Words & pictures Paul Donovan
The very first article I wrote for SA4x4 was way back in a distant time, and it covered the subject of snake bites. In that article I detailed the technique universally endorsed as the first-aid treatment for snake bikes: the Pressure Immobilisation Technique.
I’d like to bring that article up to date, as there have been advances regarding the first aid treatment of snake bites.
It has to be done properly
The problem with using the Pressure Immobilisation Technique is not only carrying enough compression bandages to apply to the bite but, more importantly, applying them properly.
I was taught how they should be applied by a first-aid responder, and a medical doctor, but it took me about six or seven attempts before I could apply them at a pressure where they would actually have worked. And there lies the overriding problem with this technique.
There is a huge gap between reading about how the bandages should be applied, and actually applying them properly. And the time not to start practising, is when you are dealing with a bite.
This is a fundamental problem with a lot of things we may read about, as it can lead us into a false sense of security. Because you may be carrying a snake bite kit, or compression bandages, this could lead you to thinking that if a bite should occur, you have the resources to deal with it. Herein lies the dilemma.
If the bandages in the Pressure Immobilisation Technique are applied too tightly, they risk cutting off the blood flow to the limb, which may result in it dying and having to be amputated. If they are not applied tightly enough, you may just as well not have applied them in the first place, because they will not be doing their intended task.
A substantial amount of medical research shows that in the majority of cases of snake bite victims arriving at hospital with pressure bandages having been administered, the bandages have not been applied properly. This is very alarming.
The disclaimer
Although the Pressure Immobilisation Technique is widely popularised in just about all publications relevant to snake bites as the first-aid treatment to use in the case of a bite, there is another method we can use which alleviates the overriding problems with applying the technique. This alternative method is called the Pressure Pad Technique.
Firstly, a disclaimer. I am NOT a medical doctor. In fact, I am not a doctor of anything, but the technique I am going to detail here (which is not widely popularised) has been included in two publications on snake bites commissioned by the World Health Organisation (WHO). Both these publications were edited by one of the world’s foremost snake bite experts, Professor David A Warrell. I have also referenced the original paper where the technique was employed to cover all avenues, should you wish to delve into the subject further.
The Pressure Pad Technique
Scientists at Monash University first suggested this alternative to pressure immobilisation, as it is a simpler way of attempting to delay the absorption of venom (Anker et al, 1982: 1983).
Rather than wrapping the entire leg or arm in bandages, the Pressure Pad Technique takes a localised slant. As the WHO publication reports suggest, the method adopted is thus: “A rubber and/or folded material pad approximately 5cm square and 2-3cm thick is placed directly over the bite site anywhere on the body and bound in place with a non-elastic bandage…” The limb should then be splinted to immobilise it.
The simplicity and effectiveness of the pressure pad technique means it can be applied to a snake bite by the layperson, with a greater chance of getting it right first time off. It also requires carrying less bandages, and utilises those one would find in any conventional first-aid kit carried by just about anyone. Not everyone carries compression bandages. The Pressure Pad itself can be made from any suitable material at hand. For the purposes of the illustration, I simply folded a triangular bandage in half.
The method was first used in the case of a Russell’s viper bite, but is still only advocated for use in the case of bites by elapid snakes, such as mambas and cobras, etc. I have done extensive research to try and find if it could be used in viper bites, as the method does not seem to contraindicate the swelling associated with bites from such snakes. Unfortunately, I have not been able to locate any medical or research papers to suggest it can, or cannot.
Tail-end
The Pressure Pad Technique seems to be a good alternative to the difficulties associated with applying the Pressure Immobilisation Technique. It is simple to apply, requires less bandages, and appears, from the scientific papers I have read, to be highly effective. If you want to learn more about the technique, I suggest you read the papers I have referenced.
Disclaimer: Neither the author nor publisher are liable for damage or injury sustained in using the above technique.
SOURCES
Anker RL et al (1982). Retarding the uptake of “mock venom” in humans: comparison of three first-aid treatments. Med J Aust. 1(5):212-4.
Tun-Pe et al. Local compression pads as a first-aid measure for victims of bites by Russell’s viper (Daboia russelii siamensis) in Myanmar. Trans Roy Soc Trop Med Hyg. 1995; 89: 293-5.
Warrell, David A. Guidelines for the management of snakebites. WHO, 2010.
