Times have changed when it comes to treating snake bitesMay 20, 2018By Michael S. Brown Edited by Elisabeth Sherwin -- ensherwin@gmail dot com Columnist It used to be that a snake-bite kit consisted of a tourniquet, a razor blade and a couple of suction cups. No more. Today's snake-bite kit consists of a cell phone and set of car keys. Recently, I found myself waiting for a Red Cross First Aid – CPR class to begin in Longmont, Co. I didn’t feel like I really needed it. I have taken many First Aid & CPR classes over the past 60 years. I took these classes when I was young as part of Cub Scouts, 4-H, Boy Scouts, life guarding, swimming and more. As an adult, I took professional certification classes in order to work in labs, refineries, chemical and power plants, shipyards and construction sites.There are so many different ways to get hurt. But, largely, the basics of First Aid have stayed the same for many years: make sure the scene and people are safe, stop the bleeding, start the breathing, keep the heart beating, mitigate shock, and wait for the ambulance. Things really haven't changed very much since doctors stopped balancing the humors by bloodletting in the 19th century. When I was young, the one aspect of First Aid that was different and exciting was the treatment of venomous snake bites. This treatment called for heroics. None of that boring "apply a pressure bandage to open wounds and keep patient warm until help arrives.” No sir! In my younger days, you had to be in equal parts a medical social worker, surgeon, and hero. You had to: 1. Keep the patient calm and relaxed; 2. Tie a tourniquet between the snake bite and the heart to keep the venom from getting into the blood stream (and, remember to loosen it for a couple of minutes every 15 minutes); 3. Cut an incision over each fang puncture; 4. Use a suction device to remove the venom from the incisions; 5. Prepare a stretcher or bodily carry the victim to a hospital. When I first learned this catechism, I was about 8 years old. I lectured my friends and family at length about how to survive a snake bite. There were nifty little snake bite kits that you could buy that had a couple of rubber suction cups, a shoelace for a tourniquet, and a couple of small razors. I owned several and used to carry one with me everywhere. Not only walking to and from school but at school: The probability of encountering a snake bite victim while walking from English to Social Studies wasn’t high. But I had been told to be prepared and I wasn't going to be found wanting. Additionally, the incongruity of a frightened snake bite victim remaining calm while an 8-year-old straddled him, slicing at the bite site with a razor and yanking a tight shoestring around his arm or leg, never occurred to me. I probably would have had to physically subdue the victim if he tried to resist. Fortunately, over the years my enthusiasm for playing snake-bite hero has abated. I’ve become more relaxed about snake encounters. I’ve met quite a few snakes, and have been bitten several times, although not by a venomous snake. In my experience, snakes are generally introverted and businesslike and just want to be left alone, especially by humans. Most snakes, when they are traveling on the ground, are only about an inch or so tall. And most North American snakes only weigh a few pounds. So when a snake meets a human that is 65 inches tall and weighs 150 pounds, it is meeting a creature that is 65 times taller and 75 times heavier than it is. This would be like me meeting a creature that was over 300 feet tall and weighed 7 tons. I would certainly want to slither off into the grass if I met something like that. Given a chance, a snake will also. So, anyway, I was waiting for the CPR -First Aid class to begin while I mentally reviewed what I’d learned over the years. I felt pretty cocky. After all, I’d heard it all before or so I thought. But I was both surprised and disappointed. The venomous snake First Aid application was nothing like I'd remembered. No tourniquets; no razors, knives or incisions; no heroic sucking out of the venom; no carrying stretchers or litters. The only admonition that remained the same was the suggestion to keep the victim calm. Why the change in life-saving treatment? It turns out that a lot of enthusiastic amateur first-responders caused significant collateral damage during the last half of the 20th century. Hospitals found that more limbs and lives were lost to crude First Aid than were lost to snake venom. Consider that: People put on skinny tourniquets, like shoe strings and rope, which damaged veins, arteries and tissue. Gangrene and necrosis set in. People put tourniquets on, and never took them off. Limbs literally died and fell off. People let their enthusiasm get the better of them, slicing deeply and widely with the razors – cutting tissue, muscle, tendons and arteries all at once. People didn’t keep the incisions clean. Infections, necrosis, sepsis, shock and death resulted. So, hospitals and the American Red Cross, in the very last part of the last century, developed new First Aid rules for venomous snake bites. No drama, no heroics, no cutting and sucking, no more jokes about how if you get bit on your butt, you’re gonna die. The new rules are simple: 1. Keep the patient calm. 2. Call 911. 3. Get the patient to a hospital. Remember: Today the recommended snake bite kit is a cell phone and car keys. (Elisabeth Sherwin and Mike Brown are volunteer naturalists, Class of 2018, serving hikers and outdoor enthusiasts in Boulder County, Colo.) -- Reach Elisabeth Sherwin at ensherwin@gmail.com
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