Talk:Snakebite

Plan for article

I have just come across this Wikipedia import while authoring in Snake (animal) venom. The two articles are best maintained as complementary to each other. The introduction of this article concerns me as a physician.

(1) As best as I can tell, snakebite is a condition that is often mishandled by aggressive first aid efforts, many papers in the English language medical literature document worse outcomes for those who have had incisions and suction attempts by well-meaning people in the field, with a higher rate of orthopedic surgery, for example, needed by those who had such attempts, and an overall better outcome for those who have not.

(2) The key issues are very different in places like the United States, where anti-venom is certainly available if the victim is brought rapidly to a hospital, and the poorer and more rural areas of the tropics in the less developed world where such treatment may be impossible to obtain. It is crucial that this article clearly explains the importance of regional variation in the world and it is a disservice to set a tone, as the article has at present, that there is some standard way to handle "snakebite" that the article will convey to the user.

(3) Further, there are many documented cases of extraordinary (and sometimes very harmful) interventions people have foisted on their friends who were "snakebit", presumeably by a "poison snake" only to discover that the bite was from a non-venemous snake or from another animal altogether, also non-venemous, but not a snake. The approach to first aid for snake bite has to make this scenerio very clear.

(4) The World Health Organization has made known that treatment for snake bite by venemous snakes is a major inequity between the developed and undeveloped world. This should be discussed in the article. Clear reccomendations for snake bite in such areas should be given, and they will not be the same as those for a bite in a region where a helicopter is coming very soon. Nancy Sculerati MD 11:52, 30 December 2006 (CST)

Helpful References for Authors, and Editors

These references are placed in a running list for future use in writing the article.

(1) Carlos F. S. Amaral, Délio Campolina, Mariana B. Dias, Cláudio M. Bueno and Nilton A. Rezende: Tourniquet ineffectiveness to reduce the severity of envenoming after Crotalus durissus snake bite in Belo Horizonte, Minas Gerais, Brazil • SHORT COMMUNICATION Toxicon, Volume 36, Issue 5, May 1998, Pages 805-808

(2) Carlos F. S. Amaral, Delio Campolina, Mariana B. Dias, Claudio M. Bueno, Carlos Chávez-Olortegui, Cláudia L. Penaforte, Carlos R. Diniz and Nilton A. Rezende:Time factor in the detection of circulating whole venom and crotoxin and efficacy of antivenom therapy in patients envenomed by Crotalus durissus • ARTICLE Toxicon, Volume 35, Issue 5, May 1997, Pages 699-704

(3) Márcia Gallacci, Elaine C. Nunes, Estefânia G. Moreira, Nancy Nascimento, José R. Rogero and Vera S. Vassilieff: Reduction of crotoxin-induced neuromuscular blockade by gamma radiation • SHORT COMMUNICATION Toxicon, Volume 36, Issue 6, June 1998, Pages 941-945

(4) Owuor BO, Kisangau DP: Kenyan medicinal plants used as antivenin: a comparison of plant usage. Journal of Ethnobiology and Ethnomedicine 2006, 2:7 (1 February 2006) (no clear efficacy, different traditional healers use different plants in same region for same bite- points out inequities of anti-venom availability, and gives statistics on snakebite)

(5) Lans C, Harper T, Georges K, Bridgewater E: Medicinal and ethnoveterinary remedies of hunters in Trinidad. BMC Complementary and Alternative Medicine 2001, 1:10 (30 November 2001)("Snakes in the Viperidae family are locally called 'mapepire'. These pit vipers have long, hollow fangs. The mapepire 'z'ananna' or 'bushmaster' (Lachesis muta muta) and 'mapepire balsain' or 'fer-de-lance' (Bothrops atrox atrox) are large and poisonous. Lachesis muta can inject a large dose of venom in a single bite. Goes over treatment for dogs given by hunters using plant enzymes)

(6) Tagwireyi DD, Ball DE, Nhachi CFB:Routine prophylactic antibiotic use in the management of snakebite. BMC Clinical Pharmacology 2001, 1:4 (2 November 2001) (nice article on a small epidemiology study snakebite in a single hospital in Zimbabwe.) (7) Cox, Mark R. PharmD; Reeves, Jordan K.; Smith, Kelly M. PharmD Concepts in Crotaline Snake Envenomation Management. Orthopedics. 29(12):1083-1087, December 2006.

(8) Stanford, C F; Richardson, W H; Bush, S P; Frazier, J; Pizon, A F; Liebelt, E L; Olsen, D; Bogdan, G M; Dart, R C Crotaline Snakebite Management with Fab Antivenom in Pediatric Patients: 312. Annals of Emergency Medicine. 48(4) Supplement:S94, October 2006.

(9) Gunja, Naren 1,3 So close and yet so far: Health care in our nearest neighbour. Emergency Medicine Australasia. 18(5-6):513-516, October/December 2006.

(10) Winkel, Ken Snakebite education and training in the new Millenium. Emergency Medicine Australasia. 18 Suppl. 1:A21, April 2006.

Venemous

Replaced all occurences of "venemous" to "venomous" as it is the more common spelling, hope you don't mind. If you do, just revert. --Christian Liem 19:58, 1 January 2007 (CST)

venom biochemical response

I'd enjoy reading pathophysiology breakdown of steps of a snakebite, including defibribronation (spelling?? using clotting factors). -Tom Kelly (Talk) 13:07, 29 January 2007 (CST)

will try- but it's soooooo complicated! Nancy Sculerati MD 14:12, 29 January 2007 (CST)

Some words misspelled in this document:

llife - life occurance - occurrence knowlege - knowledge manuever - maneuver maneater - man eater inadvertant - inadvertent Papau New Guinea - Papua New Guinea nonsterile - non sterile recognise - recognize travellers - travelers Phillipines - Philippines venemous - venomous snakebote - snakebite Triopical - Tropical envonomation - envenomation

It might be an idea to extract your article and run it through a spell checker.

Please feel free to correct spelling. Nancy Sculerati 07:48, 24 April 2007 (CDT)

references: treatment of snake bite

Cohen WR. Wetzel W. Kadish A. Local heat and cold application after eastern cottonmouth moccasin (Agkistrodon piscivorus) envenomation in the rat: effect on tissue injury. [Journal Article] Toxicon. 30(11):1383-6, 1992 Nov. UI: 1485335