At snake bite anti venom topic medical shock question came out.So,state of shock is very serious condition ,and I wonder is there any good practical advices how to recognize and to deal with one in the bush,when no immediate health care is available.Any personal experience?
Medical shock
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No personal experiance, but shock is a lack of oxegenated blood to the vital organs.
It can be caused by many things, including internal & external bleeding, pain, burns etc. Any serious injury will probably result in shock. Symptoms include paleness, cold and clammy skin, rapid shallow breathing, dehydration, anxiety, etc.
First you need to treat the cause of shock, there is no point treating the shock if while you are doing it they are bleeding to death. Once you have treated the cause, get the casualty to lie down & elevate they legs. This will help increase the blood supply to the vital organs.
Summon qualified medical aid immediatly.
It can be caused by many things, including internal & external bleeding, pain, burns etc. Any serious injury will probably result in shock. Symptoms include paleness, cold and clammy skin, rapid shallow breathing, dehydration, anxiety, etc.
First you need to treat the cause of shock, there is no point treating the shock if while you are doing it they are bleeding to death. Once you have treated the cause, get the casualty to lie down & elevate they legs. This will help increase the blood supply to the vital organs.
Summon qualified medical aid immediatly.
Yep, have experienced people going into shock at traffic accident, bicycle accident and on operations in the Middle East (both physiological and psychological).
I would suggest that you use the St John's training book to get a good idea of signs/symptoms and treatment; however, I would also suggest that you treat the victims of any accident or traumatic event as either in, or about to go into shock.
Lie victim down, legs elevated, keep warm (not boiling hot), reassure, protect from elements/further injury, and treat the cause of the shock if possible.
I would suggest that you use the St John's training book to get a good idea of signs/symptoms and treatment; however, I would also suggest that you treat the victims of any accident or traumatic event as either in, or about to go into shock.
Lie victim down, legs elevated, keep warm (not boiling hot), reassure, protect from elements/further injury, and treat the cause of the shock if possible.
Not quite sure if the question is about envenomation, shock or shock from envenomation?
I dont know much about envenomation as there is nothing in the UK that represents any serious risk - I think the last fatal adder bite in the UK was over 100 years ago and that was probably from anaphylaxis. But I would think the first aid treatment for serious envenomation from a potent species, would not involve stimulating the blood flow to the vital organs. Where the envenomation is from a potentially lethal specias, the last thing you want to do is stimulate circulation. I cant see how that would do anything other than accelerate death, it would at least reduce what time is available to get an effective antivenin shot. Certainly shock can be a killer, but a bite from a funnel web or a copperhead will do it a lot faster.
I dont know much about envenomation as there is nothing in the UK that represents any serious risk - I think the last fatal adder bite in the UK was over 100 years ago and that was probably from anaphylaxis. But I would think the first aid treatment for serious envenomation from a potent species, would not involve stimulating the blood flow to the vital organs. Where the envenomation is from a potentially lethal specias, the last thing you want to do is stimulate circulation. I cant see how that would do anything other than accelerate death, it would at least reduce what time is available to get an effective antivenin shot. Certainly shock can be a killer, but a bite from a funnel web or a copperhead will do it a lot faster.
I thought the question was about shock in general (could be wrong though)
Yeah, it probably is but as the issue of snake bite was mentioned, I thought I'd chip in cos it changes the treatment significantly. What is the right treatment for shock, is also the worst thing for a bite from a potentially lethal species.
BOD
Bushcrafter (boy, I've got a lot to say!)
The shock would not be physiological but purely psychological so lying down, elevation etc are all not needed just reassurance.
From what I recall snakebite is treated pretty much the same way all the time.
Rest, Relax and Reassure. In other words get the casualty to sit down, get them talking and try to calm them down and let them know they will be alright.
Whilst this is going on you can be doing the physical side of life, immobilize the bite by splinting ensuring that once splinted if the injury swells the splint does not become a tourniquet. I believe that elevation of the injury can also be done.
The casualty must be dissuaded from using the injured limb which is one of the reasons for splinting.
After that you are looking at evacuate to the nearest medical facility which has the potential to administer anti-venom.
When looked at you could say that the treatment is similar to that used for shock, but as Martyn has mentioned different snakes have different venoms.
IIRC Venoms are generally broken down into four major groups, Heamotoxin working on and in the blood stream, Cytotoxin that is destructive to tissue, Neurotoxin which effects the nervous system and Cardiotoxin that acts directly on the heart.
Most snake bites don't just fall into one of these categories they actually fall into all of them as the venoms are constructed from a series of complex proteins which exhibit certain characteristics. The venom of the Puff adder for instance is classed as a cytotoxin as the majority of the complex proteins that are contained within the venom will cause local tissue damage, it does also have other protein strands that cause other damage, but to a lesser degree.
That is pretty much the same for any snake, cobra venom is normally looked upon as being a Neurotoxin, however the site of the bite can exhibit characteristics of other types of toxin like local damage associated with cytotoxins and bleeding associated with heamotoxin.
Identification of the snake is an important factor, but more important is not getting bitten yourself, snakes like the Cape Cobra can appear to be aggressive as they will continuously strike until it believes that the threat to itself is no longer apparent. One bite from a Cape Cobra can carry enough venom to kill 6 people and you maybe the recipient of a few.
Rest, Relax and Reassure. In other words get the casualty to sit down, get them talking and try to calm them down and let them know they will be alright.
Whilst this is going on you can be doing the physical side of life, immobilize the bite by splinting ensuring that once splinted if the injury swells the splint does not become a tourniquet. I believe that elevation of the injury can also be done.
The casualty must be dissuaded from using the injured limb which is one of the reasons for splinting.
After that you are looking at evacuate to the nearest medical facility which has the potential to administer anti-venom.
When looked at you could say that the treatment is similar to that used for shock, but as Martyn has mentioned different snakes have different venoms.
IIRC Venoms are generally broken down into four major groups, Heamotoxin working on and in the blood stream, Cytotoxin that is destructive to tissue, Neurotoxin which effects the nervous system and Cardiotoxin that acts directly on the heart.
Most snake bites don't just fall into one of these categories they actually fall into all of them as the venoms are constructed from a series of complex proteins which exhibit certain characteristics. The venom of the Puff adder for instance is classed as a cytotoxin as the majority of the complex proteins that are contained within the venom will cause local tissue damage, it does also have other protein strands that cause other damage, but to a lesser degree.
That is pretty much the same for any snake, cobra venom is normally looked upon as being a Neurotoxin, however the site of the bite can exhibit characteristics of other types of toxin like local damage associated with cytotoxins and bleeding associated with heamotoxin.
Identification of the snake is an important factor, but more important is not getting bitten yourself, snakes like the Cape Cobra can appear to be aggressive as they will continuously strike until it believes that the threat to itself is no longer apparent. One bite from a Cape Cobra can carry enough venom to kill 6 people and you maybe the recipient of a few.
May not be relavent, but in hospital when/if a patient is becoming shocked, I try to get venous access as early on as possible. I konw most people dont carry cannulae packs around with them, but if youre in a group with that equipment and expertise available its sometihnng to consider, but I agree completely with the Lie victim down, legs elevated, keep warm (not boiling hot), reassure, protect from elements/further injury, and treat the cause of the shock if possible"
Yes,question was about shock in general,so we are all out far from hospital.And exposed to injuries that could lead to medical shock,and if we were alone how to prevent and help ourself..Anaphhylactic shock is something that also threating us,one could never know when may become allergic.Yesterday just bee sting today my be lethal.Few years ago acquaintance of mine was almost killed by hornet sting.
And idea was to get as much as possible knowledge from people,not from books.One could have some medical training,but if not used or freshed,it fade,and gone.
And idea was to get as much as possible knowledge from people,not from books.One could have some medical training,but if not used or freshed,it fade,and gone.
Well Id say go by the book, but a word of warning ... we don't really know what we are doing.
"Dr. Winston makes an interesting comparison between the survival rate of soldiers injured in the Falkland conflict and those in the Vietnam war.
Proportionally more died in Vietnam than in the Falklands. In the Falklands there was a poorer medical response than in Vietnam and the soldiers did not get the comforts of modern medicine as quickly as those in Vietnam. This fact, coupled with the bitter cold, and the body's tendency to cool down under shock conditions actually improved their survival rate."
The initial stages of shock serve a purpose the body has been evolving for millions of years. Perhaps we first aiders aught to only consider intervening with shock if necessesary- and that includes keeping people warm - only when shock has entered stage 2 or 3 which is when it becomes serious. id advise treating the underlying conditions first.
"Dr. Winston makes an interesting comparison between the survival rate of soldiers injured in the Falkland conflict and those in the Vietnam war.
Proportionally more died in Vietnam than in the Falklands. In the Falklands there was a poorer medical response than in Vietnam and the soldiers did not get the comforts of modern medicine as quickly as those in Vietnam. This fact, coupled with the bitter cold, and the body's tendency to cool down under shock conditions actually improved their survival rate."
The initial stages of shock serve a purpose the body has been evolving for millions of years. Perhaps we first aiders aught to only consider intervening with shock if necessesary- and that includes keeping people warm - only when shock has entered stage 2 or 3 which is when it becomes serious. id advise treating the underlying conditions first.
Hmmm...I think I disagree. My logic being is that shock is, as described earlier, a lack of oxygenated blood to the vital organs. Thus, whether the cause is psychological or physiological, the treatment is the same.
It was an intersting point made about the Falklands/Vietnam survival rates but we then get into a big area of how we teach first aid. The idea of first aid training is to use simple techniques to prolong life and treat the cause of the injury until a trained medical person arrives. This is why St Johns, etc, teach a single set of responses to shock. If we start muddying the waters, and providing more options, people are less likely to remember what to do and the death rate will increase. No-one has ever said that first aid provides all of the answers but it is a 'best effort' process, using simple training and techniques.
The other issues about obtaining rapid venous access are valid because as blood pressure drops, it becomes more difficult to obtain access and - personally, I don't want to start opening the skin on the lower leg or sticking needles into the neck or collarbone. However, as stated, these are advanced procedures for medical professionals.
The bottom line is that shock is a killer and noticing the signs of shock and then treating shock, as stated in the St John's manual, are absolutely critical.
BOD
Bushcrafter (boy, I've got a lot to say!)
I may have got the wrong impression of this thread.
Despite the title, it seemed that the question was what to do if someone was in psychological "shock" after being bitten by a venomous snake, in which case I do not think the response should be other than reassurance and evacuation.
I certainly would not lie them down with elevated limbs till the nature of the snake bite became apparent.
In Australia with mainly elapid snakes why would you want to increase blood flow to vital organs? Even with a viper bite why would you want to do that unless there was a great loss of volume?
As for haemorrhagic shock due to the nature of the venom, its unlikely to happen that quickly and then in a clear case of major envenomation do you still want to increase blood flow?
In case of anaphylactic shock as a result of a bite then, if one has the drugs available, you have treat them for that even if it spreads the venom.
Sanke bite treatment revolves aound reducing blood flow by lowering the limb, reassurance, reducing activity and, in the case of a bite by an elapid, a pressure bandage (which is not the same as a tourniquet)
Despite the title, it seemed that the question was what to do if someone was in psychological "shock" after being bitten by a venomous snake, in which case I do not think the response should be other than reassurance and evacuation.
I certainly would not lie them down with elevated limbs till the nature of the snake bite became apparent.
In Australia with mainly elapid snakes why would you want to increase blood flow to vital organs? Even with a viper bite why would you want to do that unless there was a great loss of volume?
As for haemorrhagic shock due to the nature of the venom, its unlikely to happen that quickly and then in a clear case of major envenomation do you still want to increase blood flow?
In case of anaphylactic shock as a result of a bite then, if one has the drugs available, you have treat them for that even if it spreads the venom.
Sanke bite treatment revolves aound reducing blood flow by lowering the limb, reassurance, reducing activity and, in the case of a bite by an elapid, a pressure bandage (which is not the same as a tourniquet)
I once went into shock from major blood loss and can say that if i had been on my own i would certainly have died, the deterioration in my condition was frighteningly fast. If you are alone in these circumstances you would have to act very quickly to save yourself.
Martin
Martin
Mariobab,
if you are concerned about you or one of your family going into anaphylactic shock as a result of a sting or other allergy, talk to your GP. He can give you a perscription for an Epi pen. You'll need to convince him there is a genuine concern. The pens are available at any chemist. But be aware they have a fairly short shelf life. If you are living in an isolated area, you will need at least three pens to keep you going until medical help arrives.
Hope this helps.
Raptor
I think he is talking about an exam question mate!! If you read the first post things may be clearer.
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