Although this has been brought up from time to time all across the different forums and we have many paramedics on this site, I guess my question is this: If you were out in an area that you could not get medical attention and were bitten by a rattler, water moccasin or what have you, what if any would be the best thing you could do after being bitten by a venomous snake.

Now I own 3 of the Sawyer Extractors, 1 in the truck,1 in the house, 1 in my BOB and had very good results from insect and spider bites as long as I used it within 5 min. of the bite. Now I have never tested it out on a snake bite and insurance companies like Cigna and several organizations tell you not to use it because it's ineffective as well as I think I saw one article on a FDA or CDC site saying it was ineffective. Even on Doug's site showed a 35% effectively, all though recent testing has shown less. I think if I new I would not be able to get to a doctor that it would be worth the risk of using the Sawyer Extractor as long as it's within 3 minutes of the bite. I don't know of any portable anti venom that would be available but you would think some of these snake hunters carry a vile or something. Anyway what do you think would be the best carry option for snakebites?

Watch this idiot:
http://www.youtube.com/watch?v=uWITKklxeLw



Doug's View:
http://www.equipped.org/medical.htm
The only kit worth carrying is the Sawyer "Extractor." This has proved very effective with insect bites, if used promptly. It will also improve your chances after a snake bite, reportedly removing about 35% of the venom, if treatment is started within three minutes, without causing further injury or trauma. The Extractor uses a venom pump suction device, akin to a syringe but it creates suction when the plunger is depressed, with various form fitting adapters to create a *very strong* vacuum, sucking the venom out through the original punctures. )

Jeffrey A. Manion's view
http://survival.com/IVB/index.php?showtopic=33
Sawyer Extractor (vacuum suction): Some evidence of limited effectiveness. One animal study reported up to 34% removal of venom; others 10-20% efficacy, and some found no benefit. Needs to be used immediately - before venom can move outward. General recommendation is within 3 minutes of bite, continuing for 30 minutes. Probably cannot increase damage, in any case, so is not unreasonable to try, in my opinion.


Cigna's View
http://www.cigna.com/healthinfo/snake.html
Do not use a suction extraction device. There is no proof these devices actually help, and they cause further injury and increase your chances of having an infection.

Others
http://www.kingsnake.com/toxinology/foru...178b664d51ecaf1

See pages #105 (Overdose/Poisoning: Injection Insect/Snike Bite) and #240 (approx. half way down the page of the Maryland EMS-Wilderness Protocol -

Use distal and proximal contricting bands

Use of the Sawyer Extractor is recommneded for use within 5 mintues of bite.

Pete

Maryland EMS Protocols

Keep in mind that this portion does not apply directly to the Sawyer Extractor, but refers to suction extraction devices in general. Many of the suction extraction devices recommend cutting an X in the skin to (supposedly) allow for more fluid removal, and this is the action that "causes further injury and increases your chances of having an infection".

This point of view is also expressed in Doug's recommendations (http://www.equipped.org/medical.htm):

First Aid advice given in current U.S. Armed Forces Survival Manual is to bind the limb so as to constrict blood flow and to elevate THE BODY above the limb. This is to slow or stop the venom from reaching the casualties vitals.

Note: THIS IS THE OPPOSITE TREATMENT TO THAT GIVEN TO A SUSPECTED HEART ATTACK VICTIM.

One major problem you have is identifying the snake. Some venom's are blood agents that act as a coagulant. Causes Heart failure. Others are nerve agents. Nerve agents are far and away the most life threatening.

All that assumes that the bite is to an extremity. If it is to the body then unless you have a supply of the antivenin to hand it is quite likely that the victim will die.

Devices like the Sawyer might help to reduce the dosage from the bite but that depends on time since bit, type of venom etc.

I carry a suction-type extractor for use on insect bites and stings, most notably bees and wasps. If I were bitten by a snake and was more than 60 minutes from medical assitance, I would probably use it on the snakebite, along with a tourniquet for whatever its worth. If I had a real good chance of getting help within an hour, I would probably be inclined to follow the "current" theories that you're better off not implementing these measures.

The best cure for snakebite is not getting bitten in the first place. In snake country I usually wear tall boots and work jeans or canvas pants. Yes, they're heavy and hot in summer. But unless you're crawling around on all fours you probably will not receive a bite that breaks the skin, at least in my part of the country where we don't have tree-dwelling vipers. I also will pick up or cut a staff and poke it ahead and move slowly, pausing often to look and listen if I find myself having to go through heavy brush. The point is, an ounce of prevention is normally worth a pound of cure, but where poisonous snakes are concerned that ounce is worth something more like a ton.

Frank2135

DISCLAIMER: I'm providing the following excerpt for INFORMATION ONLY, not at a TREATMENT guideline!! Edited slightly for length.

From Harrison's Principles of Internal Medicine, 16th Ed., P. 2593:

"Initial (prehospital) measures should focus on rapidly delivering the victim to definitive medical care while keeping him/her as inactive as possible to limit systemic spread of venom. Any other measures employed should at least do no further harm to the victim.
Although mechanical suction has been recommended in the field management of venomous snakebite for many years, there is now literature that demonstrates that this intervention is of little, if any, benefit...
...There is concern that severely restricting venom to the bite site may, in fact worsen local tissue necrosis. If the victim is >1 hour from medical care, a constriction band or pressure-immobilization may be considered, but with realization that one may be sacrificing tissue in order to reduce systemic toxicity... The bitten extremity should be splinted if possible and kept at approximately heart level.
For elapid or sea snake bites, the Australian pressure-immobilization technique, in which the entire bitten extremity is wrapped with an elastic or crepe bandage and then splinted, is highly effective..."

There are several more pages of in-hospital treatments, but that's outside this discussion (and quite frankly, my expertise and experience).

It's useless, according to the recent 10 First Aid Myths forum thread:

1. Sucking Venom From a Snakebite

Cutting the skin of a snakebite victim to suck out the poison may be a classic first-aid technique, but doctors now say it’s useless and even dangerous. “Cutting and sucking, or applying a tourniquet or ice does nothing to help,” says Dr. Robert Barish, an emergency physician at the University of Maryland. The outdated measures “may do more harm than good by delaying prompt medical care, contaminating the wound or by damaging nerves and blood vessels,” Barish says in an article released by the university’s School of Medicine and the Rocky Mountain Poison Center.

“The victim should be moved out of harm’s way and transported to the nearest medical facility as soon as possible,” Barish advises. So the best cure for snakebite: a cell phone and a helicopter.

So you can trash it right now and buy a pocket survival helicopter (I guess you have the cell phone already).

Thanks Pete for the link to that pdf file!

Adam

So I wonder what would be a more effective method a stun gun or the extractor? Both are not really proven and shocking myself is a little hard for me, I had tried a 50K stun gun in the past before and it felt like getting burned when they first came out but I could never get my self to do it again. In the field you would probably want a magneto from an aircraft or a hand cranked one to get rid of battery problems out in the field. I have heard of the shock in the past but I haven't heard any true positive feedback. I know the sawyer has worked for insects unless it gives me a false since of security. I was bitten in the back of the neck awhile back by a wasp and it felt like being hit by a bat, I used the extractor within 2 min and the pain went away immediately and had no issues after that.

Many good points are brought up which has a lot of merit and thanks also pete for the PDF file.

< Use distal and proximal contricting bands

< Use of the Sawyer Extractor is recommneded for use within 5 mintues of bite.

I've got one in my backpack, it's there for emergencies, but I've never had the occasion to use it.

Do you think that it would be a serious mistake to push down on the plunger while treaing a person for snake and insect bites ?

I get the impression that it would be a SERIOUS MISTAKE to push down on the plunger because it would force toxic venom right back into the wound. The downward motion of the piston would force the venom deeper into the victim's body. OK, but how are you supposed to maintain "suction" with the device if you cannot push the down on the plunger while treating someone for snake and insect bites ?

I think it says somewhere in the instruction manual that you're supposed to get "suction" by coating the wound with a fine layer of petroleum jelly. OK, but now let's imagine the worst-case scenario and let's assume that you don't have any petroleum jelly on you, then what ?

LW.