What are the first aid methods for being bitten by a snake? First aid is one of the important keys to treating snake bites. After being bitten by a poisonous snake, whether it can be dealt with in a timely, reasonable and effective manner has a great relationship with the recovery. Although for a long time, most of the folk snake doctors in my country have also used methods such as opening, squeezing and detoxification, or applying Chinese herbal medicine to the wound around the wound. However, due to insufficient understanding of the physical and chemical properties of snake venom and the absorption route of snake venom, the expected effect is often not received, and even the disease is aggravated or the limbs are disabled. Since 1972, the editor of Snake Net has a consistent view on the local emergency treatment of snakebite, and believes that it should be treated according to the following methods and steps:

(1) Local emergency treatment Local emergency treatment The purpose is to prevent the absorption of snake venom and the elimination of venom, which is an important part of preventing snake venom poisoning.

1. After being bitten by a poisonous snake, stop the activities of the injured limb immediately, put the injured limb in the lowest position, and promptly (within 2-3 minutes) use a rubber band or straw rope, cloth Strips, vines, etc. are ligated about 10 cm above the wound (proximal end) or at the corresponding part of a joint above the wound. The degree of ligation requires that it can only block the return of lymph and venous blood without hindering the supply of arterial blood. After the ligation, release once every 30 minutes, 2-3 minutes each time, so as not to affect the blood circulation and cause tissue necrosis. Generally, the ligation can be lifted 3 hours after taking the effective snake medicine, or after injecting crystalline trypsin or antivenom. Those who have been bitten for more than 12 hours may not be ligated (Figure 6-2).

2. After ligation, tap water, river water, well water, soapy water, preferably 1/5000 potassium permanganate solution or hydrogen peroxide can be used to rinse the skin around the wound. The purpose is to destroy and wash away the venom adhering to the wound, so as to achieve the purpose of reducing snake venom poisoning.

3. After incising, rinsing, squeezing and detoxifying the topical area with 2% iodine tincture and 7596 alcohol for disinfection, pay attention to remove the poisonous fangs that may be broken in the wound, and then use a sharp tool (such as a knife, etc.) to cut along the teeth The incision is made as a one-shaped longitudinal incision, about 1-1.5 cm long, and its depth reaches under the skin. It can also be combined with cupping and other negative pressure methods to take drugs, and then use 1/5000 potassium permanganate solution or 5% sodium edetate, hydrogen peroxide, etc., while rinsing, from the proximal end of the injured limb to the wound direction and around the wound repeatedly and gently squeeze pressure, prompting the venom to escape from the wound. Flushing and squeezing to detox should last for 20-30 minutes. After flushing, cover with a sterile dressing and keep the injured limb in a low position. However, it is generally not advisable to open the wound if bitten by a five-step snake or a viper or continue to bleed after the bite to prevent the bleeding.

4. Local ice compresses can be soaked in ice cubes, cold spring water or well water within 24 hours after the bite to slow down the absorption of snake venom.

(2) Topical application of destroying snake venom preparations mainly uses the following drugs and methods:

1. Local injection of crystalline trypsin 2000-4000 units of injected crystalline trypsin, plus 0.25% 10-60 ml of 0.5% procaine is used for local infiltration injection of the wound, and a ring seal can be made above the wound or on the swelling, and the injection can be repeated if necessary.

Injectable crystalline trypsin is a powerful proteolytic enzyme. It can quickly destroy the main toxic component of snake venom, the toxic protein, and make the snake venom lose its toxicity. It is used to treat various venomous snake bites in the early stage, and a higher curative effect can be obtained.

This therapy has clinically treated 1167 patients bitten by 12 kinds of venomous snakes in Guangxi, Yunnan, Guangdong, Hunan and other provinces, and the cure rate is over 99.8%. Trypsin in the treatment of snakebite has the advantages of high efficiency, quick effect, wide range, low price and less side effects, which is superior to other domestic treatment methods. This therapy won the third prize of the National Invention Award in 1984.

2. After the local injection of potassium permanganate solution is bitten by a poisonous snake, first use 20-40 ml of 0.25%-0.5% procaine for partial closure, and then use 0.5% potassium permanganate solution 5-10ml for local injection of wound. When snake venom encounters potassium permanganate, it will be destroyed by oxidation.

It can be used to treat various venomous snake bites in the early stage, and good results can be obtained. However, it must be pointed out that potassium permanganate has a strong damaging effect on tissues, and can cause severe pain after injection, so it is not suitable to use it more. At the same time, it should be noted that potassium permanganate cannot be mixed with procaine, because potassium permanganate has reacted after mixing. If it is injected again, it will lose the effect of destroying snake venom.

3. Burn the wound to destroy the snake venom. After being bitten by a poisonous snake, first cut the wound and rinse it repeatedly, that is, use 6-8 matches each time, put it on the wound, and burn it 2-3 times repeatedly . When the snake venom encounters high heat, it will solidify and be destroyed, making it lose its toxic effect. In the case of being bitten by a venomous snake in the wild or in difficult first aid conditions, you can also use the fire burn alone for first aid.

4. DC electric shock to treat snakebite This therapy is a special method pioneered in Illinois, USA to treat snakebite, and has achieved satisfactory clinical results. This method is also useful in the treatment of scorpion stings.

This therapy is to use 20-25KV<1mA direct current to shock the snake bite part for 1-2 seconds through an insulated probe, and the limb closest to the injured part is used as current grounding.

(3) Snakebite First Aid Kit This kit is specially used for snakebite first aid. It is now officially produced by the Chinese Herbal Medicine Factory Affiliated to Guangxi Academy of Orthopaedic and Traumatology.

The first aid kit includes sterile syringes, injection needles, trypsin, 2% procaine, snakebite medicine, razor blades and tourniquets for wound expansion. If the snakebite can be handled in accordance with the instruction manual during use, the snakebite can be saved from danger, and the symptoms of poisoning and critical symptoms will not appear. After a large number of investigations and statistics, it is proved that the medicine box has the advantages of being convenient to carry, simple in method, effective and economical. Workers, farmers and field soldiers who wish to engage in field operations always keep this first aid kit so that they can be prepared.

Treatment of snakebites

After being bitten by a venomous snake, first aid must be taken quickly. At the same time, it is necessary to do a good job of the patient's ideological work, eliminate fear, and keep quiet. At the same time, closely observe the patient's consciousness, blood pressure, pulse, respiration, urine output, and local wound conditions. For patients who are suspected of being bitten by a venomous snake and have no local or systemic symptoms, they need to be closely observed for 24 hours. The treatment measures for venomous snake bites are described as follows:

(1) Application of antivenom Antivenom has the effect of neutralizing snake venom, and the curative effect is relatively certain. The earlier the application, the better the curative effect. At present, the domestically produced antivenoms include refined anti-bungus venom, refined anti-cobra venom, refined anti-five-step snake venom, and refined anti-pit viper venom. In addition, anti-viper serum and anti-ring snake venom serum are currently in clinical trial and have not been officially produced.

1. Serum typing Antivenoms are divided into two types: monovalent and multivalent. Monovalent antivenom can only neutralize the venom of the same kind of snake, but has no effect on other snake venoms, or only partially neutralizes it; polyvalent antivenom can treat a variety of venomous snake bite poisoning, and generally, the higher the unit price, the better the effect. .

2. Serum usage In order to prevent allergic reactions when using antivenom, an intradermal test must be done first, and only those with negative intradermal test can be used. If the intradermal test is positive, and antivenom must be applied, routine desensitization should be performed.

(1) Intradermal test method: take 0.1 ml of this product, add 1.9 ml of normal saline (that is, dilute 20 times), inject 0.1 ml into the skin of the fore palm, and inject it after 20-30 minutes. If the skin mound is within 2 cm, and there is no blush around the skin mound and no spider feet, it is negative and can be injected directly. If the positive is suspicious, 10 mg of chlorpheniramine should be pre-injected (the dose for children should be reduced according to the body weight) 15 minutes after the injection of this product. If the positive is positive, the desensitization injection method should be used.