lying down, quiet, and warm. DO NOT give alcohol or any other stimulant to drink.
5. Treat for shock.
6. Use a splint to immobilize the victim’s affected extremity, keeping the involved area at or below the level of the heart.
7. Cover the wound to prevent further contamination.
8. Give aspirin for pain.
9. Telephone the nearest medical facility so that the proper antivenin can be made available.
10. Transport the victim (and the dead snake) to a medical treatment facility as soon as possible. All suspected snake bite victims should be taken to the hospital, whether they show signs of envenomation or not.
Treatment of a nonenvenomated snakebite is essentially the same as the treatment for puncture wounds.
In most situation, the definitive care of the victim will be in the hands of a medical officer. This care will center around the use of antivenin serum. All western hemisphere snakes, with the exception of the eastern coral snake, can be treated with the same polyvalent antivenin. This is given in doses of 3 vials for small reactions; 5 to 8 vials for cases in which there is swelling of a hand or foot; and at least 8 vials for moderate or severe envenomation. Extra vials are kept at the ready. Children will receive higher doses than adults since the poison has more effect on them because of their smaller size and lower weight.
Because the antivenin is a horse serum base, the medical officer will order a sensitivity test before it is given. Routine laboratory tests will also be run in preparation for the possible start of whole blood infusion.
Additional medical facility care would include tetanus prophylaxis, wound cleansing and debridement, Burow’s solution soaks, antiseptic ointment, and sterile dressing.
Bites, Stings, and Punctures from Sea Animals
A number of sea animals are capable of inflicting painful wounds by biting, stinging, or puncturing. Except under rare circumstances, these stings and puncture wounds are not fatal. Major wounds from sharks, barracuda, moray eels, and alligators can be treated by controlling the bleeding, preventing shock, giving basic life support, splinting the injury, and transporting the victim to a medical treatment facility. Minor injuries inflicted by turtles and stinging corals require only that the wound be thoroughly cleansed and the injury splinted.
Other sea animals inflict injury by means of stinging cells located in tentacles. This group includes the jellyfish and Portuguese man-of-war (fig. 4-69). Contact with the tentacles produces burning pain, a rash with small hemorrhage in the skin, and, on occasion, shock, muscular cramping, nausea, vomiting, and respiratory distress. Treatment consists of pouring sea water over the injured area and then removing the tentacles with a towel or gloves. Next, pour rubbing alcohol, formalin, vinegar, or diluted ammonia over the affected area to neutralize any remaining nematocysts (minute stinging structures). Finally, cover the area with a dry powder, to which the last nematocysts will adhere, and then scrape them off with a dull knife.
Figure 4-69.—Jellyfish and Portuguese Man-of-war.
Spiny fish, stingrays, urchins, and cone shells inject their venom by puncturing with spines
