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E.R nightmare
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by spanky on February 16, 2003
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Last June I was biten by a cottonmouth on the left index finger. I live in northern Mississippi. I did all the right things for the bite.Rapping the area above the bite with a ace- bandage. Cleaning the area with anti-bacterial soap.And having a seat in my recliner to see how bad it would get.Well after three hours, There was a lot of swelling up past my elbow,And my hand was about twice as big. I felt ok. Just a fair amount of pain. I went to the E.R. in my town. which has 10,000 people in it.I told them at the desk what happend and they took me back to the exam-room. When the Doctor came in he asked what happend. And I told him. He looked at finger a few minunties.and told me it looked like a spider bite. and he thought I would be ok.He sead he would give me some antibiotics.And I could go home.After a few more words, Trying my best to tell him it was not a spider bite. I told him to keep the antibiotics. And I went to another hospital.I Told them the story. And thay put me on I.V. drip and keep me eight hours. And let me go home. But told me if it got any worse. To go to another hospital, In a town not far from them. It was a better place for snake bites.After a few hours at home the swelling was getting bad. Up into my neck.So I went to the other hospital. After fourteen hours I was put into I.C.U. and put on antivenin. after seven days and surgery on my finger. I got to go home.So my question is, How do we get the word to the E.R. Doctors about snake bites.? Thanks Fabian.
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RE: E.R nightmare
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by Chris_Harper on February 16, 2003
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You have to become an educated patient. You have to know your rights, and you need to know CLINICALLY what the effects of a snakebite -- by species -- will be. Then, when you walk into an emergency -- if indeed you do walk and aren't carried -- you hand them a well researched snakebite protocol. I suggest that you print a copy of eMedicine.com's snakebite protocol for the species you were bitten by if nothing else! If a doctor sees something that another doctor wrote on the subject, he/she is much more likely to follow that advice. Unless you are medical personnel yourself, that's the best you can do. Besides, next time you might not be able to talk. Believe me, it happens. I consulted on a canebrake bite that left the patient unconcious for 5 days.
CH
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RE: E.R nightmare
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by Parcelmouth on February 17, 2003
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Hello,
I have never posted a reply due to my thinking that I am the one who should listen,however I have been lucky enough to have a good friend who is a doctor and has spent the last few Saturday afternoons with me going over venom toxicology and treatments of snake envenomation.My M.D. friend has been nice enough to go over all the materials I brought for him to look at including envenomation protocals,anaphylaxis article by Chris Harper,a lot of info from BGF's sight(www.venomdoc.com)and F.E. Russell's book Snake Venom Poisoning(book is 20 years old but I was told it was an extreamely valuable work on envenomations.)Please understand that I myself am not a doctor or a professional herpetologist,and I am just relating some of our conversations.
First there are very few doctors that have ever treated or even seen a snake envenomation.This is also not a topic that recieved a great deal of attention in med school classes from what I have been told.Many treatments that are believed to be benifical are in fact actuality useless and some even contraindicated.Some of the effects of the venom may promt a doctor to take certain actions or give certain meds that a diffrent medical condition in which simular problems develop would be benificial to a patient but would in fact worsten the condition of a patient with snake envenomation.
What I was told would most likely happen would be that upon admittance to the E.R. the primary concern would be to stabalize the patient.From what I understand shock due to hypotention from the massive loss of fluid in the blood to edema is countered by giving i.v. fluids.I believe that I read that C.adamanteus envenomation could cause shock in as little as 20-30 min post bite.Also the snake should be identified.If person does not know for sure best to bring it with you.My friend told me he has had to sit and go through plate after plate in books with a jar containing a dead spider next to him to identify it.(granted this could be alot more difficult with a snake)After patient is stable the attending doctor will most likely call poison control(my friend has also done this and said that they are very helpful and speedy even at 0200 AM)and consult a book on envenomation or call someone who is more knowledgeable.
There are many test that should be run(simple cbc won't get it not even close) but those are listed in protocals and Russell's book.Some tests such as arterial pressure I was told should only be done in ICU.Also if an envenomation is severe enough to require antivenom, that should only be given in ICU as well.Also my friend was shocked by the amout of antivenom given to a patient.He said that doctors are not used to having to give 10 - 20 vials of anything,let alone 40 vials.(again as we are now going through F.E. Russell's book the only antivenom available at that time was horse serum).
I personally keep 3 diffrent envenomation protocals as well as the anaphylaxis article in my car at all times.If I am out hunting or at home feeding I don't have to think about it.It is there waiting if I need it.I also have poison control on speed dial on my cell phone.This may all sound paranoid but I am a big believer in Murphy's Law and the amendment"Murphy was an optamist."better to have it and not need it than to need it and not have it.
Lastly,Again I am not a trained medical professional or a herpetologist.I enjoy keeping the snakes I have caught but am by no means an expert.Had alot of study time lately,what else can a snake freak do Dec.-Mar. especially if you are dealing with hots.Ther are a lot of people on this sight who are much more knowledgable than myself.Also I apologize if anything in my reply is not accurate and I invite and welcome corrections to increase my own knowledge as well as every one else's.Also the venom toxicology and actions are amazing.The proteins,proteases,enzymes and how they all work is very very interesting if anyone can recomend some other books or info along this line please do so.Thanks to all you guys and girls at SHHS this is a great site with alot of good info.
J.S.
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Bite victims lately...
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by AnonEMouse on February 17, 2003
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Seems to be a lot in the various forums lately about bites and how people got them treated.
On another forum, a guy got bit by a massassauga and treated it with electricity only to be surprised that the electricity didn't help.
You say:
"I was biten by a cottonmouth"
"I did all the right things for the bite"
"And having a seat in my recliner"
"after three hours"
"I went to the E.R."
Well, I am not sure why nobody has said anything yet but sitting around to see if it is going to kill you is NOT doing everything right!
There is an article on the main page about a guy who got bit and was at the hospital 40 minutes later. You might want to check it out:
http://www.venomousreptiles.org/articles/72
Your question is, How do we get the word to the E.R. Doctors about snake bites.?
It seems to me that they took your situation about as seriously as you did. You need to get a set of snakebite protocols (ask Chris or Karl or Chad or one of those important guys here where to get them) and consider yourself very lucky that you didn't just sit down in your easy chair and die.
As the venomous keeping hobby expands, it seems more and more people are getting bitten and don't seem to realize that any bite could be the one that kills them and that you don't necessarily have all the time in the world to decide whether you need medical treatment. You got off lucky, man.
Cheesed At Complacency
The Mouse Is Back In The House
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RE: Bite victims lately...
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by biff on February 17, 2003
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I agree w/ the mouse...guess he's off tour...lol
seriously, he does bring up some good points...
Steve
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RE: E.R nightmare
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Anonymous post on February 17, 2003
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Get a protocol sheet and keep it on the wall in your hot room. Give it to the EMT or Dr. or whoever. There is also good info on this site about anaphylaxis, I have a copy of it at the front of my protocol binder. Did you tell them that you SAW THE SNAKE bite you, and you know that is not a spider bite? If they still say "no, it's a spider bite." Then all I can say is that he or she is not ready to be an EMT or a Dr. and needs to go back to school. Your story blew me away, you might want to talk to the person in the experts column that is looking for stories for a book.
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RE: E.R nightmare
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by greasemonkey on February 18, 2003
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How many times have you been bitten? answer that and all will see how bad you are at keeping hots. Fabian told me he has been bitten alot by cottonmouths and copperheads and anyone stupid enough to sit and wait to see how bad it will be sounds like they need to get rid of the hots and stay out but that is just my .02
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RE: E.R nightmare
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by spanky on February 18, 2003
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Greasemonkey, Well I have been biten 2> times by cottons, And 3>times by coppers. In the last sevral years.And Once by a canebrake. The cottonmouth bite takes more than a few hrs. to kill. Way go to the hospital, And make a bad name for hot keepers if I don't have to. Just makes sense to me. Spanky
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RE: E.R nightmare
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Anonymous post on February 19, 2003
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I would rather have you around to help support us, than risk your life to save our name. Bluntly: You're no good to us if your dead.
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RE: E.R nightmare
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by TomT on February 19, 2003
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It is best to get to the hospital for ANY venomous snake bite. If you stay at home and wait to see what happens, your delay may cost you a finger, several fingers or even your life.
If you feel the bite is not bad enough to warrant an ambulance ride, then have someone else drive you, but get to the hospital. There is no reason that a person would be considered a bad reflection of the hobby if they do the responsible thing and get to the Emergency Room immediately following a bite. If antivenom had been administered inside of the two hours you delayed, you may not have had to have the faciotomy and there may have been no necrosis... lots of ifs and buts, but you'll never know how incidental the bite might have been if immediate and appropriate treatment were given... That's why it's important to take treatment protocols with you and for you to KNOW what the right course of action is, before you get bit....
Just my observations....
Tom T
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