Emedinews:Insights on Medicolegal Isues:First aid for poisonous bites and stings

People often panic if they have been bitten or stung. You should tell the patient that many snakes, spiders, insects and sea creatures are harmless and that even the bites and stings of dangerous animals often do not cause poisoning.

Keep the patient calm and still. Moving the bitten or stung limb speeds up the spread of venom to the rest of the body. Fear and excitement also make the patient worse. The patient should be told not to use the limb and to keep it still and below the level of the heart. The limb may swell after a while, so take off the patient’s rings, watch, bracelets, anklets and shoes as soon as possible. A splint and a sling may help to keep the limb still.

Avoid doing the following:

• Do not cut into the wound or cut it out.
• Do not suck venom out of the wound.
• Do not use a tourniquet or tight bandage.
• Do not put chemicals or medicines on the wound or inject them into the wound (for e.g., potassium permanganate crystals).
• Do not put ice packs on the wound.
• Do not use proprietary snake bite kits.
• The patient should lie on one side in the recovery position so that the airway is clear, in case or vomiting or fainting.
• Do not give the patient anything by mouth – no food, alcohol, medicines or drinks. However, if it is likely to be a long time before the patient gets medical care, give the patient water to drink to stop dehydration.
• Try to identify the animal, but do not try to catch it or keep it if this will put you, the patient or others at risk. If the animal is dead take it to hospital with the patient, but handle it very carefully, because even dead animals can sometimes inject venom.
• As soon as possible, take the patient to a hospital, medical dispensary, or clinic where medical care can be given. The patient should not walk but should keep as still as possible. If there is no ambulance or car, carry the patient on a stretcher or trestle, or on the crossbar of a bicycle.
• Antivenom should only be given in a hospital or medical Centre where resuscitation can be given, because the patient may have an allergic reaction. If available, antivenom should be used if there is evidence of severe poisoning. It should not be used when there are no signs of poisoning.