They make a lot more money for the hospital by doing any type of surgery than they do by just injecting antivenom. Also, the reluctance to not measure compartment pressures seems to be a very major factor.
Best Regards John Z
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RE: Fasciotomy questions
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by toddg on October 10, 2008
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John,
I think you're assuming that said doctor has actually treated snakebite in the past and is aware of the previously mentioned statistic.
Medically speaking, (and I’m just talking out of my rear-end here) doing something to alleviate a perceived symptom (i.e. fasciotomy to relieve intracompartmental pressure) may involve less liability than doing nothing.
Also your suggestion that doctors are unnecessarily performing , potentially harmful and disfiguring surgery just so he or she can get that new Porsche is indeed disturbing.
Perhaps hot keepers need to ad to their medic alert badges. Along side DNR (do not resuscitate) should be NFF (NO FREAKING FASCIOTOMIES!).
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