Apply a pressure bandage that immobilises the limb and transfer Joe to a facility that has antivenom, and if possible try to identify the snake.
We need the snake venom detection kit! And we need to check his coags and electrolytes!
Joe may be showing signs of neurological damage, with visual disturbances and limb and respiratory muscle weakness
I'm confused!
double vision
Venom induced consumption coagulopathy (VICC) Acitvates the clotting pathway by prothrombin activator toxins and consumption of clotting factors. International normalised ratio (INR) is elevated and activated partial thromboplastin time ( APTT) may be prolonged Fibrinogen is low or undetectable and D-dimer level is very high. Elevated creatine kinase indicates myotoxicity.
fibrinogen
Administer antivenom and observe for signs of anaphylaxis Release the PBI
SUMMARY * Ascertain snake bite and identify * Immobilise the limb with a pressure bandage *Transport to appropriate facility *Resuscitate and give antivenom * Observe for anaphylaxis *Repeat bloods at 6,12 & 24 hours to check for coagulation correction * Continues observation in a critical care area for signs of neurotoxicity, myotoxicity and thrombotic microangiopathy
References: Journal article reviewed: Ibister, G, Brown, S, Page, C, McGroubrie, D, Greene, S & Buckley, N, 'Snakebite in Australia: A pratical approach to diagnoses and treatment', Medical Journal of Aurtralia, vol. 199, no. 11, pp. 763 - 768.