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Constriction/Pressure bandage for viper bites
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by Snake18 on March 30, 2006
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Hy guys,
I would like to know if the use of pressure bandages in the event of a hemotoxic/citotoxic envenomation bite is apropriate. I know that this is what is recomanded for elapid or neurotoxic bites but what about bites from Crotalus atrox, Bitis arietans and other powerfull hemotoxic/citotoxic snakes ?
Thank you.
Best regards, Alex S.
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RE: Constriction/Pressure bandage for viper bites
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by Phobos on March 30, 2006
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Dr. Sean Bush's research indicates if you use a pressure bandage for a typical C. atrox bite it will prolong your life if bitten in the field but at the cost of the limb. I would say the prognosis for the bitten appendage when Bitis is involved might even be worse.
Al
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RE: Constriction/Pressure bandage for viper bites
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by GREGLONGHURST on March 30, 2006
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I agree with Al. In the case of a bite whose symptoms include swelling, a pressure bandage becomes a tourniquet fairly quickly. Dr. Findlay Russell states in Snake Venom Poisoning that he has never had to perform an amputation on a snakebite victim that had not been treated with a tourniquet.
~~Greg~~
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RE: Constriction/Pressure bandage for viper bites
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by pygmybait on March 30, 2006
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The logic behind applying a compression bandage after a bite is that it will restrict the flow of lymphatic fluid. Considering that the majority of viperidae venom constituants are almost immediately incorporated in the tissues surrounding the bite through the lymphatic system, rather than through vascular structures, you would do just as much good by simply immobilizing the affected limb (assuming that definitive medical treatment, i.e. Antivenom is not too far away). The main issue with constricting bandages is that they do just what the name implies; they constrict. That includes lymphatic fluid as well as oxygenated blood. Considering that the restriction of lymphatic circulation may be accomplished with a simple splint, the logic behind the constrictive bandage begins to fall apart(at least in my mind). When you also consider the fact that most viper bites develop notable swelling, the bandage can actually become a tourniquet in no time which can lead to the loss of valuable tissues. Interestingly enough, the constricting bandage that has been used for so many years with the Elapids may not actually be doing the job that we all thought it was doing. The neurotoxic peptide components found in Elapids disperse primarily through the bloodstream where they are not subject to any mechanical constraint short of a full on tourniquet. Basically, we had it backwards for a long time...
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RE: Constriction/Pressure bandage for viper bites
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by Rabies on March 31, 2006
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Hi Matt
"The neurotoxic peptide components found in Elapids disperse primarily through the bloodstream where they are not subject to any mechanical constraint short of a full on tourniquet. Basically, we had it backwards for a long time... " Have you any ref material for this? Thanks. I was aware of some components that may be able to enter the blood stream showing signs of systemic envenomation fairly quickly, i.e mamba's is commonly reported that pins and needles (paraesthesia) is seen within in minutes of a bite, possibly due to this route of absorbtion. But not all neurotoxic compounds are peptides, there is a good selection of enzymes (PLA2) which are alot larger and there for enter systemicly via the lymph system.
As for constriction bandage, if it is fitted correctly blood flow should not be affected, but during the heat of the moment this could be difficult. It only works if bandaging and splinting are done together, one or the other does not stop lymphatic movement. The bandage compresses the lymph vessels while the splint prevents muscle contraction, which is responsible for lymphatic flow. But as you and the others have pointed out, this could be contraindicated for bites that cause significant swelling.
Regards
John
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RE: Constriction/Pressure bandage for viper bites
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by pygmybait on March 31, 2006
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I can't remember exactly where I got that bit of information but it was lodged firmly in my brain...which isn't saying much. You are correct, of course, that not all neurotoxic venom constituents are peptides. There's all sorts of goodies in there...
The problem that I have seen first hand is that not too many people know how to properly apply a lymphatic wrap. Every one that I have seen attempted (by physicians AFTER A/V has been administered!!!) have turned into tourniquets within a very short time and ALWAYS end up causing some sort of circulation problem. They end up doing more harm in these cases. I don't see the logic in applying something like this when definitive medical treatment usually isn't far enough away to justify the risk. On the other hand, I'm not entirely sure that the original poster in this thread would be near such treatment. Are we talking about captive animals or are they going to be in their native areas?
I know that there are more factors involved in cases like this than we can cover in a single thread. I'm interested to hear more opinions. BGF???
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RE: Constriction/Pressure bandage for viper bites
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by Rabies on April 1, 2006
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I have a pdf doc some where, if I can find it I'll send it you. It's a survey undertaken on medical personel i.e Dr's, medics etc on the correct application of a constriction bandage after snake bite. The end result that not even they can get it correct, with out practice.
John
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RE: Constriction/Pressure bandage for viper bites
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by Snake18 on April 1, 2006
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Hy guys,
Sorry it took me so long to reply but my internet connection was down yesterday.
Thanks for all the info. It`s exaclty what I suspected.
The thing is that every romanian snake-bite first aid poster recomands the use of a pressure bandage. I`ve seen ice being used on a Vipera ammodytes bite patient in one of our hospitals and I realy got pissed. But, I bet incompetence is ever-present everywhere.
Thanks again guys,
Take care & Happy herping !
Alex S.
P.S.: I caught my first 2006 REPTILE today: a Lacerta agilis(sand lizard). With some luck, I`ll be catching my first 2006 snakes tomorow.
Cheers!
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RE: Constriction/Pressure bandage for viper bites
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by thenovice on July 31, 2006
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it all depends on how far you are from help if you are a good 18 hours away, i would apply presure to save your life, if you are near help then you could lose you limb when your life is in less danger so you decide, life or limb
C.H.
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