First Aid Kit

[Joomy]

What happens if you need a compression bandage in winter then?

For what? I always have leukoplast on me which is better IMO for supporting sprains.

Also my snake bite kit is separate and only taken when needed.

How do you know when it will be needed? Crystal ball?

There are certain places and times when I'm pretty confident I won't encounter snakes...

[Joomy]

A comment on "snake bite kit".
http://online.wsj.com/article/SB124208165196508345.html

My kit doesn't contain any pumps or scalpels. Pressure-immobilisation is the recommended treatment for all Australian snake bites.

[GPSGuided]

My kit doesn't contain any pumps or scalpels. Pressure-immobilisation is the recommended treatment for all Australian snake bites.

Wasn't referring to your specific "kit" but can see how variable commercial kits can be to make them standout. For straight pressure immobilisation, it can be easily achieved by general first aid equipments eg. Elastic bandage, combine pads etc.

[slparker]

A comment on "snake bite kit".
http://online.wsj.com/article/SB124208165196508345.html

Do not use US sourced Snake Bite kits on bites inflicted by australian snakes. Australian snakes and american snakes don't just hiss in different accents but have different venom.

www.resus.org gives the treatment for australian snake bites; in particular they emphasise the following:

DO NOT cut or incise the bite

DO NOT use an arterial tourniquet

DO NOT wash or suck

St johns australia publish a factsheet on snake bite treatment see this link:

http://www.stjohn.org.au/images/stjohn/ ... kebite.pdf

In regards to rectogesic: rectogesic is not a treatment for snakebite. There has been a study in 2011 in regards to treating snakebite by topical application of glyceryl trinitrate that looks promising. No clinician, too my knowledge, is recommending rectogesic for the treatment of snakebite. For those clinicians who are interested there is an good summary of the emergency medical treatment of snakebite in the QLD Health primary care Manual listed here:

http://www.health.qld.gov.au/pccm/pdfs/pccm_sect_2.pdf



In time topical GTN ointment may prove to be a safe and efficacious treatment, I have strong suspicions tha the authors of this article are on to something. I also caution readers that using a pharmaceutical to treat snakebite may have unintended consequences for the victim. Also be aware that rectogesic ointment has systemic effects and is not suitable for use on children, on those with a cardiac history and interacts with many prescription medications.

[GPSGuided]

I agree. The potential systemic effects of nitro may adversely affect the victim of a venomous snake bite. We need to know much more before adopting this potential strategy as a routine. So best to leave Rectogesic out of our kits unless one has anal problems.

[icefest]

Australian snakes and american snakes don't just hiss in different accents but have different venom.

True, Australian snakes' venom has very little local cytotoxic effect. This means it does little local damage when prevented from spreading.

In regards to rectogesic: rectogesic is not a treatment for snakebite.

Also true. That said, Pressure Bandage Immobilisation isn't either. Antivenom is.
Rectogesic and PBI are just management techniques to increase the time it take the venom to enter systemic circulation.
From the study that was linked to earlier: "Delaying venom transportation through the lymphatics is likely to decrease the peak venom concentration in blood and therefore venom-induced effects"

There has been a study in 2011 in regards to treating snakebite by topical application of glyceryl trinitrate that looks promising. No clinician, too my knowledge, is recommending rectogesic for the treatment of snakebite.

Of course not. It's off-label and irresponsible.
Incidentally this is the decision tree for off label use from the Medical Journal of Australia 2007 : http://puu.sh/4h1Yz.png (I do not think it has "been approved by (an) institutional drug committee")

In time topical GTN ointment may prove to be a safe and efficacious treatment, I have strong suspicions that the authors of this article are on to something. I also caution readers that using a pharmaceutical to treat snakebite may have unintended consequences for the victim. Also be aware that rectogesic ointment has systemic effects and is not suitable for use on children, on those with a cardiac history and interacts with many prescription medications.

I agree with your recommendation risks associated with rectogesic. That said, I would not hesitate to use it on myself, knowing my own medical history, if I thought there was a chance that rescue would take longer than I can expect PBI to protect me for.

[GPSGuided]

I agree with your recommendation risks associated with rectogesic. That said, I would not hesitate to use it on myself, knowing my own medical history, if I thought there was a chance that rescue would take longer than I can expect PBI to protect me for.

Medical advancements have always been achieved through selfless individuals who tried that new treatment first time. Some lived some not. Just make sure you are well informed for the call. All else will be history. For all others, the official treatment recommendation is what should be adopted and disseminated in public.

[slparker]

I am cautioning against the misapplication of one study. Why substitute a method that has been shown to work , however imperfect, with one that has not?

There is potential for harm administering a vasodilator to a casualty who is envenomated with an agent with the potential for cardiac depression, sudden hypotension and coagulopathy. These sequelae to snake envenomation can take place rapidly. What would be the potential effect of a rescuer applying GTN ointment to a victim who is hypotensive, unable to clot and with cardiac depression rather than, or in addition to, PIM? My point being 'just apply rectogesic' (with or without PIM) is too much of a blunt instrument at this stage.

of course one's always welcome to experiment on oneself.

[icefest]

Sorry, I didn't mean to imply that I'd replace the PIM with GTN. I would be using GTN as adjunctive treatment.

I did also state that I would only use it on myself, and only if I thought evacuation would be delayed.
I would only be using it if I was expecting that there would be a large likelihood of my death.

They did mention in the journal, that the GTN was to be applied immediately after the bite and not by the rescuer.

Since this has started going off topic, this is my fist aid gear, from memory.

Compression bandages
1 suture cutter blade
1 scalpel blade
paracetamol + panadeine
ibuprofen or naproxen
iodine (scars be dammed)
sterile gauze
antihistamine

And then there is dual use stuff:

bic mini
knife
tape

This discussion reminds me of something a friend linked me to a couple weeks ago:
Have you heard of adipotide?
It's a drug that causes the blood vessels going to fat deposits to die off. It's only ever been tested in rodents and is currently going through phase one trials in humans.
This guy decided to get some made and inject it into himself.

[TerraMer]

http://www.thehappywalk.com/#!__photos/photostackergallery0=7
http://www.thehappywalk.com/#!__photos/photostackergallery0=8

[wayno]

your images arent displaying

[Strider]

That is a massive kit TerraMer, but you're obviously not carrying it on your back and your trip is much much longer than most.

[TerraMer]

your images arent displaying

They never do but thought I'd give it another go with url instead

[TerraMer]

That is a massive kit TerraMer, but you're obviously not carrying it on your back and your trip is much much longer than most.

I use the same one for bushwalking but my bushwalks are also longer than most and I like to be prepared to help others. The one I used to carry on previous road walks was twice this size, a car kit, because there was more likelyhood of coming across a traffic accident walking along the road than a walking accident in the bush. Now I have a sat phone I don't think about the first 24hrs of remote care so much as I used to, someone else can advise me over the phone how best to use what I have packed until real help arrives.

[slparker]

redirected from the snakebite thread as htis thread also contains commentary on the correct treatment of snakebite:

I have contacted the Vic poisons Info centre and the author of the aforementioned study on the use of GTN ointment (rectogesic) for snakebite.

The victorian poisons information centre recommends the use of the Pressure Immobilisation method, in line with the Australian Resuscitation Council website. GTN is not recommended for pre-hospital or inpatient care of snake envenomation.

The co-author of the rectogesic study stated to me that Pressure immobilisation should be used as
'when it is applied correctly it can near completely inhibit venom movement into the circulation (this is certainly upheld by our animal model studies).' however, he goes on to state that theoretically GTN ointment should help in cases where the PIM is not applied correctly'.

The use of GTN ointment as an adjunct therapy (ie with PIM) has theoretical benefit, although I caution that the studies are very limited and in the aforementioned study the ointment was applied contemporaneous with the envenomation, certainly not a circumstance always applicable in the real-world treatment of snakebite. There are known dangers with GTN ointment usage, particularly in cardiovascularly unstable casualties.

In summary: PIM works (in retrospective studies and in animal modelling with envenomatiomn of pigs) to slowdown the systemic envenomation of snakebite. You are better off learning to apply the PIM well than to adopt theoretical modes of treatment. In order to treat a snakebite well do a wilderness first aid course is my advice...[/quote]

[GPSGuided]

Thank you slparker for checking with the author of the study.