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Hi gang! I may have missed, but very interested in learning more about snake bite dos and do not's. We have encountered an increasing amount of rattlesnakes in Northern CA trails (rattlers), and last year at the Rubicon trail a person camping by us was medi evacuated. Appreciate info, suggestions etc on what you normally carry and how to handle (or any actual hands on experiences). Thanks!
 

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El Solis

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Ah...snake bites....so much myth and folklore about treatment. In the simplest explanation, treating snake bites comes down to this: get the person to the hospital for anti-venom as fast as possible.

Now, along the way there are dos and don’ts which I’ll list here. I’m going to start with the don’ts as these are more likely to cause harm.

Don’t cut the wound to make it bigger. People thought it would help the venom drain out, it doesn’t. You are just cutting your friend for your entertainment.

Don’t try to suck the venom out. I mean, really?!? One it doesn’t work and two why would you expose yourself to venom and potentially have two victims?

Don’t apply a tourniquet. Tourniquets stop arterial flow from the heart to the area, they don’t do a great job of stopping the venous flow back to the heart. This is where the venom will be, in the venous side.

Don’t give the person any medications, alcohol, caffeine. The explanation requires a lot more time and space than it needs to, do just take my word on this one.

Don’t apply an ice pack. The venom will start to kill the tissue in the area and the ice will help it by slowing the body’s ability to respond to the trauma.

Don’t buy a snake bite kit.


Ok, on to the dos:

Scene Safety: make sure the snake is gone or get the person away from the snake and any other dangers.

Call for help and plan evacuation.

Start the primary survey, the ABCs (for those who have watched or been to a class, you’ll see that this is applied to everything!). If there is major bleeding apply pressure to the area. Despite the don’t above, if you need to apply a tourniquet to stop massive bleeding it is ok in this instance only. It would be rare to have the snake hit a major artery so direct pressure should be fine the majority of the time. Make sure the Airway, Breathing, and Circulation are doing their thing. The person may have fallen and hit their head trying to get away or have other injuries that need to be addressed.

Once the ABCs are done, try to keep the person as calm as possible. The slower the heart beats the slower the venom spread.

Cover the wound with gauze. Only needs to be as tight as needed for the amount of bleeding. If there is no real bleeding keep the the dressing loose.

Remove jewelry from the area that was bitten. The area will swell and this can cause other issues. Same thing with shoes, take off shoes on the affected side unless the person has to walk for evac. If you are hiking you can make a makeshift litter with branches and jacket to drag them out. Boy Scout handbook taught me this one.

Try to clean the area but don’t give it a deep clean. Takes too much time that needs to be spent getting help.

Now this all for venous snakes. If you are 100% certain that the bite was a non-venomous snake, treat the wound as a puncture wound. Irrigate and wash it out well and cover with clean gauze. Usually these aren’t deep enough to warrant closing.


Now, if you can....and I mean if....try to remember what the snake looks like. Color, shape of head, etc. Don’t try to capture it.


As you can see, snake bites aren’t treated differently than other injuries in the immediate care setting. Like most major injuries we will encounter at home or in the back country, getting help is really what the person needs. Have your trauma and basecamp first aid kits stocked and learn how to use the contents and you’ll always be able to help.

Hope this helps!!

Chris
 

HappyOurOverlanding

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Ah...snake bites....so much myth and folklore about treatment. In the simplest explanation, treating snake bites comes down to this: get the person to the hospital for anti-venom as fast as possible.

Now, along the way there are dos and don’ts which I’ll list here. I’m going to start with the don’ts as these are more likely to cause harm.

Don’t cut the wound to make it bigger. People thought it would help the venom drain out, it doesn’t. You are just cutting your friend for your entertainment.

Don’t try to suck the venom out. I mean, really?!? One it doesn’t work and two why would you expose yourself to venom and potentially have two victims?

Don’t apply a tourniquet. Tourniquets stop arterial flow from the heart to the area, they don’t do a great job of stopping the venous flow back to the heart. This is where the venom will be, in the venous side.

Don’t give the person any medications, alcohol, caffeine. The explanation requires a lot more time and space than it needs to, do just take my word on this one.

Don’t apply an ice pack. The venom will start to kill the tissue in the area and the ice will help it by slowing the body’s ability to respond to the trauma.

Don’t buy a snake bite kit.


Ok, on to the dos:

Scene Safety: make sure the snake is gone or get the person away from the snake and any other dangers.

Call for help and plan evacuation.

Start the primary survey, the ABCs (for those who have watched or been to a class, you’ll see that this is applied to everything!). If there is major bleeding apply pressure to the area. Despite the don’t above, if you need to apply a tourniquet to stop massive bleeding it is ok in this instance only. It would be rare to have the snake hit a major artery so direct pressure should be fine the majority of the time. Make sure the Airway, Breathing, and Circulation are doing their thing. The person may have fallen and hit their head trying to get away or have other injuries that need to be addressed.

Once the ABCs are done, try to keep the person as calm as possible. The slower the heart beats the slower the venom spread.

Cover the wound with gauze. Only needs to be as tight as needed for the amount of bleeding. If there is no real bleeding keep the the dressing loose.

Remove jewelry from the area that was bitten. The area will swell and this can cause other issues. Same thing with shoes, take off shoes on the affected side unless the person has to walk for evac. If you are hiking you can make a makeshift litter with branches and jacket to drag them out. Boy Scout handbook taught me this one.

Try to clean the area but don’t give it a deep clean. Takes too much time that needs to be spent getting help.

Now this all for venous snakes. If you are 100% certain that the bite was a non-venomous snake, treat the wound as a puncture wound. Irrigate and wash it out well and cover with clean gauze. Usually these aren’t deep enough to warrant closing.


Now, if you can....and I mean if....try to remember what the snake looks like. Color, shape of head, etc. Don’t try to capture it.


As you can see, snake bites aren’t treated differently than other injuries in the immediate care setting. Like most major injuries we will encounter at home or in the back country, getting help is really what the person needs. Have your trauma and basecamp first aid kits stocked and learn how to use the contents and you’ll always be able to help.

Hope this helps!!

Chris
On cleaning the wound...besides water, can you use alcohol or hydrogen peroxide for a snake bite?
 

El Solis

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I would not use hydrogen peroxide or alcohol on any wound. Those fluids are no longer recommended as cleaning. Regular drinking water is sufficient. You want to really just pour it over and not try to irrigate or force the water in for a puncture wound. You will just drive the dirt and bacteria deeper into the wound. Just pour the water over the wound until it is clean.
 

HappyOurOverlanding

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I would not use hydrogen peroxide or alcohol on any wound. Those fluids are no longer recommended as cleaning. Regular drinking water is sufficient. You want to really just pour it over and not try to irrigate or force the water in for a puncture wound. You will just drive the dirt and bacteria deeper into the wound. Just pour the water over the wound until it is clean.
Well I feel old.... time to relearn first aid. Thanks for setting me straight.
 
Chris, thanks for all the great tips! As we are finding more snakes than ever now on the trail is always good to know what to do and be prepared!

Yep, that rattler is an actual pic a buddy sent me. This was at the Rubicon trail some months back. the rainfly was not closed and the rattler sneaked in. Definitely a bad surprise and could have been worse if they have had too many more drinks at the campfire before getting in.

A month earlier from n July we were camping at Buck Island at the Rubicon and the other guy was not as lucky and got bit twice and had to be medivac out. I highly recommend everyone to get a service, they cost about $60 a year and cover all of the family.
 

Stewart (Stu) Pirie

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I'm curious if anyone has used a RATS tourniquet and can tell me how well it works compared to a CAT?

I'm hoping to carry one and an Israeli type bandage together in my pocket in my boiler suit at work, as we work with high pressure fittings and rotating machinery often so would like something smaller than a CAT.
 

El Solis

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The RATS tourniquet is fine and will work. As it is narrower that the CAT the pressure is only applied to a smaller space and can be more painful to the patient. I prefer the CAT tourniquet as you can continue to apply more pressure after the initial wrap. Both get the job done.
 
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Rick Schlepphorst

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Chris, got a question. I live in Texas, and the interior of my vehicle gets ridiculously hot during the summer. Will that degrade some or all of the items in my FAK? Should i be replacing some of them on some sort of rotation? I was thinking of the tape and bandages mostly, maybe the gloves. I always have some Benadryl and ibuprofen in there too.
 
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El Solis

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Yes and maybe. Heat will definitely degrade the adhesive on the bandages etc so keep an eye on them and rotate them. I’ll sometimes buy new bandaids for the rig and bring the others in the house. As for the medications this is a maybe. It might decrease the effectiveness of the meds but usually doesn’t make them unusable. I do the same thing here and cycle them to the house.
 

MunsterGeo Overland

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This thread is for any questions related to first aid, trauma care, medical care in general, and for members to post suggestions or request topics to be covered. Don't be shy, if you have the question in your head I guarantee others do to!

Chris
For those who may not have come across it before, could you do one of your scenario posts on a penetrating wound with the object still in the casualty e.g. a stick or piece of glass etc...?

If it's not asking too much, could you cover Sepsis too? In 2016 in Ireland there were approximately 15,000 diagnosed cases resulting in 2,735 deaths. To put that into perspective Ireland had a population of 4.7 million and Sepsis caused more deaths in 2016 than heart attack, breast cancer and lung cancer combined.
 
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El Solis

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I’ll add that to my list! I have an On Call With Chris video about puncture wounds, including snake bites, that needs to be published. I didn’t include what to do if the object is still stuck inside as it was beyond the scope of the video but will make a scenario about it.

As for sepsis, tough to take that on for the masses but I’ll make a video about it. Was there something specific about sepsis you wanted to see addressed?
 

MunsterGeo Overland

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That's great. Thank you.


In relation to sepsis, I understand it's a difficult one but I suppose recognition of the signs would be the most important along with the importance of seeking professional help as quickly as possible. Perhaps something on how it may be acquired in the Overland / Outdoor scene?


The videos are a great idea too.
 

CracklinFire

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@El Solis

Chris, I recently completed an EMR Certification. Part of my EMR training was in the safe handling / proper administering of oxygen. Given the importance of oxygen in treating shock, what is your recommendation (for or against) the following:

- Do you include oxygen in your kit?
- Size of bottle you carry?
- Method for safely storing in your vehicle?
- Any other insight / do's or don'ts?

Thanks in advance! More questions to come!

-Braden
 

El Solis

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Hey Braden!
Great questions! I don’t carry oxygen in my kit just because of the logistics of transporting and storing. Despite the benefits of oxygen for almost all emergencies, the amount of gear and training needed for the average person to safely use it doesn’t match with improved survival in our world of backcountry travel. Unfortunately we put ourselves at higher risk for bad outcomes once we leave the “safety” of the urban setting. Being prepared, getting the training, and having the proper gear all improve those outcomes but oxygen is one of those items that is better left off the list. Put your money into things that have a more direct impact on survival: tourniquets, training, pocket ambu bag, satellite communication to call for help, etc.

If you are going to carry oxygen make sure you have it well secured in case of rollover. The bottles can become missiles and oxygen explodes when it comes in contact w fire so the bottle becomes a bomb. Putting it in a bag designed for oxygen transport and securing that bag is probably the best method of transport.

Regarding size, if you want to carry oxygen you need to figure out what a realistic transport/wait for help time is and go from there.

Hope this helps!

Chris
 

CracklinFire

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Hey Braden!
Great questions! I don’t carry oxygen in my kit just because of the logistics of transporting and storing. Despite the benefits of oxygen for almost all emergencies, the amount of gear and training needed for the average person to safely use it doesn’t match with improved survival in our world of backcountry travel. Unfortunately we put ourselves at higher risk for bad outcomes once we leave the “safety” of the urban setting. Being prepared, getting the training, and having the proper gear all improve those outcomes but oxygen is one of those items that is better left off the list. Put your money into things that have a more direct impact on survival: tourniquets, training, pocket ambu bag, satellite communication to call for help, etc.

If you are going to carry oxygen make sure you have it well secured in case of rollover. The bottles can become missiles and oxygen explodes when it comes in contact w fire so the bottle becomes a bomb. Putting it in a bag designed for oxygen transport and securing that bag is probably the best method of transport.

Regarding size, if you want to carry oxygen you need to figure out what a realistic transport/wait for help time is and go from there.

Hope this helps!

Chris
Chris, thank you very much for your prompt reply! You've answered my questions and addressed my fears about carrying oxygen. I will focus on the medical / trauma aspects of my kit. You're also right on the money about the sat phone... it is an expense I need to take on and possibly the most effective one for a serious emergency.

BTW, your first video "Vehicle Based Trauma Kit" was what prompted me to seek training.... resulting in my EMR certification. I also plan to continue additional training programs whenever possible. I'm looking forward to more of your videos!

-Braden