NORTH COAST EMERGENCY MEDICAL SERVICES Policy #5319
POLICIES AND PROCEDURES
Subject: Medical Control
Snake Bite Kit
I. Background information:
A. Venomous snakes: Pit Vipers and Coral Snakes are the only venomous snakes indigenous to the U.S.
B. The Pacific Northwest Rattler is the only venomous snake indigenous to this area and has a fairly low poison capacity.
C. Base Hospital may call the Poison Control Center for assistance.
D. Envenomization may not occur with bite.
E. Symptoms of Pit Viper envenomization (includes all rattlesnakes):
1. Local symptoms:
Rapid onset of pain, redness, ecchymosis, and swelling of site with later swelling of entire limb
2. Systemic symptoms:
a. Mild - Tachycardia, bradycardia, tachypnea, tingling around mouth
b. Moderate - Dyspnea, weakness, faintness, nausea, and vomiting
c. Severe - Muscle tremors, hypotension, seizures, delirium, coma
F. Factors affecting severity of response to envenomization:
1. Size and type of snake
2. Size of patient
3. How much venom snake injected
4. Whether or not bite penetrated vascular system
5. General medical conditions of patient
II. Use of Snake Bite Kit
A. Complete primary survey and intervene as indicated.
B. Immobilize affected limb below the level of the heart to delay absorption.
C. If envenomization occurred less than one hour ago, implement use of suction extraction device.
1. Use the safety razor provided to remove body hair from the bitten area. This will improve the extractor's suction.
2. Fit the extractor vacuum pump with the suitable size suction cup.
3. Pull the plunger out to its fullest extent and place the cup over the bite.
4. Push the plunger all the way in until you feel the suction, and let the pump extract the poison. This may take up to three minutes for snakebites.
NORTH COAST EMERGENCY MEDICAL SERVICES Policy #5319
POLICIES AND PROCEDURES Page 2 of 2
Subject: Medical Control
Snake Bite Kit
5. Pull the plunger up gently to release the vacuum. This will put the extracted poison on the surface of the patient's skin. Be careful. Avoid poison splatter. For a snakebite, if no poison appears on the skin surface, and you have followed steps 1 to 6 properly, then the patient has most likely received a "Dry" bite with no venom injection.
6. Wash the poison away carefully from the wound with soap and water. Apply antiseptic and cover the wound with a dressing.
D. Measure and note degree of swelling/discoloration.
E. Apply cardiac monitor
F. Establish IV access with IV NS TKO, unless patient shows signs and symptoms of shock.
G. Continue supportive treatment and transport.
Approved: Date:
Approved As To Form: Date: