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#142409 - 07/31/08 11:15 PM Re: Sawyer Extractor Test [Re: bmisf]
Hikin_Jim Offline
Sheriff
Pooh-Bah

Registered: 10/12/07
Posts: 1804
Loc: Southern California
Originally Posted By: bmisf
I'm a Wilderness First Responder and in the latest curriculum the Sawyer extractor is no longer recommended for snake bite; recent research studies showed that it had no positive effect, could damage tissues, and delayed getting to the best course of action - which is immediate evacuation for treatment. (For insect stings, still OK to use, though not always effective.)

There's a "wrap" treatment for elapid bites (coral snakes and all kinds of tropical snakes not found here) that shows some promise - but evacuation with elevation of the bitten limb if possible is still the way to go for those and for all pit viper bites.

(Oh - and definitely no "cut and suck" treatments - those have been out for years as they cause damage, expose the wound to further chance of infection, and get very little venom out!)

+1 to what bmisf is saying. I took a Wilderness First Aid course last year. They advised us that any suction was ineffectual and could actually make things worse. There really wasn't much that one could do in the field for a snake bite victim, just clean the wound, cover the wound with a sterile dressing, keep the victim as calm as possible, and evacuate ASAP. Antivenom is really the only effective means of treatment, which is not especially good for those of us who like to wander "off the beaten track." Perhaps yet another really good reason to carry a PLB?

It's a valid point that the test cited has some flaws, but I wonder if that particular study is what the "no suction" advice is based on. Is that the only study out there? Did that study result in the "no suction" recommendation? I'm not saying the study isn't relevant, but it's a least worth asking what other factors were included in the "no suction" recommendation.
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#142411 - 07/31/08 11:31 PM Re: Sawyer Extractor Test [Re: bmisf]
OldBaldGuy Offline
Geezer

Registered: 09/30/01
Posts: 5695
Loc: Former AFB in CA, recouping fr...
"...elevation of the bitten limb if possible..."

Elevation? Isn't that just going to help any venom flow toward the heart faster???
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#142417 - 08/01/08 12:19 AM Re: Sawyer Extractor Test [Re: OldBaldGuy]
Hikin_Jim Offline
Sheriff
Pooh-Bah

Registered: 10/12/07
Posts: 1804
Loc: Southern California
Originally Posted By: OldBaldGuy
"...elevation of the bitten limb if possible..."

Elevation? Isn't that just going to help any venom flow toward the heart faster???

IIRC, we were instructed to keep the extremity below the level of the heart, but maybe elevation would reduce the blood flow and thus the rate of propagation of the venom?
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#142419 - 08/01/08 12:22 AM Re: Sawyer Extractor Test [Re: Hikin_Jim]
wildman800 Offline
Carpal Tunnel

Registered: 11/09/06
Posts: 2816
Loc: La-USA
Elevation is used to slow bleeding so as to assist the coagulation process. Elevation above the heart's level.
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#142440 - 08/01/08 03:38 AM Re: Sawyer Extractor Test [Re: Hikin_Jim]
OldBaldGuy Offline
Geezer

Registered: 09/30/01
Posts: 5695
Loc: Former AFB in CA, recouping fr...
I know that I was taught to keep the limb below heart level as much as possible. Elevation to help slow bleeding. But then I have been out of the loop for a while, and medicine is changing all the time, that is why doctors have a "practice"...
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#142452 - 08/01/08 04:31 AM Re: Sawyer Extractor Test [Re: OldBaldGuy]
BobS Offline
Old Hand

Registered: 02/08/08
Posts: 924
Loc: Toledo Ohio
Heck, if you get bit by a deadly snake, just cut the problem limb off, that will stop the flow of poison to the rest of the body...
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#142454 - 08/01/08 05:25 AM Re: Sawyer Extractor Test [Re: BobS]
Hikin_Jim Offline
Sheriff
Pooh-Bah

Registered: 10/12/07
Posts: 1804
Loc: Southern California
Originally Posted By: BobS
Heck, if you get bit by a deadly snake, just cut the problem limb off, that will stop the flow of poison to the rest of the body...

lol. Now why didn't I think of that.
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#142486 - 08/01/08 03:12 PM Re: Sawyer Extractor Test [Re: Hikin_Jim]
bmisf Offline
Member

Registered: 03/19/03
Posts: 185
My apologies; the recommendation is to keep the bite at approximately heart level - I can no longer edit my original post (which I'd love to do to make sure it's accurate). The idea is to balance minimizing swelling and venous flow.

Here's the update from the school I trained with:

http://www.nols.edu/wmi/curriculum_updates/archive/041105_sawyer.shtml

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#142504 - 08/01/08 05:00 PM Re: Sawyer Extractor Test [Re: bmisf]
Hikin_Jim Offline
Sheriff
Pooh-Bah

Registered: 10/12/07
Posts: 1804
Loc: Southern California
Good update. NOLS certainly has a lot of credibility.

This little bit
Quote:
...evacuating the patient by carrying, walking only if it's necessary.
is a bit disconcerting. If one is miles into the wilderness, carrying someone out is going to be tough, particularly in steep, brushy, snow-covered, or other difficult terrain. A big group would be helpful inasmuch as you could rotate the carriers to prevent exhaustion, but I ususally hike with one or two other guys, hardly a group big enough to have effective rotation.

I'd definitely be pulling out my PLB, particularly if I were multiple days away from the nearest trailhead.


Edited by Hikin_Jim (08/01/08 05:00 PM)
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#142533 - 08/01/08 07:08 PM Re: Sawyer Extractor Test [Re: Hikin_Jim]
Jay Offline
Stranger

Registered: 07/31/08
Posts: 4
I agree. That the study has some flaws doesn't mean there isn't other good information out there to recommend against using the Sawyer extractor. I've read varying accounts on the effectiveness of the device. I wonder if some of the variables I mentioned are factors in that.

As for the whole circulation question, one of the things I read some time ago made the point that letting the poison circulate has the potential benefit of dilution. The more the poison is allowed to spread and dilute, the weaker its effect in those areas to which it has spread. The reality may simply be that for every person and bit combination that somewhat different treatments may be optimal.

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