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Title: | Harm due to the use of pressure bandage immobilisation in patients bitten by snakes in Australia | Authors: | Little, Mark | Issue Date: | 2023 | Source: | Mark Little (2023) Harm due to the use of pressure bandage immobilisation in patients bitten by snakes in Australia, Clinical Toxicology, 61:8, 611-612, DOI: 10.1080/15563650.2023.2252586 | Journal: | Clinical Toxicology | Abstract: | Background Pressure bandage immobilisation has remained the recommended first aid treatment for more than 40 years in Australia. However, whilst it is used in most people bitten by a snake, it is often applied poorly, and patients have been envenomed despite good pressure bandage immobilisation. We report two patients who suffered harm from this procedure. Case reports Two men, a 35-year-old and a 44-year-old, were bitten by snakes. Both had a prompt application of pressure bandage immobilisation, and both reported significant pain requiring opioid analgesia whilst being transferred from remote Australia to Cairns Hospital, Queensland. There were substantial delays (9.5 h and 7.5 h) before the pressure bandage immobilisation was released. As a result, both patients developed severe rhabdomyolysis (33,600 U/L and 16,800 U/L [normal < 171 U/L], respectively); there was no evidence of systemic envenoming. The 35-year-old developed a compartment syndrome that required urgent and repeated surgery. The 44-year-old has ongoing foot paraesthesia two years after the bite. Conclusion With limited good evidence of benefit, and many issues with its use, I recommend that pressure bandage immobilisation as a first aid measure for snakebite in Australia needs to be re-examined. | Description: | Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Mark Little | DOI: | 10.1080/15563650.2023.2252586 | Keywords: | Snakebite;first aid;pressure bandage immobilisation | Type: | Article |
Appears in Sites: | Cairns & Hinterland HHS Publications |
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Harm due to the use of pressure bandage immobilisation in patients bitten by snakes in Australia.pdf | 566.4 kB | Adobe PDF | View/Open |
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