First of all congrats to our patch winners! In order of correct answer submission:
- Kevin Mitch
- WJ Bowman
I encourage you to read the paper we’ve used in both our patch contests so far. It contains a lot of SOF-relevant medical info pertinent to African operations, and it could be used for future reference. Thanks to Breakaway Media, LLC – JSOM Publisher – we are offering you a FREE COPY!
BRiEF TAKE HOME MESSAGE ABOUT SNAKE BiTES & ANTiVENiNS:
As Bill V. likes to say, it’s important to wrap your head around treating the SYNDROME and NOT the symptoms. The symptoms will help you determine the syndrome to treat. Symptoms will vary and progress over time, so reassess, reassess, and one more time reassess.
- Almost every snakebite hurts initially
- Almost all bleed for a short period, and then stop
- Initially there is some swelling
Establish the baseline to increase your ability to identify the specific syndrome as it progresses:
CYTOTOXiC (PROGRESSiVE PAiNFUL SWELLiNG) syndrome:
- Effects start within minutes of the bite
- Spreads from the bite to the trunk
- Swelling is hot, hard & painful
- Time the spread of swelling to determine the severity of the bite
NEUROTOXiC (PROGRESSiVE WEAKNESS) syndrome:
- Overall effects occur AWAY from the bite site
- Normally take effect within the first hour
- Severe cases can take effect within minutes
- Death results from respiratory paralysis
- Ventilation is the most effective treatment
HEMOTOXiC (PROGRESSiVE BLEEDiNG) syndrome:
- Symptoms begin within 1 hour of bite
- Venom acts as a powerful anti-coagulant
- Venom causes a breach of the capillary endothelium leading to internal bleeding
- Death usually occurs 24-72 hrs after the bite from cerebral hemorrhage or multi-organ failure
Administration of antivenin is a clinical decision and should be based on evidence of severe or systemic symptoms. However, due to risk of anaphylaxis carried by all antivenins, administration should be performed in at least a Role 2 facility with appropriate monitoring and emergency treatment resources available.
Currently available antivenin has a defined range of therapeutic efficacy and there are several species for which no antivenin is available. Antivenin is in short supply, has a limited shelf life, requires dependable cold storage, and is available only through a select few manufacturers. So PACE your antivenins!