Snake, Snake, Snake!

No, not a rant about the use of pulmonary artery catheters…was out walking recently & came across this fellow.

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As it’s winter, the snakes come out onto road surfaces to warm up. This is a tiger snake – Kangaroo Island has two snakes, the tiger and the pygmy copperhead. KI tiger snakes don’t have the usual tiger stripes, being black to help absorb heat quicker. As is common with island speciation, the tiger snakes here are larger and more venomous that their mainland counterparts. You can see the ‘hood’ on this fellow as he makes himself appear more threatening.

We don’t see that many snake envenomations locally…the vet sees more, as dogs and snakes don’t mix. Generally snakes will avoid humans…although in the colder months I take especial care when collecting logs from the woodpile, as snakes like to rest there. Come summer, they are generally more active at night – hunting mice and frogs – and occasionally engaging in fights-to-the-death with local Rosenberg’s goanna.

It’s worth thinking about how YOU are going to manage a snake bite in your community – both from immediate first aid (pressure immobilisation, keep still) through to assessment (was this a true envenomation, a ‘dry bite’ or even a ‘stick bite’?) as well as use of snake-venom detection kit to aid decision-making as to which anti-venin to use (clue – if it’s a tiger snake or copperhead, use tiger snake antivenin!) and subsequent resuscitation.

Few quick Qs :

  • who is most likely to get envenomated by snakes?
  • how do you apply pressure-immobilisation?
  • how do determine envenomation or not in a rural setting?
  • how to use a venom-detection kit? to guide choice of antivenin?
  • are there any pitfalls in resuscitation of the snake bite victim?

Rural docs coming along to the RDASA Education Event Aug 8-9th at Wirrina Cove, South Australia will get a chance to quiz Prof Julian White on this topic. I’d recommend the CSL Antivenom Handbook, although I am not at all convinced about counting anal scales in the middle of a resus!

Might also be asking Prof White for his views on use of redback antivenom!

Eminence vs evidence-based medicine? Great review here from AdelaideEmergencyPhysicians.

 

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