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Medical protocol
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Anonymous post on April 6, 2004
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What all should be included in a snake venom protocol book?
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RE: Medical protocol
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by JRHarrison on April 8, 2004
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First contact numbers for doctors that have treated snakebite envenomation. Second what antiserum to use on what species and how much you have available . Then any support numbers like herpetologists and zoo keepers. Most important you should have your own antiserum on hand.
I am writing this at 3:00am because I was awoken at 2:30 about a private keeper bitten by his Naja naja that had no antiserum available. This wake up call is getting way to common these days. Delay in using the antiserum can lead to death, organ damage and more loss of tissue.
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RE: Medical protocol
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by Trex on April 8, 2004
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I've prepared protocol based on the advice of the Miami-Dade Venom Response Unit and I feel it's good advice.
First, I have a tag that can be worn around my neck, with the immediate information, like the name of the snake, the Latin name, the contact number for the Miami-Dade Envenomation Emergency numbers, the antivenom name, where it can be obtained, my blood type, type of venom, where I bought the snake, my doctor's name and number then brief instructions on what to do, like, "Patient should recieve 0.25 mg of adrenaline by the subcutaneous route. The adrenaline should never be given intravenously especially in a normotensive patient. An antihistamine may also be given parenterally. The antivenom is the Haffkine Bio-Pharmaceutical Polyvalent Antivenom, with a lactated Ringers Solution..."
Then I have a folder with detailed information, indexed and highlighted for easy focus. I also have an Ace wrap ready so I can wrap the bite area, from the wound up, right near the enclosures. My rule is not to expose myself to the snakes unless I have someone with me in case of an emergency.
All of the anti venom is considered experimental and not approved by the FDA. Legally, a private citizen can not obtain and keep anti venom. You have to have your doctor order it and store it (unless he allows you to store it). Zoos are not eager to help out or provide much information on thier stock, so you have to assume antivenom based on their exhibit.
To me, the most important part is the phone number, so once you're on your way to the hospital, they will be in contact with an expert who can give real-time advice.
That's what I do, but am open to better suggestions.
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RE: Medical protocol
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by JRHarrison on April 8, 2004
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First if you work with a doctor he can get you a BBIND number to import and hold antisera. The delay waiting for antisera could cost you your life. Antisera banks unless they are with in 1 hour drive time are of little usage in a severe envenomation. Most bites are not severe but you can never predit the out come of any bite.Each person and bite is different with a few known factors involved.
Going to your local zoo to check out their collection so as to know what antisera they have is pretty low down. They house antisera for their workers not for private keepers and you risk their lives.
If you want to have these animals get your own antisera.
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RE: Medical protocol
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by Trex on April 10, 2004
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The question was one of life-or-death logistics, not a question of morality. Whether you think it's "low" or not doesn't matter when you're envonomized. I have called and checked with my local zoo as well as the next nearest zoo and they stated that if I were to be envonomized, and a doctor asked for the antivenom, they'd provide it. That's part of my back-up, but by no means the extent of it. The responsibility is to have all the information available and ready in the event you're enveonimzed and to "not" take risks that usually result in being tagged. For someone who doesn't have all the proper protocol established, the advice I passed on would work and possibly save a life. But rest assured, I would never tap into your stash for any reason, so you can keep the high ground of morality with me, because frankly, I don't need your help.
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RE: Medical protocol
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by JRHarrison on April 11, 2004
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By law we have to provide the antisera but now it will cost legal bills and replacement costs. Much cheaper to keep your own on hand. SAIMR polyvalent is about $55.00 per vial and Thai antisera runs about $45.00 per vial you should keep at least 20 vials on hand. You can get info on obtaining IND number and producers from the Antivenom Index put out by AZA.
Protocols are great but with a delay of antisera organ damage can and has occurred. When you walk in or are carried into the hospital your chance of recovering means having antisera there with you.
I believe safe handling reduces chances of an envenomation but accidents do happen. No one plans on having an accident so a good protocol and antisera go a long way to saving lifes.
A proven protocol appears in the 1999 Antivenom Index.
As far as risking your own life that is up to you but it is a crime to risk others by not having your own antisera.
I post because I think that people should be aware of facts and I believe that if private keepers do not start keeping their own antisera they will find that they will not be able to keep venomous reptiles at all.
Each bite has caused more laws to be passed. The media love all the calling of Venom One and zoos it makes for a good story. But lawmakers and the public see it and say "Why is it that people are allowed to keep dangerous animals."
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RE: Medical protocol
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by JRHarrison on April 11, 2004
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I left out one thing do not give an envenomated patient adrenaline unless they are having an allegric reaction. Adrenaline speeds up heart rate and does nothing to the venom. Your Protocol should follow the AZA outline.
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RE: Medical protocol
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by Trex on April 11, 2004
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I agree that we, that own venomous snakes, have a duty to ourselves and others by ensuring proper protocol and not relying on the preparation of others. When I tried to buy antivenom, I was told that it was $350-$450 per vial, and that I needed 13-15 vials on hand. I was also told that I couldn't buy it and felt like I was dealing in illegal drugs.
The protocol I cited was in all of the journals and medical literature I could find. Could you please give me the site to the AZA so I can revise my protocol if it's incorrect? If the site has procedures for procurement of antivenom, then I will attempt to stock my own as well.
Thanks
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RE: Medical protocol
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by JRHarrison on April 11, 2004
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You can check on AZA website. It maybe out of print but I believe that Chris Harper posted the info somewhere here on this site. AZA Antiserum Index is going on line for Doctors and zoo keepers but Poison Control Centers have the info to contact them.
If you do not find the Index info email me at kyreptil@mailhost.mis.net. I will try to help. I will be leaving the country in a few weeks so may not get right back but will asap.
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