Pressure-immobilisation
The pressure-immobilisation first aid technique was developed in the 1970's by Professor Struan Sutherland. Its purpose is to stop the venom from spreading from the bite site into the circulation. This is effectively "buying time" for the patient to reach medical care. Research has shown that very little snake venom reaches the bloodstream if firm pressure is applied to the bitten area and if the limb is immobilized (kept still). Pressure-immobilisation was initially developed to treat snakebite, but it is also applicable to bites and stings by some other venomous creatures. It is currently recommended for most life threatening venomous bites and stings in Australia.
How to apply pressure-immobilisation first aid to:
Bites to the lower limb: 1. Apply a broad pressure bandage over the bite site as soon as possible. Crepe bandages are ideal, but any flexible material may be used. Clothing, towels etc may be torn into strips. Panty hose have been successfully used. Do not take off clothing, as the movement of doing so will promote the movement of venom into the blood stream. Keep the bitten limb, and the patient, still. Bandage upwards from the lower portion of the bitten limb. Even though a little venom may be squeezed upwards, the bandage will be more comfortable, and therefore can be left in place for longer if required. 2. The bandage should be as tight as you would apply to a sprained ankle. 3. Extend the bandage as high as possible up the limb. 4. Apply a splint to the leg. Any rigid object may be used as a splint. E.g. spade, piece of wood or tree branch, rolled up newspapers etc. 5. Bind it firmly to as much of the leg as possible. Keep the patient still. Lie the patient down to prevent walking or moving around.
Bites to the hand or forearm: Bandage as much of the arm as possible, starting at the fingers. Use a splint to the elbow. Use a sling to immobilise the arm. Keep the patient still. Lie the patient down to prevent walking or moving around.
Bites to the trunk: If possible apply firm pressure over the bitten area. Do no restrict chest movement. Keep the patient still.
Bites to the head or neck: No first aid for bitten area. Keep the patient still.
For all bites listed above: * Research stresses the importance of keeping the patient still. This includes all the limbs. Bring transport to the patient if possible. * DO NOT cut or excise the bitten area. * DO NOT apply an arterial tourniquet. (Arterial tourniquets, which cut off the circulation to the limb, are potentially dangerous, and are no longer recommended for any type of bite or sting in Australia.) * DO NOT wash the bitten area. The type of snake involved may be identified by the detection of venom on the skin. If the snake can be safely killed, bring it to the hospital with the victim. * Even if the bitten or stung person is ill when first seen, the application of pressure-immobilisation first aid may prevent further absorption of venom from the bite or sting site during transport to hospital. * If the bandages and splint have been applied correctly, they will be comfortable and may be left on for several hours. They should not be taken off until the patient has reached medical care. The treating doctor will decide when to remove the bandages. If a significant amount of venom has been injected, it may move into the bloodstream very quickly when the bandages are removed. They should be left in position until appropriate antivenom and resuscitation equipment have been assembled. Bandages may be quickly reapplied if clinical deterioration occurs, and left on until antivenom therapy has been effective. * Hospital Staff: Please note that first aid measures are usually removed soon after the patient is admitted. Do not leave on for hours.