itku2er Posted September 4, 2007 Posted September 4, 2007 You are called to a local park where a 26 yo female has fallen, has a possible broken leg she is 22 weeks pregnant and has just been bitten by a copper head snake. She is a 20 min hike into the woods.
AZCEP Posted September 4, 2007 Posted September 4, 2007 Move her quietly out of the woods. Keep the bite below the level of the heart. Splint the leg.
Timmy Posted September 4, 2007 Posted September 4, 2007 Scene safety. Pressure immobilization. Pain relief. SAMPLE. Monitor vitals. 02. Utilize any anti venom gear you might carry. How far has she fallen? C Collar? Backboard? Other injuries? Bleeding? HEMS or road? More info plz lol!
somedic Posted September 4, 2007 Posted September 4, 2007 As far as Pt treatment goes: ABCs Consider r/o spinal injuries. Splint leg. Mark bite area with a blue sharpie marker to establish swelling/on going envenomation if any . IV access with a saline lock. Notify recieving hospital of situation so that they may begin stocking up on Cro-Fab or other antivenom meds(if not contraindicated by pregnancy) This would be a good call for a SKED litter. ATVs could be used to move pt depending on terrain and resourses. Somedic sends
itku2er Posted September 4, 2007 Author Posted September 4, 2007 Scene safety. Pressure immobilization. Pain relief. SAMPLE. Monitor vitals. 02. Utilize any anti venom gear you might carry. How far has she fallen? C Collar? Backboard? Other injuries? Bleeding? HEMS or road? More info plz lol! She fell down a 10 foot enbankment, that was were she recieved the snake bite at. The Bite was on the left lower leg where the possible FX was located. No head trauma no active bleeding that you can tell. She complains of stomach cramps. Her vs are blood pressure 100/50 hr 120 resp 24. No hx accept this is her 2nd pregnancy. Allegric to Codiene PCN and shell fish. She is a 20 min hike into the woods. You are unable to get a vechicle into the area.
JonathanGennick Posted September 4, 2007 Posted September 4, 2007 She is a 20 min hike into the woods. Interesting scenario. Do we know about the 20-minute hike as part of our dispatch information? I'd want to get additional resources moving with an eye towards not having to hand-carry the patient out. For example, our county maintains a six-wheeled, all-terrain vehicle with a jump kit and litter that's ready to roll at all times. We also have deputies and others with four-wheelers (ATVs) that we can call in for help. And there's a search-and-rescue group. If I could, I'd try and get some sort of ATV lined up to drive me in. Or, if I had to hike in, I'd want someone -- park ranger, deputy, whomever, to be lining up help to get me and the patient out. The tough part of this call seems to lie more in the logistics of getting the patient out of the woods than in treating her.
itku2er Posted September 4, 2007 Author Posted September 4, 2007 Interesting scenario. Do we know about the 20-minute hike as part of our dispatch information? I'd want to get additional resources moving with an eye towards not having to hand-carry the patient out. For example, our county maintains a six-wheeled, all-terrain vehicle with a jump kit and litter that's ready to roll at all times. We also have deputies and others with four-wheelers (ATVs) that we can call in for help. And there's a search-and-rescue group. If I could, I'd try and get some sort of ATV lined up to drive me in. Or, if I had to hike in, I'd want someone -- park ranger, deputy, whomever, to be lining up help to get me and the patient out. The tough part of this call seems to lie more in the logistics of getting the patient out of the woods than in treating her. Cant drive in due to the lay out of the area, Its a small hiking trail. 4-Wheelers will take about 30 to get to the scene. The Medvac cant fly due to fog in the area where they are based. Fire dept is on scene with you. Patients Husband has Killed the snake he hiked out to call 911.
brentoli Posted September 4, 2007 Posted September 4, 2007 Primary concern with a copperhead bite is infection. Possibly allergic reaction. I would hike back with ALS and have them start pain management and monitor for shock. We can wait the 30 min for arrival of a 6x6 or whatever else is coming our way. If the pt starts to show symptoms of shock, or an allergic reaction then we will need to expadite things. Otherwise, hold tight and keep her comfortable. I would probably contact med control to confirm. I know at least in Missouri, where copperheads are abundant, no one has died from a bite in 50 years. At the hospital she will recieve antibiotics most likely. Anti-Venom will produce more harm than good in this pt.
FireMedic65 Posted September 4, 2007 Posted September 4, 2007 call for a helicopter and await their arrival
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