Why don't you put ice on a snake bite?

[JPINFV]

That's what I was going to say. Only the leaders were allowed to use them, though. I would imagine the bite kit is better than no kit if it's a confirmed witnessed poisonous snake bite?

Though, I personally, just suck the poison out and swallow it. Builds character. Then I bite the snake back.

(Yes, I know that wouldn't work.)

Hell, I think my first handbook still has the treatment for hypothermia being strip down to your skivies and join the patient in the sleeping bag. I wonder why they changed that one.

[AnthonyM83]

Hell, I think my first handbook still has the treatment for hypothermia being strip down to your skivies and join the patient in the sleeping bag. I wonder why they changed that one.

WHAT!? They changed it!? I'm going to pretend like I never heard that....uhh unless I'm camping with a bunch of dudes.

[CC64]

Hell, I think my first handbook still has the treatment for hypothermia being strip down to your skivies and join the patient in the sleeping bag. I wonder why they changed that one.

But they didn't completely change it for backcountry medicine...

[WANTYNU]

OK, I’m going to date myself here, but back in 1975 (When I first took Wilderness First Aid) it was use the kit, now it’s not, the caveat is unless prolonged transport time is anticipated, and antidote is unavailable, as in your deep in the back woods and it’s a few days from getting definitive care.

I’ve read every post here, but as far as I can see nobody’s given a direct answer to the question, It’s pretty straight forward.

The REASON you don’t Ice a snake bite, is because unlike a bug sting, snakebites are envenomated PUNCTURE wounds, that typically pass below the epidermis in the fat and mussel layer (IM), by cooling the skin you do two things, you constrict surface peripheral blood vessels and dilate deeper vessels forcing the venom deeper into the mussel and circulatory system causing the body to circulate it faster.

Sorry for not quoting you, but someone here said keep the patient calm, limit movement, and keep the affected limb below heart level all also part of the treatment plan.

But the bottom line is: no ice is correct, but the answer is not intuitive.

As Always,

Be Safe,

WANTYNU

[Dustdevil]

I’ve read every post here, but as far as I can see nobody’s given a direct answer to the question...

You must have skipped over the first page. Spenac answered it succinctly in replies 2 and 3. Dwayne elucidated on the exact physiology a few posts later. Neither ERDoc nor I would have been posting jokes if the question was still dangling.

The REASON you don’t Ice a snake bite, is because unlike a bug sting, snakebites are envenomated PUNCTURE wounds, that typically pass below the epidermis in the fat and mussel layer (IM), by cooling the skin you do two things, you constrict surface peripheral blood vessels and dilate deeper vessels forcing the venom deeper into the mussel and circulatory system causing the body to circulate it faster.

Sources? I challenge that entire theory.

The "frostbite" answer that spenac originally gave was on the money. The same reason we don't see the precordial thump in lay CPR anymore. People -- EMTs included -- too often think that more is better, and they go overboard, causing tissue damage from immersing hands in ice for over an hour. Yeah, I know that sounds improbably crazy, but so does training "EMS professionals" in 120 hours of night school.

As spenac also said, there was the theory of localising the venom to prevent systemic spread that has also been disproved. Localisation of most snake venoms only results in increased local necrosis. Only in the neurotoxic venoms (coral snake) is localisation even theoretically sound. And in those cases, lymphatic constriction is a more reasonable option, although still somewhat controversial.

Another theory that didn't pan out under scientific scrutiny was that of enzymatic deactivation of venom by cold therapy. Neither cold nor electric shock has been shown do have any effect on the structure of any snake venoms.

So, despite intuitive theories, multiple studies have also failed to show any benefit to cryotherapy in snake envenomation. That alone is reason to disregard it. Throw in serious side effects and damage from the cold, as well as increasing the damage of the venom through localisation, and there ya go.

There are still some hold-outs around the world, especially in countries where neurotoxic snakes predominate, like Australia. Many there still recommend closely controlled, intermittent cryotherapy, for something like fifteen minutes per hour. Again, these are areas -- unlike the U.S. -- where neurotoxics are much more common than the haemotoxics.

Sorry for not quoting you, but someone here said keep the patient calm, limit movement, and keep the affected limb below heart level all also part of the treatment plan.

Actually, the current recommendation is elevation above heart level in order to limit oedema and the potential for compartmentalisation.

But the bottom line is: no ice is correct, but the answer is not intuitive.

Agreed. The confusing thing is that both cold and hot therapy are intuitive on different levels, however both are contraindicated.

[Dustdevil]

Hell, I think my first handbook still has the treatment for hypothermia being strip down to your skivies and join the patient in the sleeping bag. I wonder why they changed that one.

So that's why my scoutmaster only held campouts in the winter? :shock:

Anyhow, I spent a little while on Google to see if I was forgetting anything. Found a nice article from JEMS just this year that is a good update.

• Also, for whoever was challenging the frostbite theory, seems like at least half the articles on Google -- including the ones from medical sources, and not just home first aid sources -- all specifically mention frostbite by name when discouraging the use of cryotherapy.

[CC64]

So that's why my scoutmaster only held campouts in the winter? :shock:

Anyhow, I spent a little while on Google to see if I was forgetting anything. Found a nice article from JEMS just this year that is a good update.

Quite possibly for other reasons, too. Slightly discouraging to go wandering very far in the snow, no? Well, and the tracks show up a bit more easily... :angel7:

Frostbite and cryotherapy...well, if you aren't specifically told that ice should not be held on a spot for more than 15-30 minutes, then people are inclined to just slap that cold pack/ice pack on and leave it. I like to subscribe to the "people are idiots unless otherwise proven" theory about life.

[spenac]

[DwayneEMTP]

Also, for whoever was challenging the frostbite theory, seems like at least half the articles on Google -- including the ones from medical sources, and not just home first aid sources -- all specifically mention frostbite by name when discouraging the use of cryotherapy.

Hell, that was me. I thought the frostbite theory was so far off in the ditch that spenac was just poking the new guy to see if he was paying attention! My apologies to spenac.

What confuses me about this theory, is that as a lifetime migraine sufferer, there have been many times that I've fallen asleep with a big back of ice/salt/water on my head (one gallon bag of ice, mixed with salt and water) and wakened hours later with no apparent ill effects. Both brain cells seemed to be intact as well as nothing more than some pain/reddening of the skin. I have heard rumors that this killed some rock star, causing a blood clot in his brain. I'm also sure that it's not a good habit to get into (though I'm guessing that those with migraines will tell you that dying seems like an acceptable risk if pain control seems even remotely possible).

So what's up? Has anyone actually seen frostbite from an ice pack? Or even a bucket of ice water? Having lived in northern Minn when I was younger, I had, on several occasions been cold enough to lose the upper layers of skin off of my hands, nose, and ear lobes, yet didn't seem to be in the frostbite arena yet. It's hard to imagine getting anywhere near that level of cold/damage from locally applied ice.

I'm certainly not questioning you or your sources Dust (In fact, haven't had time to read them), I'm only questioning the theory for fun based on my own anecdotal/intuitive reasoning.

Have a great day all!

Dwayne

[spenac]

Hell, that was me. I thought the frostbite theory was so far off in the ditch that spenac was just poking the new guy to see if he was paying attention! My apologies to spenac.

What confuses me about this theory, is that as a lifetime migraine sufferer, there have been many times that I've fallen asleep with a big back of ice/salt/water on my head (one gallon bag of ice, mixed with salt and water) and wakened hours later with no apparent ill effects. Both brain cells seemed to be intact as well as nothing more than some pain/reddening of the skin. I have heard rumors that this killed some rock star, causing a blood clot in his brain. I'm also sure that it's not a good habit to get into (though I'm guessing that those with migraines will tell you that dying seems like an acceptable risk if pain control seems even remotely possible).

So what's up? Has anyone actually seen frostbite from an ice pack? Or even a bucket of ice water? Having lived in northern Minn when I was younger, I had, on several occasions been cold enough to lose the upper layers of skin off of my hands, nose, and ear lobes, yet didn't seem to be in the frostbite arena yet. It's hard to imagine getting anywhere near that level of cold/damage from locally applied ice.

I'm certainly not questioning you or your sources Dust (In fact, haven't had time to read them), I'm only questioning the theory for fun based on my own anecdotal/intuitive reasoning.

Have a great day all!

Dwayne

Dwayne I have not seen it occur. Of course I never put ice directly on site. I always put a towel between icepak and skin. I do know some of the older instant icepaks I used got a lot colder and a lot faster than those we carry today, they almost seemed to act more like dry ice. I have had my fingers get stuck to the icepak before I got it wrapped. I really believe that if someone were to have placed those on somebodys skin it would have destroyed tissue within a short time.

I really wish I was energetic enough to locate the info from the snake doc in Florida.