Prolonged Field Care Podcast 57: Snake Envenomation In Austere Environments

Dangerous snakes can be found both while training at home and far away  while deployed. It may be a rare occurrence, but a catastrophic event  when it does happen. Some austere providers may be aware of outdated  treatments, and don’t know where to start when it comes to  identification and management of a snake bite.  Feel free to ask yourselves these questions, or bring them up in a group  discussion before listening to the podcast:  

1.) Which type(s) of snakes would you put a tourniquet on?  

2.) Under what conditions would you apply ice, cut into, or use an  extractor on the wound?  

3.) Before you deploy to “country x”, how can you find out dangerous  fauna and flora? How can I prepare, equipment wise?  

4.) How important is it to identify the snake? What if it cannot be  found?  

5.) How do I assess a snake bite patient and tell a difference between  the various types of venom?  

6.) How can you tell if it’s a “dry bite”?  

7.) You receive a patient with a Tourniquet already applied by a  non-medic or junior medic… what now?  

8.) When do I give anti-venom, of what type and quantity? What are the  side effects?  

9.) When would you take the airway in a patient with snake envenomation?  When would you have MSMAID ready?  

10) How do you handle a patient with venom sprayed into their eyes?  

11) What are concerns with compartment syndrome in these patients?  

12) How do you administer a push dose pressor or dirty epi drip for  anaphylactic reaction?  

13) If you have a confirmed snake bite but NO antivenom… how can you  manage a patient, if at all?  

14) What are your pain management considerations for these patients? Do you know the onset and durations for the medications you push or TIVA?  What happens if the patient has breakthrough pain before the expected  time?